CAJ | 학술논문

目的：检测肥胖及2型糖尿病患者血清视黄醇结合蛋白（RBP4）、脂联素及肿瘤坏死因子α（TNF-α）水平变化，探讨三者的相关性。方法选择135例上海地区中国人，分为正常糖调节正常体质量（NBM-NGR）组、正常糖调节超重/肥胖（OW/OB-NGR）组、2型糖尿病正常体质量（NBM-T2DM）组及2型糖尿病伴超重/肥胖（OW/OB-T2DM）组，测定体脂、生化指标及RBP4、脂联素及TNF-α水平。结果 T2DM各亚组及OW/OB-NGR组RBP4均显著高于NBM-NGR组， OW/OB-T2DM组RBP4显著高于NBM-T2DM组；T2DM各亚组及OW/OB-NGR组脂联素均显著低于NBM-NGR组；T2DM各亚组TNF-α均显著高于NBM-NGR组及OW/OB-NGR组。Spearman相关分析显示，RBP4与脂联素呈负相关，与TNF-α呈正相关，TNF-α与脂联素呈负相关（P＜0.05或0.01）。多元逐步回归分析显示，甘油三酯及腰臀比（WHR）是血清RBP4的独立相关因素；性别、甘油三酯、糖化血红蛋白（HbA1c）及高密度脂蛋白是血清脂联素的独立相关因素；HbA1c是血清TNF-α的独立相关因素。结论 RBP4与腹内型肥胖的关系更为密切，而与血糖不相关；脂联素、TNF-α主要与糖代谢相关；RBP4与脂联素及TNF-α均相关。
목적：검측비반급2형당뇨병환자혈청시황순결합단백（RBP4）、지련소급종류배사인자α（TNF-α）수평변화，탐토삼자적상관성。방법선택135례상해지구중국인，분위정상당조절정상체질량（NBM-NGR）조、정상당조절초중/비반（OW/OB-NGR）조、2형당뇨병정상체질량（NBM-T2DM）조급2형당뇨병반초중/비반（OW/OB-T2DM）조，측정체지、생화지표급RBP4、지련소급TNF-α수평。결과 T2DM각아조급OW/OB-NGR조RBP4균현저고우NBM-NGR조， OW/OB-T2DM조RBP4현저고우NBM-T2DM조；T2DM각아조급OW/OB-NGR조지련소균현저저우NBM-NGR조；T2DM각아조TNF-α균현저고우NBM-NGR조급OW/OB-NGR조。Spearman상관분석현시，RBP4여지련소정부상관，여TNF-α정정상관，TNF-α여지련소정부상관（P＜0.05혹0.01）。다원축보회귀분석현시，감유삼지급요둔비（WHR）시혈청RBP4적독립상관인소；성별、감유삼지、당화혈홍단백（HbA1c）급고밀도지단백시혈청지련소적독립상관인소；HbA1c시혈청TNF-α적독립상관인소。결론 RBP4여복내형비반적관계경위밀절，이여혈당불상관；지련소、TNF-α주요여당대사상관；RBP4여지련소급TNF-α균상관。
Objective To detect the serum levels of retinol binding protein 4 (RBP4), adiponectin and tumor necrosis factor-alpha (TNF-α) in the patients with obesity and type 2 diabetes mellitus (T2DM), and to explore their correlations. Methods A total of 135 Chinese individuals living in Shanghai area were divided into the subjects with normal glucose regulation and normal body mass (NBM-NGR), overweight or obese subjects with normal glucose regulation (OW/OB-NGR), T2DM with normal body mass (NBM-T2DM) and T2DM with overweight or obesity (OW/OB-T2DM). The body fat, biochemical indices and the serum levels of RBP4, adiponectin and TNF-αwere determined. Results Serum RBP4 levels were significantly higher in the subjects with T2DM and OW/OB-NGR than in those with NBM-NGR, and also in those with OW/OB-T2DM than in those with NBM-T2DM. Serum adiponectin levels were significantly lower in those with T2DM and OW/OB-NGR than in those of NBM-NGR. Serum TNF-αlevels were significantly higher in those with T2DM than in those with NBM-NGR and OW/OB-NGR (P<0.05 or 0.01). Spearman analysis indicated that RBP4 was negatively correlated to adiponectin but positively to TNF-α, and TNF-αhad a negative correlation with adiponectin (P<0.05 or 0.01). Multiple stepwise regression analysis showed that triglycerides (TG) and waist-hip ratio (WHR) were the independent risk factors for RBP4. TG, sex, hemoglobin A1c (HbA1c) and high density lipid protein-cholesterol (HDL-C) were the independent risk factors for adiponectin. HbA1c was the independent risk factor for TNF-α. Conclusion RBP4 is closely associated with abdominal obesity, but has no correlation with blood glucose. Adiponectin and TNF-αare mainly related to glucose metabolism. RBP4 is related with adiponectin and TNF-α.