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2型糖尿病患者中抵抗素与炎症及胰岛素抵抗的关联。

Associations of resistin with inflammation and insulin resistance in patients with type 2 diabetes mellitus.

作者信息

Mojiminiyi O A, Abdella N A

机构信息

Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait.

出版信息

Scand J Clin Lab Invest. 2007;67(2):215-25. doi: 10.1080/00365510601032532.

Abstract

OBJECTIVE

Resistin has been linked to obesity, type 2 diabetes, inflammation and atherosclerosis but the results of animal and human studies have been at variance. The purpose of this study was to investigate the potential roles of resistin in patients with type 2 diabetes and to evaluate the correlation between resistin and markers of obesity, inflammation, insulin resistance, metabolic parameters, diabetes control and complications.

MATERIAL AND METHODS

Fasting resistin, leptin, insulin, glucose, HbA1c, full lipid profile, C-reactive protein (CRP) (high sensitivity assay) and complete blood count were determined in 135 patients with type 2 diabetes. Univariate regression and multivariate logistic regression analyses were used to relate resistin with indices of obesity, inflammation, insulin resistance (homeostasis model, HOMA), insulin sensitivity, diabetic control, coronary heart disease (CHD) and degree of microalbuminuria.

RESULTS

Resistin showed significant (p<0.05) correlations with body mass index (BMI) "(Spearman r=0.67), waist circumference (r=0.54), fasting insulin (0.51), insulin sensitivity (r=-0.29), HOMA (r=0.30), leptin (r=0.39), CRP (r=0.29), white cell count (r=0.25) and lipid parameters but showed no significant correlation with glucose and HbA1c. Partial correlation analysis, with correction for BMI, abolished the correlation of resistin with insulin sensitivity and HOMA but not with the white cell count. When confounding factors were fixed using multiple logistic regression, resistin was not independently associated with CHD (odds ratio=1.05, p=0.08) and degree of microalbuminuria (odds ratio=1.06, p=0.24).

CONCLUSIONS

Resistin showed significant BMI-dependent associations with insulin resistance and factors linked with obesity and inflammation in patients with type 2 diabetes. Resistin may represent a link between obesity and insulin resistance via pro-inflammatory pathways.

摘要

目的

抵抗素与肥胖、2型糖尿病、炎症和动脉粥样硬化相关,但动物和人体研究结果存在差异。本研究旨在探讨抵抗素在2型糖尿病患者中的潜在作用,并评估抵抗素与肥胖、炎症、胰岛素抵抗、代谢参数、糖尿病控制及并发症标志物之间的相关性。

材料与方法

对135例2型糖尿病患者测定空腹抵抗素、瘦素、胰岛素、血糖、糖化血红蛋白(HbA1c)、全血脂谱、C反应蛋白(CRP)(高敏检测法)及全血细胞计数。采用单变量回归和多变量逻辑回归分析来关联抵抗素与肥胖、炎症、胰岛素抵抗(稳态模型评估,HOMA)、胰岛素敏感性、糖尿病控制、冠心病(CHD)及微量白蛋白尿程度的指标。

结果

抵抗素与体重指数(BMI)(Spearman相关系数r = 0.67)、腰围(r = 0.54)、空腹胰岛素(0.51)、胰岛素敏感性(r = -0.29)、HOMA(r = 0.30)、瘦素(r = 0.39)、CRP(r = 0.29)、白细胞计数(r = 0.25)及血脂参数呈显著(p < 0.05)相关,但与血糖和HbA1c无显著相关性。校正BMI后的偏相关分析消除了抵抗素与胰岛素敏感性和HOMA的相关性,但未消除与白细胞计数的相关性。当使用多变量逻辑回归固定混杂因素时,抵抗素与冠心病(比值比 = 1.05,p = 0.08)及微量白蛋白尿程度(比值比 = 1.06,p = 0.24)无独立相关性。

结论

在2型糖尿病患者中,抵抗素与胰岛素抵抗以及与肥胖和炎症相关的因素呈显著的BMI依赖性关联。抵抗素可能通过促炎途径代表肥胖与胰岛素抵抗之间的联系。

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