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目的探讨2型糖尿病及糖尿病大血管病变中血浆脂联素(adiponectin,APN)的变化及相关性。方法选取健康对照组42例(G1组),单纯2型糖尿病(T2DM)患者43例(G2组),2型糖尿病合并下肢动脉病变组39例(G3组)。对所有研究对象常规行空腹血糖(FPG)、高密度脂蛋白(HDL)、三酰甘油(TG)、糖化血红蛋白(HbA1c)、空腹C肽(C-P)、空腹胰岛素(FINS)和血浆APN水平测定,计算体质指数(BMI)及胰岛素敏感指数(ISI),并对各组间临床指标进行比较,对各指标与脂联素水平的相关性进行相关分析。结果2型糖尿病患者FPG,TG,HDL,FINS,BMI,C-P,APN和HbA1c水平明显高于对照组(P<0.05或P<0.01);APN,C-P水平及ISI值糖尿病合并大血管病变组明显低于单纯糖尿病组和对照组(P<0.01);2型糖尿病患者血浆APN水平与下肢血管病变、FPG,C-P,TG及BMI呈显著负相关,与HDL及ISI呈显著正相关。结论血浆APN在2型糖尿病患者中明显降低,合并大血管病变患者降低更明显,提示血浆APN水平降低可能是发生糖尿病及糖尿病大血管病变的一个独立危险因素。
Objective To investigate the changes and correlations of plasma adiponectin (APN) in type 2 diabetes mellitus and diabetic macroangiopathy. Methods Forty-two healthy controls (group G1), 43 patients with type 2 diabetes mellitus (Group G2), and 39 patients with type 2 diabetes mellitus (group G3) with arterial disease of the lower extremities. Fasting blood glucose (FPG), high density lipoprotein (HDL), triglyceride (TG), glycosylated hemoglobin (HbA1c), fasting plasma C peptide (CP), fasting insulin (FINS) and plasma APN levels were measured routinely in all the study subjects , Body mass index (BMI) and insulin sensitivity index (ISI) were calculated. The clinical indexes of each group were compared, and the correlation between each index and adiponectin level was analyzed. Results The levels of FPG, TG, HDL, FINS, BMI, CP, APN and HbA1c in patients with type 2 diabetes mellitus were significantly higher than those in controls (P <0.05 or P <0.01). The levels of APN, CP and ISI in diabetic patients with macrovascular complications were significantly (P <0.01). Plasma APN levels in type 2 diabetic patients were significantly negatively correlated with lower extremity vascular diseases, FPG, CP, TG and BMI, and positively correlated with HDL and ISI. Conclusion Plasma APN is significantly lower in patients with type 2 diabetes mellitus, with more significant reduction in patients with macrovascular complications, suggesting that plasma APN levels may be an independent risk factor for the occurrence of diabetes and diabetic macroangiopathy.