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目的分析不同糖耐量人群肿瘤坏死因子-αt(TNF-α)、游离脂肪酸(FFA)及脂联素(APN)的变化及其影响因素。方法选择2014年3月—2015年3月石家庄市第一医院内分泌三科诊治2型糖尿病(DM组)、糖耐量减低(IGT组)患者及同期健康体检者(NGT组)各30例作为研究对象,进行收缩压(SBP)、舒张压(DBP)、体质量指数(BMI)、三酰甘油(TG)、总胆固醇(TC)、胰岛素抵抗指数(HOMA-IR)、TNF-α、FFA及APN等指标的检测,并进行危险因素分析。结果血清TNF-α、FFA水平比较:NGT组IGT组>DM组(F=3.014,P=0.011)。DM组中TNF-α、FFA与TG、FPG、FINS、HOMA-IR、HbA_(1c)呈显著正相关(r=0.410、0.274、0.428、0.490、0.400,P均=0.000;r=0.420、0.350、0.370、0.480、0.410,P均=0.000),APN与TG、FPG、FINS、HOMA-IR、HbA_(1c)呈显著负相关(r=-0.410、-0.370、-0.370、-0.490、-0.400,P均=0.000)。高三酰甘油、高胆固醇、高血压、HOMA-IR、TNF-α、FFA、APN是糖尿病发生的危险因素[OR值(95%CI)=1.739(1.286~2.353)、1.486(1.096~2.016)、1.743(1.290~2.356)、2.302(1.707~3.104)、1.624(1.135~2.321)、1.212(1.081~1.359)、0.665(0.500~0.884)]。结论 TNF-α、FFA及APN可能在糖尿病的发生及发展过程中发挥一定作用,因此应加强糖尿病前期人群的脂代谢及相关脂肪因子的早期干预。
Objective To analyze the changes of tumor necrosis factor-α (TNF-α), free fatty acids (FFA) and adiponectin (APN) and its influencing factors in different glucose tolerance population. Methods Thirty patients with type 2 diabetes (DM), impaired glucose tolerance (IGT) and 30 healthy controls (NGT) were enrolled in the first hospital of Shijiazhuang City from March 2014 to March 2015 respectively. SBP, DBP, TG, TG, HOMA-IR, TNF-α, FFA, and the levels of serum lipids in the patients were measured. APN and other indicators of detection, and analysis of risk factors. Results Serum levels of TNF-α and FFA were significantly higher in NGT group than in IGT group (F = 2.711, P = 0.014; F = 3.274, P = 0.008) F = 3.014, P = 0.011). The levels of TNF-α and FFA were positively correlated with TG, FPG, FINS, HOMA-IR and HbA 1c in DM group (r = 0.410,0.274,0.428,0.490,0.400, P = 0.000; r = 0.420,0.350 , 0.370,0.480,0.410, P = 0.000). There was a significant negative correlation between APN and TG, FPG, FINS, HOMA-IR and HbA 1c (r = -0.410, -0.370, -0.370, -0.490, -0.400 , P = 0.000). The triglyceride, hypercholesteremia, hypertension, HOMA-IR, TNF-α, FFA and APN were the risk factors of diabetes mellitus (OR 95% CI 1.739 1.286-2.353, 1.486 1.096 2.016) 1.743 (1.290-2.356), 2.302 (1.707-3.104), 1.624 (1.135-2.321), 1.212 (1.081-1.359), 0.665 (0.500-0.884)]. Conclusion TNF-α, FFA and APN may play a role in the pathogenesis and development of diabetes. Therefore, the early intervention of lipid metabolism and related adipokines in pre-diabetic patients should be strengthened.