2型糖尿病患者脂联素/瘦素比例与代谢指标关系的研究

Association between serum adiponectin/leptin ratio and metabolic index in patients with type 2 diabetes mellitus

关键词:  代谢综合征  胰岛素抵抗  脂联素/瘦素比例

Key words:  metabolic syndrome  insulin resistance  adiponectin/leptin ratio

摘要:

目的探讨2型糖尿病患者脂联素/瘦素比例与胰岛素抵抗之间的关系及其临床意义。方法收集本院内分泌科2型糖尿病病例152例,男72例,女80例。根据FPG水平分组研究脂联素和瘦素水平,结合患者胰岛素抵抗相关指标,如空腹胰岛素、糖化血红蛋白、血脂和BMI等因素,以稳态模型公式评估HOMA-IR,分析脂联素/瘦素与各参数间的相关性。结果 A/L与BMI、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）相关（均P〈0.05）。其中,A组患者的BMI、TG、HDL、LDL指标与A/L均关系密切,A/L与B组和C组中的部分指标有关。结论 A/L比单独采用脂联素和瘦素指标更适于评估胰岛素抵抗。HOMA-IR不能做为精确评估胰岛素抵抗的指标,A/L较之HOMA-IR可能更加适用于评估胰岛素抵抗。

Abstract:

Objective To investigate the relationship between adiponectin /leptin（ A /L） ratio and insulin resistance（ IR） in patients with type 2 diabetes mellitus（ T2DM）. Methods One hundred and fifty two patients with T2 DM admitted from January 2012 to December 2012 were enrolled in the study. Patients were divided into three groups according to their fasting plasma glucose（ FPG） level：Group A（ FPG 7. 2 mmol / L）,Group B（ 7. 2 ≤ FPG ≤ 9. 4 mmol / L） and Group C（ FPG 9. 4 mmol / L）. Enzyme-linked immunosorbent assay（ ELISA） was used to examine serum leptin and adiponectin level. Homeostasis model assessment was applied to assess the status of insulin resistance（ HOMA-IR）. The fasting insulin,glycosylated hemoglobin,serum triacylglycerol and body mass index（ BMI） were also measured. The correlation of A/L and with metabolic parameters was analyzed by the Pearson regression. Results Pearson analysis showed that serum A/L ratio was correlated with BMI,triglycerides（ TG）,high density（ HDL） and low density（ LDL） levels（ P〈0. 05）. There was no association between HOM A-IR and other parameters except the BMI in female patients（ P〈0. 05）. A / L ratio was correlated significantly with HOM A-IR in group A and B（ P〈0. 05）,but not in group C. Conclusion A / L ratio may be more effective for IR evaluation than adiponectin and / or leption alone.