Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Diabetes Res Clin Pract. 2009 Nov;86(2):89-95. doi: 10.1016/j.diabres.2009.08.010. Epub 2009 Sep 10.
Adiponectin is an adipocytokine with insulin sensitizing effect while chronic inflammation damages pancreatic beta-cells leading to reduced insulin response. We aimed to prove the hypothesis that adiponectin levels and inflammatory markers (white blood cell counts [WCC], Helicobacter pylori [HP] titers, high sensitivity C-reactive protein [hs-CRP]) may interact to affect risk of diabetes. We studied 288 Chinese men (age-median: 41.0 years, IQR: 35.3-46.0 years) being recruited from the community in Hong Kong. The mean adiponectin level was 5.39+/-2.81 microg/ml and 40.9% (n=107) had low adiponectin level (<4 microg/ml). On multiple regression analysis, adiponectin was negatively associated with diabetes, HOMA insulin resistance top quartile, plasma glucose (PG) and 2h insulin; and positively associated with HOMA insulin sensitivity index. WCC was independently associated with PG and 15' insulin, and negatively associated with HOMA insulin sensitivity top quartile. HP titre was associated with 30' PG level and diabetes. hs-CRP did not enter the multivariable model. In conclusion, adiponectin, WCC and HP titer are independent predictors for hyperglycemia and reduced insulin sensitivity in Chinese men. These findings may explain the high risk for diabetes in Chinese population despite their relatively low adiposity.
脂联素是一种具有胰岛素增敏作用的脂肪细胞因子,而慢性炎症会损害胰岛β细胞,导致胰岛素反应减弱。我们旨在验证以下假说,即脂联素水平和炎症标志物(白细胞计数[WCC]、幽门螺杆菌[HP]滴度、高敏 C 反应蛋白[hs-CRP])可能相互作用,影响糖尿病的发病风险。我们研究了 288 名来自香港社区的中国男性(年龄中位数:41.0 岁,IQR:35.3-46.0 岁)。脂联素的平均水平为 5.39+/-2.81μg/ml,40.9%(n=107)的人存在低脂联素水平(<4μg/ml)。在多元回归分析中,脂联素与糖尿病、HOMA 胰岛素抵抗最高四分位、血浆葡萄糖(PG)和 2h 胰岛素呈负相关,与 HOMA 胰岛素敏感性指数呈正相关。WCC 与 PG 和 15'胰岛素独立相关,与 HOMA 胰岛素敏感性最高四分位呈负相关。HP 滴度与 30'PG 水平和糖尿病相关。hs-CRP 未进入多变量模型。总之,脂联素、WCC 和 HP 滴度是中国男性发生高血糖和胰岛素敏感性降低的独立预测因子。这些发现可能解释了中国人群尽管肥胖程度相对较低,但糖尿病风险较高的原因。