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脂联素浓度作为2型糖尿病患者代谢控制的标准?

Adiponectin concentrations as a criterion of metabolic control in persons with type 2 diabetes mellitus?

作者信息

Stejskal David, Růzicka Viktor, Adamovská Sylva, Juráková Renata, Prosková Jitka, Jedelský Ladislav, Bartek Josef

机构信息

Department of Laboratory Medicine, Hospital Sternberk, Jívavská 20, 785 16 Sternberk, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2003 Dec;147(2):167-72. doi: 10.5507/bp.2003.023.

Abstract

UNLABELLED

Adiponectin (ADP) is an adipocytokin with many antiatherogenic properties; its decreased level is associated with numerous atherogenic diseases and syndromes (e.g. diabetes mellitus (DM), dyslipidemia, endothelial dysfunction, hypertension, and obesity). Decreased ADP values in blood may be an independent risk factor of atherosclerotic (ATS) complications.

AIM OF THE STUDY

  1. Do persons with type 2 diabetes have lower ADP values than individuals without DM but with a high risk of ATS complications? 2) Do ADP values differ between persons with well controlled and persons with uncontrolled type 2 diabetes? We examined 109 patients of the Metabolic Center of Hospital Sternberk. Out of them, 58 had type 2 diabetes, others were individuals with variously expressed risk factors of early atherosclerosis (obesity, hypertension, age, family history, smoking, dyslipidemia, etc.). In all persons under this study the following parameters were determined in peripheral venous blood: adiponectin, resistin, leptin, ObRe, cholesterol, HDL-cholesterol, triacylglycerols, glucose, HbA1c, creatinine, urea, ALT, AST, CRP, homocysteine, thrombocyte aggregation after CPG induction. The whole group was divided according to the presence of type 2DM into two subgroups; persons with diabetes were divided into the well controlled and uncontrolled subgroups. All data obtained were processed statistically using the software SPSS for Windows and Medcalc. The adiponectin/BMI index correlated negatively with HbA1c value (correlation coefficient -0.37, p = 0.00053), triacylglycerols (-0.4, p = 0.000001), P-glucose (-0.3, p = 0.0017), uricemia (-0.35, p = 0.0007) and positively with HDL-cholesterol value (0.6, p=0.00001). Women had higher adiponectin values than men. Persons with hypertension and with diabetes mellitus, individuals with atherogenic lipotype or persons with inflammation signs had lower values than individuals without these diseases and syndromes. Persons with wellcontrolled diabetes mellitus had higher values than persons with uncontrolled diabetes (medians of the adiponectin/BMI index 9.7 vs. 6.7, p < 0.01). Persons with type 2 diabetes mellitus have lower ADP values than persons with a high ATS risk without diabetes mellitus. Persons with wellcontrolled diabetes mellitus (DM) and with satisfactory compensation have significantly higher ADP levels (independently of other metabolic parameters of DM control). ADP may be a new marker of metabolic control in persons with a high risk of atherosclerotic complications.
摘要

未标注

脂联素(ADP)是一种具有多种抗动脉粥样硬化特性的脂肪细胞因子;其水平降低与多种动脉粥样硬化性疾病和综合征相关(如糖尿病(DM)、血脂异常、内皮功能障碍、高血压和肥胖)。血液中ADP值降低可能是动脉粥样硬化(ATS)并发症的独立危险因素。

研究目的

1)2型糖尿病患者的ADP值是否低于无糖尿病但有较高ATS并发症风险的个体?2)血糖控制良好的2型糖尿病患者与血糖控制不佳的患者之间的ADP值是否存在差异?我们对斯特恩伯克医院代谢中心的109例患者进行了检查。其中,58例患有2型糖尿病,其他患者有不同程度的早期动脉粥样硬化风险因素(肥胖、高血压、年龄、家族史、吸烟、血脂异常等)。在本研究的所有受试者中,测定外周静脉血中的以下参数:脂联素、抵抗素、瘦素、ObRe、胆固醇、高密度脂蛋白胆固醇、三酰甘油、葡萄糖、糖化血红蛋白、肌酐、尿素、谷丙转氨酶、谷草转氨酶、C反应蛋白、同型半胱氨酸、CPG诱导后的血小板聚集。根据是否存在2型糖尿病将整个组分为两个亚组;糖尿病患者再分为血糖控制良好和控制不佳的亚组。使用Windows版SPSS软件和Medcalc对所有获得的数据进行统计学处理。脂联素/BMI指数与糖化血红蛋白值呈负相关(相关系数 -0.37,p = 0.00053),与三酰甘油呈负相关(-0.4,p = 0.000001),与血糖呈负相关(-0.3,p = 0.0017),与血尿酸呈负相关(-0.35,p = 0.0007),与高密度脂蛋白胆固醇值呈正相关(0.6,p = 0.00001)。女性的脂联素值高于男性。患有高血压和糖尿病的患者、具有动脉粥样硬化性脂质型的个体或有炎症迹象的个体的值低于无这些疾病和综合征的个体。血糖控制良好的糖尿病患者的值高于血糖控制不佳的患者(脂联素/BMI指数中位数分别为9.7和6.7,p < 0.01)。2型糖尿病患者的ADP值低于无糖尿病但有较高ATS风险的个体。血糖控制良好且代偿满意的2型糖尿病患者(DM)的ADP水平显著更高(独立于DM控制的其他代谢参数)。ADP可能是动脉粥样硬化并发症高风险人群代谢控制的新标志物。

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