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目的 了解2型糖尿病患者血浆脂联素水平与体重指数(BMI)、血浆胰岛素水平、游离脂肪酸(FFA)及血脂的相关性。方法 根据BMI水平将51名2型糖尿病患者分为肥胖2型糖尿病组(BMI≥25kg/m2)、正常体重2型糖尿病组,将28名正常体重非糖尿病者设为对照组。以ELISA法测定脂联素和FFA,化学发光法测定空腹胰岛素(FINS),同时测定空腹血糖(FPG)、餐后2 h血糖(2HPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C),计算低密度脂蛋白胆固醇(LDL-C)和胰岛素抵抗指数(HOMA-IR)。结果 肥胖2型糖尿病组脂联素水平显著低于非肥胖2型糖尿病组和对照组(P<0.05),后两组脂联素水平无差异。单因素相关分析显示脂联素与BMI及TG负相关,相关系数分别为-0.3459(P<0.01)和-0.3603(P<0.01),与FFA等无相关性。包括年龄、BMI、HDL-C、LDL-C、TG、TC、FPG、FINS、FFA和HOMA-IR的多因素回归分析显示,BMI和TG对脂联素的影响相当。结论 不同BMI个体的脂联素水平具有差异,在正常BMI范围内的2型糖尿病患者与非糖尿病者血浆脂联素水平差异无显著性。胰岛素抵抗程度对脂联素无明显影响。TG和BMI是一组很好的评估脂联素水平和作用的指标。
Objective To investigate the relationship between plasma adiponectin level and body mass index (BMI), plasma insulin level, free fatty acid (FFA) and blood lipids in type 2 diabetic patients. Methods According to the level of BMI, 51 patients with type 2 diabetes were divided into 2 groups: type 2 diabetes mellitus (BMI≥25kg / m2), type 2 diabetes mellitus with normal body weight, and 28 normal weight non-diabetic patients as control group. Adiponectin and FFA were determined by ELISA and fasting insulin (FINS) by chemiluminescence. Fasting plasma glucose (FPG), 2 h postprandial blood glucose (2HPG), triglyceride (TG), total cholesterol High-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) and insulin resistance index (HOMA-IR) were calculated. Results The level of adiponectin in obese type 2 diabetic patients was significantly lower than that in non-obese type 2 diabetic patients and controls (P <0.05). There was no difference in adiponectin levels between the latter two groups. Univariate correlation analysis showed that adiponectin was negatively correlated with BMI and TG, with correlation coefficients of -0.3459 (P <0.01) and -0.3603 (P <0.01), respectively, but no correlation with FFA. Multivariate regression analysis including age, BMI, HDL-C, LDL-C, TG, TC, FPG, FINS, FFA and HOMA-IR showed that BMI and TG had similar effects on adiponectin. Conclusion There are differences in adiponectin levels in different BMI individuals. There is no significant difference in plasma adiponectin levels between type 2 diabetic patients and non-diabetic patients in the range of normal BMI. Insulin resistance had no significant effect on adiponectin. TG and BMI are a good set of indicators for assessing adiponectin levels and effects.