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新诊断2型糖尿病患者血清肌联素与胰岛素抵抗的相关性研究

Relationship between serum myonectin and insulin resistance in newly diagnosed type 2 diabetic patients

    摘要
  • 摘要:
      目的  探讨新诊断2型糖尿病（nT2DM）患者血清肌联素与胰岛素抵抗的关系。
      方法  纳入维吾尔族健康人群89例（对照组）、糖耐量受损（IGT）128例（IGT组）和nT2DM患者111例（nT2DM组）为研究对象，采用酶联免疫法检测血清肌联素的水平。
      结果  IGT组和nT2DM组年龄、体质量指数（BMI）、全身脂肪百分比（FAT%）、腰臀比（WHR）、甘油三酯（TG）、糖化血红蛋白（HbA1c）、空腹血糖（FPG）、空腹胰岛素（FINS）、75 g葡萄糖负荷后2 h血糖（2 hPG）、75 g葡萄糖负荷后2 h血浆胰岛素（2 hINS）、稳态模型评估胰岛素抵抗指数（HOMA-IR）和肌联素均高于对照组，差异有统计学意义（P < 0.05或P < 0.01）。IGT组和对照组患者高密度脂蛋白胆固醇（HDL-C）高于nT2DM组患者，差异有统计学意义（P < 0.05或P < 0.01）。IGT组与nT2DM组在FAT%、总胆固醇（TC）、HbA1c、FBG、FINS、2 hPG、2 hINS、HOMA-IR和肌联素方面比较，差异有统计学意义（P < 0.05或P < 0.01）。肌联素与年龄、BMI、WHR、HbA1c、FBG、2 hPG、FINS、2 hINS、HOMA-IR呈显著正相关q（P < 0.05或P < 0.01），与HDL-C呈显著负相关（P < 0.01）。多元逐步回归分析提示，2 hPG、2 hINS及HOMA-IR是影响肌联素水平的独立相关因素（β=0.34、0.42、0.90，P < 0.01、0.01、0.05）。受试者工作特征（ROC）曲线显示，血清肌联素预测IGT和T2DM的曲线下面积分别为0.72和0.92。
      结论  T2DM和超重/肥胖人群血清肌联素水平明显升高，肌联素与胰岛素抵抗密切相关，在T2DM、胰岛素抵抗的发生发展中发挥着重要的作用。

     

    Abstract:
      Objective  To explore the relationship between serum myonectin and insulin resistance in newly diagnosed type 2 diabetes mellitus (nT2DM) patients.
      Methods  Totally 89 Uygur healthy people (control group), 128 Uygur patients with impaired glucose tolerance (IGT group) and 111 Uygur patients with nT2DM (nT2DM group) were selected as research objects. The levels of serum myonectin were detected by enzyme-linked immunosorbent assay.
      Results  Age, body mass index (BMI), percentage of body fat (FAT%), waist-hip ratio (WHR), triglyceride (TG), glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), fasting insulin (FINS), blood glucose at 2 h after 75 g glucose load (2 hPG), plasma insulin at 2 h after 75 g glucose load (2 hINS), homeostatic model assessment of insulin resistance index (HOMA-IR) and myonectin in the IGT group and the nT2DM group were significantly higher than those in the control group (P < 0.05 or P < 0.01). The levels of high density lipoprotein cholesterol (HDL-C) in the IGT group and the control group were higher than that in the nT2DM group (P < 0.05 or P < 0.01). There were statistically significant differences in FAT%, total cholesterol (TC), HbA1c, FBG, FINS, 2 hPG, 2 hINS, HOMA-IR and adiponectin between the IGT group and the nT2DM group (P < 0.05 or P < 0.01). Myonectin was positively correlated with age, BMI, WHR, HbA1c, FBG, 2 hPG, FINS, 2 hINS and HOMA-IR (P < 0.05 or P < 0.01), and negatively correlated with HDL-C (P < 0.01). Multiple stepwise regression analysis showed that 2 hPG, 2 hINS and HOMA-IR were independent related factors affecting the level of myonectin (β=0.34, 0.42, 0.90, P < 0.01, P < 0.01, P < 0.05). The receiver operating characteristic (ROC) curve showed that the areas under the curve of serum myonectin in predicting IGT and T2DM were 0.72 and 0.92, respectively.
      Conclusion  The levels of serum myonectin increase significantly in T2DM and overweight/obese people. Myonectin is closely related to insulin resistance and plays an important role in the occurrence and development of T2DM and insulin resistance.

     

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