2型糖尿病患者血脂联素与白介素18、胰岛素抵抗关系研究

Department of Endocrinology，Zhangzhou Municipal Hospital，Affiliated to Fujian Medical University，Zhangzhou 363000，China

关键词:  糖尿病  2型  脂联素  胰岛素抵抗  白细胞介素-18

Key words:  diabetes mellitus  type 2  insulin resistance  adiponectin  interleukin-18

摘要:

目的　探讨2型糖尿病（T2DM）患者血脂联素与白细胞介素－18（interleukin 18,IL-18）、胰岛素抵抗(insulin resistance，IR)的关系。方法　根据体重指数(BMI)将120例2型糖尿病（T2DM）患者分为超重/肥胖T2DM组（DM1组,60例）和非肥胖T2DM组（DM2组, 60例），并选择姓名、年龄、BMI等与糖尿病组相匹配的非糖尿病体检者为对照组1(C1组, 30例)和对照组2(C2组, 30例)。分别测身高、体重、血压、腰围、臀围、脂联素、IL-18、空腹血糖（FPG）、空腹胰岛素(FINS)、血脂等，以改良稳态模型评估法计算的胰岛素抵抗指数（HOMA2-IR）作为评估IR的指标。结果　（1）T2DM组血脂联素、IL-18、HOMA2-IR与对照组差异均有显著性意义（P<0.01）。C1组HOMA2-IR显著高于C2组，脂联素水平显著低于C2组，而IL-18差异则无显著性意义；DM1组HOMA2-IR、IL-18显著高于DM2组，脂联素显著低于DM2组；（2）T2DM组按脂联素水平分两组后发现，低脂联素组HOMA2-IR及IL-18水平显著升高。（3）T2DM组脂联素与IL-18水平呈明显负相关。结论　（1）血脂联素水平与IR呈负相关，其下降早于IL-18水平变化，可作为评价早期IR的敏感指标，且可反映T2DM患者IR程度；（2）血脂联素与IL-18呈负相关，低脂联素可能是促发T2DM患者IL-18水平升高的原因之一。

Abstract:

Objective 〖WTBZ〗To investigate the association of serum adiponectin level with serum interlekin-18(IL-18) and insulin resistance(IR) in type 2 diabetes mellitus(T2DM). 〖WTHZ〗Methods 〖WTBZ〗120 patients with T2DM were divided into group overweight/obese T2DM (DM1,60 cases) and group non-obese T2DM (DM2,60 cases) based on the body mass index(BMI). The healthy persons with the similar age,sex,and BMI to DM group were chosen as the control group 1(group C1, 30 cases) and group 2(group C2, 30 cases). The body height, weight, blood pressure, waist and hip circumference, adiponectin, IL-18, fasting plasma glucose(FPG) and fasting serum insulin(FINS) were measured. The degree of IR was evaluated by HOMA2-IR.〖WTHZ〗Results 〖WTBZ〗(1) The serum levels of adiponectin, IL-18 and the value of HOMA2-IR were significantly different between the group T2DM and the control group（all P<0.01）. The group C1 had significantly higher HOMA2-IR and lower adiponectin level,while the serum level of IL-18 had no significant difference . The serum levels of IL-18 and HOMA2-IR were significantly higher in the group DM1 than in the group DM2. (2) According to the level of serum adiponectin, group T2DM was divided into two groups,and then it was found that HOMA2-IR and IL-18 were significantly higher in the group with lower serum adiponectin. (3) Serum adiponectin is negatively related to serum IL-18 in group T2DM.〖WTHZ〗Conclusion 〖WTBZ〗(1)Serum adiponectin is negatively related to IR and low serum adiponectin appeares earlier than the change of serum IL-18 level．It may be used as a sensitive factor to reflect an earlier IR and the degree of IR in T2DM. (2)Serum adiponectin is negatively related to serum IL-18，low adiponectin level may be the cause of an increase in IL-18 secretion in T2DM.