摘要
目的探讨2型糖尿病（T2DM）患者中血清内脂素、肿瘤坏死因子-α（TNF-α）水平与肥胖、胰岛素抵抗及大血管病变的关系。方法85例研究对象中43例为T2DM患者，并根据体重指数（BMI）分为T2DM肥胖组（22例）和T2DM非肥胖亚组（21例）；另有42例为糖耐量正常者，并根据BMl分为单纯肥胖组（22例）和正常对照组（20例）；各组均测定血内脂素、TNF—α、胰岛素水平、血糖和血脂、血浆高敏C反应蛋白（hs—CRP）、纤维蛋白原（Fib）、颈动脉内一中膜厚度（IMT）、BMI及腰围／臀围比值（WHR）、胰岛素抵抗指数（HOMA-IR）等指标。结果（1）4组问的内脂素、IMT、Fib、hs—CRP、胰岛素水平、HDL—C、WHR的差异均有统计学意义（P〈0．05），进一步两两比较提示内脂素各组间的差异无统计学意义；（2）正常对照组和T2DM组内脂素和空腹胰岛素、HOMA—IR的差异均无统计学意义，两组IMT、Fib、hs—CRP的差异均有统计学意义（均P〈0，05）；（3）正常体重对照组和肥胖组内脂素和空腹胰岛素的差异均有统计学意义（P〈0．05），而两组IMT、FIB、hs—CRP和HOMA—IR的差异均无统计学意义；（4）直线相关分析显示：内脂素与血TNF-α、腰围、腰臀比呈正相关。与IMT、Fib、hs—CRP、HOMA—IR无相关性。结论肥胖人群的血浆内脂素显著增高。内脂素不是单一而是与其它介质相互作用；内脂素与TNF—α可能相互影响，共同参与胰岛素抵抗的发生和发展。
Objective To study the relationship of visfatin, tumor necrosis factor- α （TNF- α） levels and the occurrence of insulin resistance and macroangiopathy in obesity and type 2 diabetes （T2DM） patients. Methods The subjects were 85 cases, including 43 cases of T2DM patients and according to body mass index （BMI） is divided into DM obese group （22 cases） and non-obese diabetic sub-group （21 cases）, and another 42 cases of normal glucose tolerance, and according to BMI were divided into obese group （22 cases） and normal control group （20 cases）, four groups of gender, age, the basic matching. All subjects of the respective 75g oral glucose tolerance test, and measurement and analysis of visfatin, TNF-α , serum insulin, blood sugar and blood lipids, plasma high sensitivity C-reactive protein, fibrinogen, carotid intima - media thickness （IMT）, BMI and waist / hip ratio （WHR） and other indicators of the relationship. Results （1） Type 2 diabetes in obese group and non-obese group and normal control group, simple obese group of four single-factor ANOVA analysis showed Visfatin, IMT, FIB, HSCRP, high-density lipoprotein cholesterol （HDL-C）, insulin （Fins）, waist circumference, waist to hip ratio （WHR） differences were statistically significant, further pairwise comparison SNK-q test prompted Visfatin no statistical significance among the groups; （2）85 cases were divided into normal blood sugar control and diabetic groups t test showed Visfatin in no significant difference between the two groups, IMT, FIB, HSCRP were logarithmically transformed before t test showed IglMT, lgFIB, IgHSCRP between the two groups statistically significant difference, fasting insulin between the two groups showed no significant difference ,HOMA-IR between the two group showed no significant difference. （3） 85 cases were divided into obese and normal body mass group and t-tests show Visfatin in two groups was statistically significant; t test showed lglMT, IgFIB, IgHSCRP between the tw
出处
《浙江医学》
CAS
2011年第8期1145-1148,共4页
Zhejiang Medical Journal
