Silha Josef V, Krsek Michal, Hana Vaclav, Marek Josef, Jezkova Jana, Weiss Vladimir, Murphy Liam J
Department of Physiology, University of Manitoba, Winnipeg, Canada.
Clin Endocrinol (Oxf). 2003 Jun;58(6):736-42. doi: 10.1046/j.1365-2265.2003.01789.x.
Insulin resistance, impaired glucose tolerance and type 2 diabetes are common in acromegalic subjects. The mechanism underlying this insulin resistance is unclear.
We investigated the levels of the adipocytokines, resistin, adiponectin and leptin in a group of 18 acromegalic subjects and 18 control subjects matched for age, gender and body mass index.
Here we demonstrate for the first time significant elevation in adiponectin levels in acromegalic subjects compared to control subjects 12.5 +/- 1.2 vs. 8.97 +/- 1.1 mg/l, P = 0.029. The resistin levels were similar in acromegalic subjects and controls; 20.65 +/- 2.99 vs. 19.03 +/- 4.72 micro g/l. No evidence of a correlation between adiponectin and insulin resistance as calculated from HOMA-R was found. No correlation was observed either between adiponectin or resistin levels and GH levels, total IGF-I or free IGF-I levels. Leptin levels were significantly reduced in acromegalic subjects, 8.22 +/- 2.26 vs. 18.3 +/- 4.1 micro g/l, P = 0.004. In control subjects, significant correlations between leptin levels and HOMA-R and between resistin levels and HOMA-R were observed. These relationships were not apparent in acromegalic subjects.
From these data we conclude that changes in resistin and adiponectin levels are unlikely to account for the insulin resistance of acromegaly.
胰岛素抵抗、糖耐量受损和2型糖尿病在肢端肥大症患者中很常见。这种胰岛素抵抗的潜在机制尚不清楚。
我们调查了18名肢端肥大症患者和18名年龄、性别和体重指数相匹配的对照受试者的脂联素、抵抗素和瘦素水平。
我们首次证明,与对照受试者相比,肢端肥大症患者的脂联素水平显著升高,分别为12.5±1.2 vs. 8.97±1.1 mg/l,P = 0.029。肢端肥大症患者和对照受试者的抵抗素水平相似,分别为20.65±2.99 vs. 19.03±4.72 μg/l。未发现根据HOMA-R计算的脂联素与胰岛素抵抗之间存在相关性。脂联素或抵抗素水平与生长激素水平、总胰岛素样生长因子-I或游离胰岛素样生长因子-I水平之间也未观察到相关性。肢端肥大症患者的瘦素水平显著降低,分别为8.22±2.26 vs. 18.3±4.1 μg/l,P = 0.004。在对照受试者中,观察到瘦素水平与HOMA-R之间以及抵抗素水平与HOMA-R之间存在显著相关性。这些关系在肢端肥大症患者中并不明显。
从这些数据中我们得出结论,抵抗素和脂联素水平的变化不太可能解释肢端肥大症的胰岛素抵抗。