CAJ | 학술논문

目的通过检测肥胖和新诊断2型糖尿病患者的血清脂肪甘油三酯脂肪酶( adipose triglyceride lipase,ATGL)水平,探讨ATGL与糖、脂代谢的相关性.方法选取2006年8月至2009年4月在江苏大学附属医院门诊和内分泌科住院患者114例,其中男54例,女60例,年龄38～ 70岁.分为2型糖尿病患者66例和正常糖调节者48例,再按体质指数(BMI)是否≥25 kg/m2分为4组:2型糖尿病-超重组、正常糖调节-超重组、2型糖尿病-正常体重组和正常糖调节-正常体重组,检测空腹血糖、血脂和空腹胰岛素( FINS)、ATGL水平,并计算BMI、腰臀比、体脂含量和胰岛素抵抗指数(HOMA-IR).分别进行t检验、直线相关分析、多元逐步回归分析.结果 (1)血清ATGL水平在2型糖尿病-超重组为(239±61) μg/L,与2型糖尿病-正常体重组[(355±54) μg/L]相比,差异有统计学意义(=22.53,P＜0.05)；而正常糖调节-超重组[(242 ±60)μg/L]与正常糖调节-正常体重组[( 383±58)μg/L]相比,差异也有统计学意义(f=8.23,P＜0.05).(2)简单相关分析发现,血清ATGL浓度与体脂含量、BMI、腰臀比、甘油三酯、HOMA-IR等呈负相关(r值分别为-0.271、-0.238、0.375、-0.313、0.164,均P＜0.05).多元逐步回归分析发现腰臀比、体脂含量为血清ATGL的独立相关因素.结论肥胖者的血清ATGL水平明显低于正常体重者,ATGL与腰臀比、体脂含量呈独立相关,而与血糖无明显相关.
목적 통과검측비반화신진단2형당뇨병환자적혈청지방감유삼지지방매( adipose triglyceride lipase,ATGL)수평,탐토ATGL여당、지대사적상관성.방법 선취2006년8월지2009년4월재강소대학부속의원문진화내분비과주원환자114례,기중남54례,녀60례,년령38～ 70세.분위2형당뇨병환자66례화정상당조절자48례,재안체질지수(BMI)시부≥25 kg/m2분위4조:2형당뇨병-초중조、정상당조절-초중조、2형당뇨병-정상체중조화정상당조절-정상체중조,검측공복혈당、혈지화공복이도소( FINS)、ATGL수평,병계산BMI、요둔비、체지함량화이도소저항지수(HOMA-IR).분별진행t검험、직선상관분석、다원축보회귀분석.결과 (1)혈청ATGL수평재2형당뇨병-초중조위(239±61) μg/L,여2형당뇨병-정상체중조[(355±54) μg/L]상비,차이유통계학의의(=22.53,P＜0.05)；이정상당조절-초중조[(242 ±60)μg/L]여정상당조절-정상체중조[( 383±58)μg/L]상비,차이야유통계학의의(f=8.23,P＜0.05).(2)간단상관분석발현,혈청ATGL농도여체지함량、BMI、요둔비、감유삼지、HOMA-IR등정부상관(r치분별위-0.271、-0.238、0.375、-0.313、0.164,균P＜0.05).다원축보회귀분석발현요둔비、체지함량위혈청ATGL적독립상관인소.결론 비반자적혈청ATGL수평명현저우정상체중자,ATGL여요둔비、체지함량정독립상관,이여혈당무명현상관.
Objective To investigate the relationship among serum adipose triglyceride lipase (ATGL) levels and glucose and lipid metabolism in patients with obesity and ncwly-diagnosed type 2 diabetes mellitus(T2DM).Methods Sixty-six patients with T2DM(T2DM group) and forty-eight subjects with normal glucose regulation ( NGR group) were selected from August 2006 to April 2009 in clinic and Department of Endocrinology of the Affiliated Hospital of Jiangsu University.Each group was divided into obese(OB group) and normal weight (NW group) subgroups according to whether the body mass index (BMI) ≥25 kg/m2.By using enzyme-linked immunosorbent assay (ELISA) methods,the changes of serum levels of ATGL were measured.Meanwhile,fasting blood glucose ( FBG),lipids and fasting insulin lcvcls were also measured.BMI and waist-to-hip ratio (WHR) were evaluated and insulin sensitivity was assessed by HOMA-insulin resistance (HOMA-IR). t-test,rectilinear torrelation analysis and multiple stepwise regression analysis were used for data analysis.Results ( 1 ) The serum ATGL levels of obese subjects were lower than the normal weight group in both NGR and T2DM group (T2DM-OB group vs T2DM-NW group:(239±61)vs (355 ±54) μg/L,NGR-OB group vs NGR-NW group:(242 ±60)vs (383 ±58)μg/L),and the differences were statistically significant ( t =22.53,8.23,both P ＜ 0.05 ). ( 2 ) Correlation analysis showed that the serum ATGL level was negatively correlated with Fat％,BMI,WHR,triglycerides and HOMA-IR( r value was - 0.271,- 0.238,- 0.375,- 0.313,- 0.164,respectively,all P ＜ 0.05 ).Multiple stepwise regression analysis showed that WHR,FAT％ were independent factors for serum ATGL.Conclusions The serum ATGL levels in obese patients are significantly lower than those of normal weight.ATGL is independently associated with WHR and FAT％,but no significant correlation with blood glucose.