CAJ | 학술논문

目的：探讨2型糖尿病（T2MD）患者血清中脂肪因子血管生成素样蛋白4（ANGPTL4）与糖脂代谢、体脂参数及胰岛素抵抗水平的关系。方法2012年1月至2014年1月收集120例新确诊为 T2MD的患者为T2DM 组，120例糖调节正常（NGR）的健康体检者为NGR组，并根据体质量指数（BMI）是否大于或等于25 kg／m2分为T2MD体质量正常组（NW‐T2MD）52例、T2MD超重或肥胖组（OW／OB‐T2MD）68例；糖调节正常体质量正常组（NW‐NGR）57例、糖调节正常体质量超重／肥胖组（OW／OB‐NGR）63例，测定各组血清ANGPTL4水平、糖脂代谢参数及空腹胰岛素水平，并计算各组BMI、腰臀比及胰岛素抵抗指数（HOMA‐IR）。结果 T2MD组血清AN‐GPTL4水平（25．84±4．28）ng／mL 明显低于 NGR组的（32．82±3．72）ng／mL ，差异有统计学意义（P＜0．05）。OW／OB‐T2MD组血清ANGPTL4水平明显低于NW‐T2MD组，而OW／OB‐NGR组血清ANGPTL4水平明显低于NW‐NGR组，差异有统计学意义（P＜0．05）。血清ANGPTL4与空腹血糖（FPG）、餐后2 h血糖（2 h PPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（ISN）、HOMA‐IR、BMI、腰臀比、三酰甘油（TG）呈负相关（P＜0．05），而与高密度脂蛋白胆固醇呈正相关（P＜0．05）。经 Logistic多因素回归分析显示，HbA1c、ISN、HOMA‐IR、TG是血清 AN‐GPTL4独立危险因素。结论 T2MD患者血清ANGPTL4水平明显低于健康人群，其与糖脂代谢、胰岛素水平及体脂参数具有密切的关系，提示ANGPTL4可能在糖脂代谢异常疾病及肥胖发病机制中起到重要的作用。
목적：탐토2형당뇨병（T2MD）환자혈청중지방인자혈관생성소양단백4（ANGPTL4）여당지대사、체지삼수급이도소저항수평적관계。방법2012년1월지2014년1월수집120례신학진위 T2MD적환자위T2DM 조，120례당조절정상（NGR）적건강체검자위NGR조，병근거체질량지수（BMI）시부대우혹등우25 kg／m2분위T2MD체질량정상조（NW‐T2MD）52례、T2MD초중혹비반조（OW／OB‐T2MD）68례；당조절정상체질량정상조（NW‐NGR）57례、당조절정상체질량초중／비반조（OW／OB‐NGR）63례，측정각조혈청ANGPTL4수평、당지대사삼수급공복이도소수평，병계산각조BMI、요둔비급이도소저항지수（HOMA‐IR）。결과 T2MD조혈청AN‐GPTL4수평（25．84±4．28）ng／mL 명현저우 NGR조적（32．82±3．72）ng／mL ，차이유통계학의의（P＜0．05）。OW／OB‐T2MD조혈청ANGPTL4수평명현저우NW‐T2MD조，이OW／OB‐NGR조혈청ANGPTL4수평명현저우NW‐NGR조，차이유통계학의의（P＜0．05）。혈청ANGPTL4여공복혈당（FPG）、찬후2 h혈당（2 h PPG）、당화혈홍단백（HbA1c）、공복이도소（ISN）、HOMA‐IR、BMI、요둔비、삼선감유（TG）정부상관（P＜0．05），이여고밀도지단백담고순정정상관（P＜0．05）。경 Logistic다인소회귀분석현시，HbA1c、ISN、HOMA‐IR、TG시혈청 AN‐GPTL4독립위험인소。결론 T2MD환자혈청ANGPTL4수평명현저우건강인군，기여당지대사、이도소수평급체지삼수구유밀절적관계，제시ANGPTL4가능재당지대사이상질병급비반발병궤제중기도중요적작용。
Objective To investigate the relationships between the levels of adipokine angiopoietin‐like protein 4 (ANGPTL4) and lipid metabolism ,body fat and insulin resistance in patients with type 2 diabetes (T2MD) .Meth‐ods A total of 120 patients diagnosed as T2MD and 120 person with normal glucose regulation (NGR) were collect‐ed from January 2012 to January 2014 .Groups were divided as T2MD normal weight (NW‐T2MD ,n=52) group , T2MD over weight or obese (OW/OB‐T2MD ,n= 68) group ,normal glucose regulation in normal weight (NW‐NGR ,n=57) group ,normal glucose regulation in overweight/obese (OW/OB‐NGR ,n=63) group according to body mass index The levels of ANGPTL4 ,fasting insulin and glucose ,lipid metabolism parameters were detected .The BMI ,waist hip ratio and insulin resistance index (HOMA‐IR) were calculated .Results The ANGPTL4 level of T2MD group and NGR group were (25 .84 ± 4 .28) ng/mL and (32 .82 ± 3 .72) ng/mL ,the difference was statistical‐ly significant (P<0 .05) .The levels of ANGPTL4 in OW/OB‐T2MD group were lower than the NW‐T2MD group , while the level of ANGPTL4 of OW/OB‐NGR were lower than that in the NW‐NGR group(P<0 .05) .The fasting glucose (FPG) ,2 h postprandial blood glucose (2 h PPG) ,glycated hemoglobin (HbA1c) ,fasting insulin (ISN) , HOMA‐IR ,BMI ,waist‐hip ratio ,triglyceride (TG) were negatively correlated with ANGPTL 4 (P<0 .05) ,and the high‐density protein (HDL‐C) were positively correlated with ANGPTL 4(P<0 .05) .The HbA1c ,ISN ,HOMA‐IR , TG were the risk factor of ANGPTL4 .Conclusion Serum ANGPTL4 level in T2MD patients were significant lower than that of the normal population ,which has a close relationship with glucose and lipid metabolism ,insulin levels and body fat parameters ,which prompts ANGPTL4 might play an important role in glucose and lipid metabolism disor‐ders and obesity pathogenesis .