CAJ | 학술논문

目的探讨不同糖耐量个体脂联素与胰岛β细胞第一时相分泌功能的关系.方法 37例新诊断的2型糖尿病患者(DM组),30例糖耐量异常者(IGR组),40名正常对照组(NGT组),行静脉葡萄糖耐量试验(IVGTT),ELISA法测定空腹脂联素及胰岛素原(PI)水平,比色法测定空腹游离脂肪酸(FFA).计算0～10 min胰岛素曲线下面积(AUC)、0～10 min胰岛素曲线下增加面积(iAUC)、AIR3-5、稳态模型评估的胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能(HOMA-β).探讨脂联素与AUC、iAUC、AIR3-5、PI、FFA及HOMA-IR的关系.结果 (1)DM组及IGR组脂联素、AUC、iAUC、AIR3-5显著低于NGT组(P<0.05),DM组较IGR组明显降低(P<0.05).(2)DM组、IGR组PI明显高于NGT组(P<0.05).(3)脂联素与HOMA-β、AUC、iAUC、AIR3-5、高密度脂蛋白胆固醇正相关,与PI、FFA、HOMA-IR、低密度脂蛋白胆固醇(LDL-C)负相关.(4)PI与HOMA-IR值正相关.(5)多元逐步回归分析显示,脂联素与AUC独立相关.结论脂联素为胰岛β细胞第一时相分泌功能的独立影响因素,低脂联素水平可以预测2型糖尿病患者胰岛β细胞第一时相功能受损及胰岛素抵抗.
목적 탐토불동당내량개체지련소여이도β세포제일시상분비공능적관계.방법 37례신진단적2형당뇨병환자(DM조),30례당내량이상자(IGR조),40명정상대조조(NGT조),행정맥포도당내량시험(IVGTT),ELISA법측정공복지련소급이도소원(PI)수평,비색법측정공복유리지방산(FFA).계산0～10 min이도소곡선하면적(AUC)、0～10 min이도소곡선하증가면적(iAUC)、AIR3-5、은태모형평고적이도소저항지수(HOMA-IR)급이도β세포공능(HOMA-β).탐토지련소여AUC、iAUC、AIR3-5、PI、FFA급HOMA-IR적관계.결과 (1)DM조급IGR조지련소、AUC、iAUC、AIR3-5현저저우NGT조(P<0.05),DM조교IGR조명현강저(P<0.05).(2)DM조、IGR조PI명현고우NGT조(P<0.05).(3)지련소여HOMA-β、AUC、iAUC、AIR3-5、고밀도지단백담고순정상관,여PI、FFA、HOMA-IR、저밀도지단백담고순(LDL-C)부상관.(4)PI여HOMA-IR치정상관.(5)다원축보회귀분석현시,지련소여AUC독립상관.결론 지련소위이도β세포제일시상분비공능적독립영향인소,저지련소수평가이예측2형당뇨병환자이도β세포제일시상공능수손급이도소저항.
Objective To investigate the relationship between adiponectin and the first-phase of pancreatic P-cell insulin secretion in subjects with different statuses of glucose tolerance. Methods Thirty-seven patients with newly diagnosed type 2 diabetes mellitus (DM) , 30 patients with abnormal glucose tolerance (IGR) , and 40 normal control subjects (NGT) underwent intravenous glucose tolerance test (IVGTT). Fasting adiponectin and proinsulin (PI) was assayed by EL1SA. Fasting free fatty acid ( FFA) was measured by colorimetry. Insulin area under the curve ( AUC ) , incremental AUC (iAUC) from 0 min to 10 min, AIR3-5, homeostasis model assessment for insnlin resistance (HOMA-IR) , and for β cell function ( HOMA-p) were calculated. The relationship between adiponectin and AUC, iAUC, AIR3-5, proinsulin, FFA, and HOMA-IR was explored. Results (1) The levels of AUC, iAUC, AIR3-5, and adiponectin in DM group and IGR group were significantly lower than those in NGT group (P<0.05), reduced in DM group than those in IGR group(P<0.05). (2) The levels of PI in DM group and IGR group were significantly higher than that in NGT (P<0.05). (3) Adiponectin was positively correlated with HOMA-p,AUC,iAUC,AIR3-5, and HDL-C,while negatively correlated with proinsulin, HOMA-IR, and LDL-C. (4) Proinsulin was positively correlated with HOMA-IR. (5 ) Multiple regression stepwise analysis showed that adiponectin was independently associated with AUC. Conclusions Adiponectin was an independent factor affecting the first phase of pancreatic p-cell insulin secretion. Low adiponectin level could predict the dysfunction of the first phase pancreatic p-cell secretion as well as insulin resistance in patients with type 2 diabetes.