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目的探讨肥胖及非肥胖2型糖尿病(T2DM)患者胰岛素抵抗(IR)与生长激素释放肽Gh-relin分泌的关系。方法肥胖T2DM患者26例(Ob+T2DM组)及非肥胖T2DM患者32例(NOb+T2DM组),正常对照30名(NC组)行胰升血糖素-C-P释放试验,同步取血测定血浆Ghrelin和C-P。结果 (1)Ob+T2DM组空腹Ghrelin水平低于NC组和NOb+T2DM组(P<0.05或P<0.01);Ob+T2DM组FC-P及胰岛素抵抗指数(HOMA2-IR)高于NC组和NOb+T2DM组(P<0.01或P<0.05)。静脉推注胰升血糖素后,NC组Ghrelin水平显著下降(P<0.01),肥胖及非肥胖T2DM组Ghrelin水平无显著性改变。(2)Pearson相关分析显示空腹血浆Ghrelin水平分别与WC、BMI、体脂百分比、体脂重量呈负相关;多元回归分析显示腰围(WC)是Ghrelin水平的负性预测因子(回归方程Y=4.814 0.0265X)。(3)Ob+T2DM组中,空腹血浆Ghrelin水平分别与WC、BMI、体脂百分比、体脂重量、HOMA2-IR呈负相关。结论外源性给予胰升血糖素对T2DM患者Ghrelin抑制效应减弱;肥胖T2DM患者血浆Ghre-lin水平较非肥胖患者明显降低,且与WC、BMI、体脂百分比、体脂重量、HOMA2-IR负相关;中心性肥胖T2DM患者血浆Ghrelin水平下降与IR有关。
Objective To investigate the relationship between insulin resistance (IR) and gh-relin secretion in obese and non-obese type 2 diabetic patients (T2DM). Methods Twenty-six obese T2DM patients (Ob + T2DM group) and 32 non-obese T2DM patients (NOb + T2DM group) and 30 normal control subjects (NC group) underwent glucagon-CP release test. Plasma Ghrelin And CP. Results (1) The level of fasting Ghrelin in Ob + T2DM group was lower than that in NC group and NOb + T2DM group (P <0.05 or P <0.01), and the levels of FC-P and HOMA2-IR in Ob + T2DM group were higher than those in NC group And NOb + T2DM group (P <0.01 or P <0.05). After intravenous injection of glucagon, the levels of Ghrelin in NC group were significantly decreased (P <0.01), while there was no significant difference in Ghrelin levels between obese and non-obese T2DM groups. (2) Pearson correlation analysis showed that fasting plasma Ghrelin levels were negatively correlated with WC, BMI, body fat percentage and body fat weight respectively. Multiple regression analysis showed that waist circumference (WC) was a negative predictor of Ghrelin level (regression equation Y = 4.814 0.0265X). (3) In Ob + T2DM group, fasting plasma Ghrelin level was negatively correlated with WC, BMI, body fat percentage, body fat weight and HOMA2-IR. Conclusions Ghrelin is attenuated by exogenous administration of glucagon in T2DM patients. The level of plasma Ghrelin in obese T2DM patients is significantly lower than that in non-obese patients, and negatively correlated with WC, BMI, body fat percentage, body fat weight and HOMA2-IR Related; central obesity T2DM patients with plasma Ghrelin levels decline and IR.