不同糖代谢水平血清脂联素与胰岛素抵抗及血管舒张功能相关性研究周逸丹.docVIP

不同糖代谢水平血清脂联素与胰岛素抵抗及血管舒张功能相关性研究 周逸丹1 吴佳丽2 李利2 俞娉2 [摘要] 目的 研究不同糖代谢水平人群的血清脂联素与胰岛素抵抗、血管舒张功能的相关性。方法 体检人群中经口服葡萄糖耐量试验(OGTT)筛选出糖耐量正常(NGT)17例，空腹血糖调节受损(IFG)22例，糖耐量受损(IGT)23例、2型糖尿病(T2DM)21例，检测血清脂联素（APN）水平；用HOMA-IR、HOMA-B指数分别评价胰岛素抵抗指数、B细胞功能指数；采用高分辨率血管外超声检测血流介导的内皮依赖性血管舒张功能(EDVD)和硝酸甘油介导的内皮非依赖性血管舒张功能(EIVD)。结果 在NGT、IFG、IGT、DM组，APN、EDVD水平依次降低； HOMA-IR逐渐增高。校正了年龄、性别、体质量指数、腰臀比后，APN与HOMA-IR呈负相关(r=-0．353 P0.01)，与EDVD、EIVD呈正相关(r分别为0．391，0.375. P0.01)，APN与HOMA-B无关（P＞0.05）；EDVD与HOMA-IR无关（P＞0.05）。多元逐步回归分析以APN为应变量，HOMA-IR进入方程(P0.01)；以EDVD为应变量，APN进入方程(P0.05) HOMA-IR未进入方程。结论 T2DM前期已经存在APN降低、胰岛素抵抗、血管内皮功能损害。APN与胰岛素抵抗负相关；与血管内皮功能正相关。APN与内皮依赖性血管舒张功能的关系独立于胰岛素抵抗。 [关键词 血清脂联素；胰岛索抵抗指数；血管舒张功能 Study on the dependability of vascular dilation function，insulin resistance and serum adiponectin in patients with different glucose glycometaboilsm Zhou Yidan*,Wu Jiali, ,Li Li , Yu Ping . *Department of Emergency,，Third Peoples Hospital of Hangzhou, Hangzhou, 310009,China. Email:zhouyidanf@163.com [Abstract] Objective The objective is to study the dependability of serum adiponectin level，insulin resistance and vascular dilation function in patients with different glucose glycometaboilsm. Methods 83 subjects aged 50-65，including 17 cases of normal glucose tolerance(NGT)，22 cases of impaired fasting glucose(IFG)，23cases of impaired glucose tolerance(IGT)and 21 cases of diabetes(DM)were chosen．Serum adiponectin were measured, insulin resistance index(HOMA-IR), and B cell function index were used to evaluate the phase of insulin secretion in the basic state and during OGTT .The brachial artery responses to flow-mediated endothelium-dependent dilation(EDVD)and nitroglycerin-mediated dilation(EIVD) were evaluated by the high resolution vascular ultrasound .Results The serum adiponectin and EDVD decreased in turn from NGT，IFG，IGT and DM， Meanwhile， the insulin resistance index HOMA-IR increased. Adiponectin was negatively associated with HOMA-IR (r=-0．353 P0.01 )but positively associated with EDVD and EIVD