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目的:探讨护骨素(osteoprotegerin)、内脂素(visfatin)和生长激素释放肽(ghrelin)在2型糖尿病(T2DM)代谢综合症发病机制中的作用。方法:采集受试者血清血样116例(39例2型糖尿病代谢综合症较轻组;48例2型糖尿病代谢综合症较重组;29例正常对照组)。采用酶催法检测血糖和血脂。采用ELISA法测定护骨素、内脂素、生长激素释放肽和胰岛素水平。结果:与对照组相比,糖尿病代谢综合症较轻组患者护骨素和内脂素水平显著增高,生长激素释放肽水平显著降低(P<0.05)。此外,2型糖尿病兼代谢综合症较重组患者体内护骨素和内脂素水平明显高于较轻组患者(P<0.05)。采用ROC曲线研究标记物最佳剂量值。2型糖尿病兼代谢综合症较重组患者护骨素(1.06 ng/m L)、内脂素(32.27 ng/m L)和生长激素释放肽(33.65 pg/m L)可分别表现出76%、92%和39.1%灵敏性及41%、69.2%和62.9%特异性。在研究的这些参数中,内脂素是预测糖尿病患者兼代谢综合症的有效指标(P<0.05)。结论:护骨素、内脂素和生长激素释放肽可能作用于糖尿病患者的发病过程。内脂素是预测糖尿病患者兼代谢综合症的有效指标。
AIM: To investigate the role of osteoprotegerin, visfatin and ghrelin in the pathogenesis of metabolic syndrome in type 2 diabetes mellitus (T2DM). Methods: Serum samples were collected from 116 subjects (39 patients with type 2 diabetes mellitus with mild metabolic syndrome; 48 patients with type 2 diabetes mellitus complicated by metabolic syndrome; and 29 normal controls). Enzyme-catalyzed detection of blood glucose and blood lipids. The contents of osteoprotegerin, visfatin, ghrelin and insulin were measured by ELISA. Results: Compared with the control group, the patients with diabetic metabolic syndrome showed significantly higher levels of osteoprotegerin and visfatin and ghrelin levels (P <0.05). In addition, levels of osteoprotegerin and visfatin were significantly higher in patients with type 2 diabetes mellitus and those with more severe metabolic syndrome than those in the less severe patients (P <0.05). ROC curves were used to study the best dose of marker. In patients with type 2 diabetes mellitus and metabolic syndrome, osteoprotegerin (1.06 ng / m L), visfatin (32.27 ng / m L), and ghrelin (33.65 pg / m L) 92% and 39.1% sensitivity and 41%, 69.2% and 62.9% specificity. Among these parameters studied, visfatin is a good predictor of diabetic and metabolic syndrome (P <0.05). CONCLUSION: Osteoprotegerin, visfatin and ghrelin may play roles in the pathogenesis of diabetic patients. Flutin is a valid predictor of diabetes mellitus and metabolic syndrome.