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内脏脂肪量总是与胰岛素抵抗相关,但在中国人的 2 型糖尿病和血糖正常者中,脂肪因子(脂联素和抵抗素)与胰岛素抵抗的相关性则各不相同。

Visceral fat mass is always, but adipokines (adiponectin and resistin) are diversely associated with insulin resistance in Chinese type 2 diabetic and normoglycemic subjects.

机构信息

Radiology Department, Guangzhou Red Cross Hospital, Medical College of Jinan University, Guangzhou 510220, PR China.

出版信息

Diabetes Res Clin Pract. 2012 May;96(2):163-9. doi: 10.1016/j.diabres.2011.12.014. Epub 2012 Jan 13.

Abstract

AIMS

The present study investigated alteration of abdominal visceral fat mass (VFM) and its relationship to adipokines and insulin resistance (IR) in obese and non-obese type 2 diabetes and normoglycemic subjects.

METHODS

Twenty-two diabetic patients and 37 normoglycemic controls were subgrouped into obese and non-obese according to their BMI. VFM was quantified by computed tomography. Plasma adiponectin and resistin, two adipokines exert contrary effects on insulin sensitivity were measured. Insulin sensitivity was evaluated by an established HOMA model.

RESULTS

Obese subjects showed remarkably expanded VFM, while non-obese diabetes obtained more abundant VFM than non-obese controls (104 ± 50 cm(2)vs. 77 ± 26 cm(2), P<0.05). Plasma adiponectin was only significantly decreased in obese diabetes. Plasma resistin was increased in diabetes, but compared between obese and non-obese subjects. Diabetic patients and obese controls were significantly insulin resistant. HOMA-IR index positively correlated to VFM in both groups (r=0.563, P=0.011 for diabetes and r=0.671, P=0.000 for controls). In diabetes but not controls, plasma adiponectin negatively related to VFM (r=-0.687, P=0.000) and HOMA-IR index (r=-0.659, P=0.002), while resistin had no relation to IR and VFM in both groups.

CONCLUSIONS

Increased VFM may lead to IR by mechanisms beyond adipokines in Chinese type 2 diabetic and normoglycemic subjects.

摘要

目的

本研究旨在探讨肥胖和非肥胖 2 型糖尿病及血糖正常受试者内脏脂肪质量(VFM)的变化及其与脂肪因子和胰岛素抵抗(IR)的关系。

方法

根据 BMI 将 22 例糖尿病患者和 37 例血糖正常对照者分为肥胖和非肥胖亚组。采用 CT 定量 VFM。测量两种脂肪因子脂联素和抵抗素的血浆浓度,它们对胰岛素敏感性有相反的作用。采用已建立的 HOMA 模型评估胰岛素敏感性。

结果

肥胖组患者的 VFM 明显增大,而非肥胖组糖尿病患者的 VFM 比非肥胖对照组更丰富(104±50cm2 与 77±26cm2,P<0.05)。仅肥胖型糖尿病患者的血浆脂联素显著降低。糖尿病患者的血浆抵抗素增加,但与肥胖和非肥胖组相比。糖尿病患者和肥胖对照组均明显存在胰岛素抵抗。HOMA-IR 指数与两组 VFM 呈正相关(糖尿病组 r=0.563,P=0.011,对照组 r=0.671,P=0.000)。仅在糖尿病患者中,而不是在对照组中,血浆脂联素与 VFM(r=-0.687,P=0.000)和 HOMA-IR 指数(r=-0.659,P=0.002)呈负相关,而抵抗素与两组的 IR 和 VFM 均无关系。

结论

在中国 2 型糖尿病和血糖正常受试者中,VFM 的增加可能通过脂肪因子以外的机制导致 IR。

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