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2型糖尿病患者脂联素与胰岛β细胞第一时相分泌功能的关系探讨

ISSN号：1000-6699
期刊名称：《中华内分泌代谢杂志》
时间：0
分类：R587.1[医药卫生—内分泌;医药卫生—临床医学;医药卫生—内科学]
作者机构：[1]重庆医科大学附属第一医院内分泌科,400016
相关基金：国家自然科学基金资助项目（30771038,30570744,30370670）;教育部博士点专项科研基金（20050631009）;教育部第二批＂春晖计划＂资助项目;教育部重点项目（KJ050314）;重庆市教委基金（渝科教[2003]7号文）

作者：秦登优[1], 邓华聪[1], 艾艳琴[1], 龚明[1], 刘强[1], 李永玲[1], 糜公仆[1]

关键词：脂联素, 静脉葡萄糖耐量试验, 胰岛素第一时相分泌, 胰岛素原, Adiponectin, Intravenous glucose tolerance test, First-phase of insulin secretion, Proinsulin

中文摘要：

目的探讨不同糖耐量个体脂联素与胰岛β细胞第一时相分泌功能的关系.方法 37例新诊断的2型糖尿病患者（DM组）,30例糖耐量异常者（IGR组）,40名正常对照组（NGT组）,行静脉葡萄糖耐量试验（IVGTT）,ELISA法测定空腹脂联素及胰岛素原（PI）水平,比色法测定空腹游离脂肪酸（FFA）.计算0～10 min胰岛素曲线下面积（AUC）、0～10 min胰岛素曲线下增加面积（iAUC）、AIR3-5、稳态模型评估的胰岛素抵抗指数（HOMA-IR）及胰岛β细胞功能（HOMA-β）.探讨脂联素与AUC、iAUC、AIR3-5、PI、FFA及HOMA-IR的关系.结果（1）DM组及IGR组脂联素、AUC、iAUC、AIR3-5显著低于NGT组（P〈0.05）,DM组较IGR组明显降低（P〈0.05）.（2）DM组、IGR组PI明显高于NGT组（P〈0.05）.（3）脂联素与HOMA-β、AUC、iAUC、AIR3-5、高密度脂蛋白胆固醇正相关,与PI、FFA、HOMA-IR、低密度脂蛋白胆固醇（LDL-C）负相关.（4）PI与HOMA-IR值正相关.（5）多元逐步回归分析显示,脂联素与AUC独立相关.结论脂联素为胰岛β细胞第一时相分泌功能的独立影响因素,低脂联素水平可以预测2型糖尿病患者胰岛β细胞第一时相功能受损及胰岛素抵抗.

英文摘要：

Objective To investigate the relationship between adiponectin and the first-phase of pancreatic P-cell insulin secretion in subjects with different statuses of glucose tolerance. Methods Thirty-seven patients with newly diagnosed type 2 diabetes mellitus （DM） , 30 patients with abnormal glucose tolerance （IGR） , and 40 normal control subjects （NGT） underwent intravenous glucose tolerance test （IVGTT）. Fasting adiponectin and proinsulin （PI） was assayed by EL1SA. Fasting free fatty acid （ FFA） was measured by colorimetry. Insulin area under the curve （ AUC ） , incremental AUC （iAUC） from 0 min to 10 min, AIR3-5, homeostasis model assessment for insnlin resistance （HOMA-IR） , and for β cell function （ HOMA-p） were calculated. The relationship between adiponectin and AUC, iAUC, AIR3-5, proinsulin, FFA, and HOMA-IR was explored. Results （1） The levels of AUC, iAUC, AIR3-5, and adiponectin in DM group and IGR group were significantly lower than those in NGT group （P〈0.05）, reduced in DM group than those in IGR group（P〈0.05）. （2） The levels of PI in DM group and IGR group were significantly higher than that in NGT （P〈0.05）. （3） Adiponectin was positively correlated with HOMA-p,AUC,iAUC,AIR3-5, and HDL-C,while negatively correlated with proinsulin, HOMA-IR, and LDL-C. （4） Proinsulin was positively correlated with HOMA-IR. （5 ） Multiple regression stepwise analysis showed that adiponectin was independently associated with AUC. Conclusions Adiponectin was an independent factor affecting the first phase of pancreatic p-cell insulin secretion. Low adiponectin level could predict the dysfunction of the first phase pancreatic p-cell secretion as well as insulin resistance in patients with type 2 diabetes.

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