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目的探讨2型糖尿病(T2DM)患者血清内脏脂肪素(visfatin)与糖脂代谢、肿瘤坏死因子-α(TNF-α)及血管内皮功能的关系。方法选择59例T2DM患者作为T2DM组及23例健康体检者作为对照组,采用酶联免疫吸附法检测空腹血清visfatin和TNF-α水平,同时测定糖脂代谢指标,并测定部分T2DM患者(26例)及对照组(15例)内皮依赖性舒张功能(FMD),计算体质指数(BMI)、腰臀比(WHR)、稳态模型胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)。结果对照组visfatin和TNF-α水平分别为(18.99±8.19)μg/L和(21.80±6.86)ng/L,T2DM组分别为(34.80±9.37)μg/L和(33.57±10.15)ng/L。与对照组比较,T2DM组visfatin、TNF-α明显升高,FMD明显下降,差异均有统计学意义(P<0.05),其血清visfatin水平与BMI、WHR、log10空腹胰岛素(FINS)、log10HOMA-IR、TNF-α呈正相关(r值分别为0.643、0.389、0.532、0.546、0.666,P<0.01),与FMD呈负相关(r=-0.505,P<0.01)。结论 2型糖尿病患者血清visfatin水平升高,可能与肥胖、胰岛素抵抗、炎症反应、血管内皮功能受损有关。
Objective To investigate the relationship between serum visfatin and glucose and lipid metabolism, tumor necrosis factor-α (TNF-α) and vascular endothelial function in patients with type 2 diabetes mellitus (T2DM). Methods Fifty-two T2DM patients were selected as T2DM group and 23 healthy volunteers as control group. Fasting serum visfatin and TNF-α levels were measured by enzyme-linked immunosorbent assay (ELISA) and glucose and lipid metabolism parameters were measured. Some T2DM patients (26 patients (BMI), waist-to-hip ratio (WHR), homeostasis model insulin resistance index (HOMA-IR) and islet β-cell function index (HOMA) -β). Results The levels of visfatin and TNF-α in the control group were (18.99 ± 8.19) μg / L and (21.80 ± 6.86) ng / L respectively, while those in the T2DM group were (34.80 ± 9.37) μg / L and (33.57 ± 10.15) ng / L . The levels of visfatin and TNF-α in T2DM group were significantly higher than those in control group (P <0.05). The levels of visfatin in serum of T2DM group were significantly lower than those in BMI, WHR, FINS and log10HOMA- IR and TNF-α (r = 0.643,0.389,0.532,0.546,0.666, P <0.01), but negatively correlated with FMD (r = -0.505, P <0.01). Conclusions Serum visfatin levels in patients with type 2 diabetes may be related to obesity, insulin resistance, inflammatory reaction and impaired vascular endothelial function.