CAJ | 학술논문

目的：研究健康人和2型糖尿病患者中硒蛋白P （ SEPP ）和胰岛素抵抗的相关性。方法入组门诊初发2型糖尿病患者156例和64名健康人作为对照，测定空腹血糖（ FPG）、空腹胰岛素（ FIN）、血脂谱、SEPP 水平，记录身高、体重和血压，采用稳态模型评估胰岛素抵抗指数（HOMA-IR）和计算胰岛素敏感性指数（ISI）。结果（1）肥胖和非肥胖糖尿病组的SEPP水平均显著高于对照组[（4.43±1.95）、（3.01±1.20）比（2.34±2.30）mmol/L，均P＜0.01]，肥胖糖尿病组的SEPP水平高于非肥胖糖尿病组（均P＜0.05）。（2）在总队列人群中SEPP水平和FIN、FPG、体质指数（BMI）、甘油三酯（TG）和HOMA-IR呈正相关（r＝0.401、0.202、0.420、0.239、0.445，均P＜0.05）和ISI呈负相关（r＝-0.414，P＜0.01）。（3）多元逐步回归分析显示，影响胰岛素抵抗的主要因素为SEPP水平（β＝0.293，P＜0.01）。影响ISI的主要因素为收缩压、HbA1c和SEPP水平（β＝-0.195、-0.185、-0.246，均P＜0.05）。结论血清SEPP水平不受年龄、血压、血脂等影响，是胰岛素抵抗的独立影响因素。
목적：연구건강인화2형당뇨병환자중서단백P （ SEPP ）화이도소저항적상관성。방법입조문진초발2형당뇨병환자156례화64명건강인작위대조，측정공복혈당（ FPG）、공복이도소（ FIN）、혈지보、SEPP 수평，기록신고、체중화혈압，채용은태모형평고이도소저항지수（HOMA-IR）화계산이도소민감성지수（ISI）。결과（1）비반화비비반당뇨병조적SEPP수평균현저고우대조조[（4.43±1.95）、（3.01±1.20）비（2.34±2.30）mmol/L，균P＜0.01]，비반당뇨병조적SEPP수평고우비비반당뇨병조（균P＜0.05）。（2）재총대렬인군중SEPP수평화FIN、FPG、체질지수（BMI）、감유삼지（TG）화HOMA-IR정정상관（r＝0.401、0.202、0.420、0.239、0.445，균P＜0.05）화ISI정부상관（r＝-0.414，P＜0.01）。（3）다원축보회귀분석현시，영향이도소저항적주요인소위SEPP수평（β＝0.293，P＜0.01）。영향ISI적주요인소위수축압、HbA1c화SEPP수평（β＝-0.195、-0.185、-0.246，균P＜0.05）。결론혈청SEPP수평불수년령、혈압、혈지등영향，시이도소저항적독립영향인소。
Objective To explore the relationship between selenoprotein P ( SEPP ) and insulin resistance in subjects with normal glucose tolerance and type 2 diabetes mellitus .Methods A total of 156 subjects with newly onset diabetes and 64 subjects with normal glucose tolerance were enrolled .Fasting plasma glucose ( FPG ) , fasting insulin ( FIN ) , lipid profile and SEPP level were measured and height , weight and blood pressure were recorded.Insulin resistance index was calculated by homeostatic model assessment ( HOMA-IR).Results The SEPP level was significantly higher in obese and non-obese diabetic groups than control group ((4.43 ±1.95), (3.01 ±1.20) vs (2.34 ±2.30)mmol/L, both P<0.01).The SEPP level was significantly higher in obese subgroup of diabetic group than non -obese subgroup ( P<0.05).The SEPP level was positively correlated with FIN , FPG, body mass index (BMI), triglycerides (TG) and HOMA-IR (r=0.401, 0.202, 0.420, 0.239, 0.445, P<0.05) and negatively with ISI (r=-0.414, P <0.01 ).Multivariate regression analysis demonstrated that SEPP level was independently correlated with insulin resistance (β=0.293, P<0.01).And the independent factors for ISI were systolic pressure, HbA1c and SEPP level (β=-0.195, -0.185 and -0.246, P<0.05).Conclusion Serum SEPP level may be an independent risk factor for insulin resistance regardless of age , blood pressure or lipid profile.