新诊断2型糖尿病患者血清网膜素1水平与亚临床动脉粥样硬化的相关性研究

摘要

Objective To investigate the relationship between the serum omentin-1 levels and subclini-cal atherosclerosis in newly diagnosed type 2 diabetes patients(T2DM).Methods A total of 85 cases with newly diagnosed type 2 diabetic in Guilin People′s Hospital from Jan.2012 to May 2013 were included as the research objects,and were divided into T2DM without plaque group(42 cases) and T2DM with subclinical (43 cases) according to the carotid artery ultrasonography results, another 42 healthy people for health checkup during the same period were included as the control group.The serum omentin-1,fasting plasma glu-cose,fasting insulin,blood lipid,HbA1c,hs-CRP,IMT,BMI,waist to hip ratio,HOMA-IR were tested and calculated and the relationship between omentin-1 and subclinical atherosclerosis was analyzed.Results The omentin-1 levels in the control group,T2DM without plaque group,T2DM with plaque group were going down gradually,and the pairwise differences were statistically significant (P <0.05).The omentin-1 levels were negatively correlated with BMI,waist to hip ratio,TG,TC,LDL-C,HbA1c,hs-CRP,fasting insulin,fast-ing plasma glucose,and HOMA-IR(P <0.05),but was positively correlated with HDL-C(P <0.01).Logis-tic regression analysis showed that BMI,waist to hip ratio,HOMA-IR were independent influencing factors for omentin-1.Conclusion Serum omentin-1 levels,associated with fat,insulin sensitivity,are likely to play an important role in insulin resistance and subclinical atherosclerosis occurrence and development.%目的：探讨新诊断2型糖尿病（T2DM）患者血清网膜素1水平与亚临床动脉粥样硬化的关系。方法选取2012年1月至2013年5月桂林市人民医院收治的新诊断 T2DM 患者85例作为研究对象，依据颈动脉超声检查结果分为 T2DM 无斑块组（42例）和 T2DM 伴斑块组（43例），另外同期选择42例门诊健康体检者作为对照组，测定各组受试者血清网膜素 1水平，颈动脉内膜－中膜厚度（IMT），空腹血糖、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c ）、高敏 C 反应蛋白（hs－CRP）、血脂等指标，计算稳态模式评估的胰岛素抵抗指数（ HOMA－IR）、体质指数（BMI）、腰臀比，分析网膜素 1水平与亚临床动脉粥样硬化的相关性。结果血清网膜素1在对照组、T2DM 无斑块组、T2DM 伴斑块组中逐渐降低，组间两两比较差异均有统计学意义（P ＜0.05）。血清网膜素 1水平与 BMI、腰臀比、TC、TG、LDL－C、HbA1c、hs－CRP、HOMA－IR、FINS、FBG 均呈负相关（P ＜0.05），而与 HDL－C 呈正相关（ P ＜0.01）。多元线性逐步回归分析显示：腰臀比、BMI、HOMA－IR 是影响血清网膜素 1水平的独立危险因素。结论血清网膜素 1水平的改变与胰岛素敏感性、肥胖密切相关，故可能参与胰岛素抵抗与亚临床动脉粥样硬化发生和发展。