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目的观察无糖尿病的代谢综合征(MS)患者血清脂联素(APN)水平,及其与胰岛素抵抗(IR)的相关性,了解罗格列酮(RGZ)对APN和IR的影响。方法 92例无糖尿病的MS患者,随机分为A组(n=40)仅予常规治疗,B组(n=52)常规治疗加RGZ口服。用药前及用药8周后,酶联免疫吸附法测定血清APN,计算IR指数(HOMA-IR)、胰岛素敏感性指数(ISI),并与30名健康人对照。结果(1)MS组APN水平明显低于健康对照组[(1.15±0.81)mg/L vs(4.81±1.20)mg/L,P<0.01]。(2)MS组APN水平与HOMA IR负相关(P<0.01),与ISI正相关(P<0.01)。(3)B组治疗后血清APN升高[从(0.89±0.73)mg/L升至(2.52±1.37)mg/I,P<0.01],HOMA-IR降低(从1.50±0.45降至0.99±0.35,P<0.01),ISI升高(从-4.61±0.45升至-4.10±0.36,P<0.01)。结论无糖尿病的MS患者血清APN水平降低,与IR相关。RGZ可提高APN水平,改善其胰岛素敏感性。
Objective To investigate the serum level of adiponectin (APN) in patients with metabolic syndrome (MS) without diabetes mellitus (DM) and its relationship with insulin resistance (IR) and evaluate the effect of rosiglitazone (RGZ) on APN and IR. Methods Ninety-two non-diabetic patients with MS were randomly divided into group A (n = 40) and routine treatment (group B) (n = 52) plus RGZ orally. Serum APN, HOMA-IR and ISI were measured before treatment and 8 weeks after treatment. Results (1) The level of APN in MS group was significantly lower than that in healthy control group [(1.15 ± 0.81) mg / L vs (4.81 ± 1.20) mg / L, P <0.01]. (2) The APN level in MS group was negatively correlated with HOMA IR (P <0.01), and positively correlated with ISI (P <0.01). (3) The serum level of APN in group B increased from (0.89 ± 0.73) mg / L to (2.52 ± 1.37) mg / I, P <0.01] and the HOMA-IR decreased from 1.50 ± 0.45 to 0.99 ± 0.35, P <0.01). ISI increased (from -4.61 ± 0.45 to -4.10 ± 0.36, P <0.01). Conclusion Serum APN levels are lower in MS patients without diabetes and are related to IR. RGZ increases APN levels and improves insulin sensitivity.