CAJ | 학술논문

目的：探讨老年2型糖尿病合并代谢综合征（MS）患者空腹血清抵抗素水平与胰岛素抵抗（IR）的关系。方法选取120例老年2型糖尿病患者，按照是否合并 MS 将其分为 MS 组（n ＝68）和非 MS 组（n ＝52），另选取同期体检正常的健康老年人60例为对照组。比较3组身高、体质量、腰围、臀围、收缩压、舒张压、体质指数（BMI）、腰臀比（WHR），比较3组血清抵抗素和超敏 C 反应蛋白（hs-CRP）水平以及空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血尿酸（BUA）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）水平。结果 MS 组患者血清抵抗素水平显著高于非 MS 组（P ＜0．05），非 MS 组显著高于对照组（P ＜0．05）；MS 组患者与非 MS 患者的 HOMA-IR 均显著高于对照组（P ＜0．05），MS 组患者的血清 hs-CRP 水平显著高于非 MS 组或对照组（P ＜0．05）；MS 组患者的 BMI、腰围、WHR、收缩压、舒张压、TG 水平等代谢指标均显著高于非 MS 组或对照组（P ＜0．05），MS 组患者的 HDL-C 水平显著低于非 MS 组或对照组（P ＜0．05），MS 组的 FINS 水平显著高于对照组（P ＜0．05）；针对 MS 组患者的多元线性回归分析结果显示，HOMA-IR（β＝0．468，P ＜0．05）和 WHR（β＝0．307，P ＜0．05）与血清抵抗素水平有显著相关性（P ＜0．05）。结论老年2型糖尿病患者普遍存在 IR 症状，合并 MS 的患者会同时出现血清抵抗素水平和炎性介质水平的显著升高，其血清抵抗素水平与患者的IR 和腹部肥胖的严重程度具有相关性。
목적：탐토노년2형당뇨병합병대사종합정（MS）환자공복혈청저항소수평여이도소저항（IR）적관계。방법선취120례노년2형당뇨병환자，안조시부합병 MS 장기분위 MS 조（n ＝68）화비 MS 조（n ＝52），령선취동기체검정상적건강노년인60례위대조조。비교3조신고、체질량、요위、둔위、수축압、서장압、체질지수（BMI）、요둔비（WHR），비교3조혈청저항소화초민 C 반응단백（hs-CRP）수평이급공복혈당（FPG）、총담고순（TC）、감유삼지（TG）、고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL-C）、혈뇨산（BUA）、공복이도소（FINS）、당화혈홍단백（HbA1c）수평。결과 MS 조환자혈청저항소수평현저고우비 MS 조（P ＜0．05），비 MS 조현저고우대조조（P ＜0．05）；MS 조환자여비 MS 환자적 HOMA-IR 균현저고우대조조（P ＜0．05），MS 조환자적혈청 hs-CRP 수평현저고우비 MS 조혹대조조（P ＜0．05）；MS 조환자적 BMI、요위、WHR、수축압、서장압、TG 수평등대사지표균현저고우비 MS 조혹대조조（P ＜0．05），MS 조환자적 HDL-C 수평현저저우비 MS 조혹대조조（P ＜0．05），MS 조적 FINS 수평현저고우대조조（P ＜0．05）；침대 MS 조환자적다원선성회귀분석결과현시，HOMA-IR（β＝0．468，P ＜0．05）화 WHR（β＝0．307，P ＜0．05）여혈청저항소수평유현저상관성（P ＜0．05）。결론노년2형당뇨병환자보편존재 IR 증상，합병 MS 적환자회동시출현혈청저항소수평화염성개질수평적현저승고，기혈청저항소수평여환자적IR 화복부비반적엄중정도구유상관성。
Objective To explore the relationship between fasting serum resistin level and insulin resistance (IR)in the elderly type 2 diabetic patients with metabolic syndrome (MS).Meth-ods 120 elderly patients with type 2 diabetes mellitus were selected and divided into the MS group (n =68)and the non-MS group (n =52).60 healthy elderly people were selected as the control group.Height,weight,waist circumference,hip circumference,systolic blood pressure,diastolic blood pressure,body mass index (BMI),waist hip ratio (WHR)were observed and recorded in all the groups.The serum resistin and high sensitive C reactive protein (hs-CRP)levels,and the levels of fasting blood glucose (FPG),total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),blood uric acid (BUA),fasting insulin (FINS),glycosylated hemoglobin (HbA1c)were detected and compared.Results The serum resistin level of the MS group was significantly higher than that of the non-MS group (P <0.05),and the level of the non-MS group was significantly higher than that of the control group (P <0.05).HOMA-IR of the MS group or the non-MS group was significantly higher than that of the control group (P <0.05).The serum hs-CRP level of the MS group was significantly higher than that of the non-MS group or the control group (P <0.05).The metabolic indexes of BMI,waist circumference,WHR,systolic pressure,diastolic pressure,TG level of the patients in the MS group were significantly higher than those of the non-MS group or the control group (P <0.05).The serum HDL-C level of the MS group was significantly lower than that of the non-MS group or the control group (P <0.05).FINS level of the MS group was significantly higher than that of the control group (P <0.05).Themultiple linear regression analysis on the patients in the MS group showed HOMA-IR (β=0.468,P <0.05)and WHR (β=0.307,P <0.05)were the related factors of the serum resistin level (P <0.05).Conclusion There are generally IR symp-toms in the elderly patients with type 2 diabetes mellitus.The patients complicated with MS have the significant increased serum resistin and inflammatory mediators levels at the same time.The serum resistin level is associated with severity of IR and abdominal obesity of the patients.