Kitagawa Nagako, Yano Yutaka, Gabazza Esteban C, Bruno Nelson E, Araki Rika, Matsumoto Kazutaka, Katsuki Akira, Hori Yasuko, Nakatani Kaname, Taguchi Osamu, Sumida Yasuhiro, Suzuki Koji, Adachi Yukihiko
Third Department of Internal Medicine, Mie University School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan.
Diabetes Res Clin Pract. 2006 Aug;73(2):150-7. doi: 10.1016/j.diabres.2005.12.008. Epub 2006 Feb 3.
We investigated the plasma levels of thrombin-activatable fibrinolysis inhibitor (TAFI), plasminogen activator inhibitor-1 (PAI-1) and their relation with clinical and metabolic parameters in non-obese type 2 diabetic patients. The plasma levels of TAFI and PAI-1 were evaluated in 47 non-obese type 2 diabetic patients and 31 normal subjects. The intra-abdominal visceral and subcutaneous fat areas were measured by computed tomography (CT). The degree of insulin resistance was evaluated by the euglycemic-hyperinsulinemic clamp technique using artificial pancreas. The plasma levels of TAFI (169.0+/-108.8% versus 103.7+/-52.3%; p<0.001, mean+/-S.D.) and PAI-1 (82.7+/-54.5ng/ml versus 52.9+/-51.7ng/ml; p<0.05) were significantly higher in non-obese type 2 diabetic patients than in normal subjects. Univariate analysis showed that the plasma TAFI levels are significantly and inversely correlated with the glucose infusion rate (GIR) (r=-0.42, p<0.005) in all diabetic patients. Moreover, the plasma levels of TAFI were significantly correlated with fasting plasma glucose levels (r=0.47, p<0.001) and HbA(1c) (r=0.38, p<0.005) in all subjects. The plasma levels of PAI-1 were significantly and proportionally correlated with the visceral fat area (r=0.42, p<0.005) and body mass index (r=0.33, p<0.05). There was no significant correlation between plasma levels of TAFI and PAI-1 (r=0.04). These results show that the plasma levels of TAFI and PAI-1 differently correlate with insulin resistance and visceral fat accumulation, suggesting that different factors are implicated in the plasma elevation of TAFI and PAI-1 in non-obese type 2 diabetes mellitus.
我们研究了非肥胖型2型糖尿病患者血浆中凝血酶激活的纤溶抑制物（TAFI）、纤溶酶原激活物抑制剂-1（PAI-1）的水平及其与临床和代谢参数的关系。对47例非肥胖型2型糖尿病患者和31名正常受试者的血浆TAFI和PAI-1水平进行了评估。通过计算机断层扫描（CT）测量腹部内脏和皮下脂肪面积。采用人工胰腺的正常血糖高胰岛素钳夹技术评估胰岛素抵抗程度。非肥胖型2型糖尿病患者血浆TAFI水平（169.0±108.8%对103.7±52.3%；p<0.001，均值±标准差）和PAI-1水平（82.7±54.5ng/ml对52.9±51.7ng/ml；p<0.05）显著高于正常受试者。单因素分析显示，所有糖尿病患者血浆TAFI水平与葡萄糖输注率（GIR）显著负相关（r=-0.42，p<0.005）。此外，所有受试者血浆TAFI水平与空腹血糖水平（r=0.47，p<0.001）和糖化血红蛋白（HbA1c）（r=0.38，p<0.005）显著相关。血浆PAI-1水平与内脏脂肪面积（r=0.42，p<0.005）和体重指数（r=0.33，p<0.05）显著正相关。血浆TAFI和PAI-1水平之间无显著相关性（r=0.04）。这些结果表明，血浆TAFI和PAI-1水平与胰岛素抵抗和内脏脂肪堆积的相关性不同，提示非肥胖型2型糖尿病患者血浆TAFI和PAI-1升高涉及不同因素。
