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目的测定肥胖及新诊断2型糖尿病患者血清apelin水平,探讨apelin与体脂、糖、脂代谢、胰岛素抵抗等的相关性。方法62例2型糖尿病患者和72例正常糖调节(NGR)者按体重指数(BMI)≥25 kg/m~2或<25 kg/m~2又各自分为超重/肥胖与正常体重亚组,采用放射免疫分析法检测空腹血清apelin水平,同时检测空腹血糖(FPG)、HbA_(1C)、血脂各项指标及空腹胰岛素(FINS)水平,计算BMI和腰臀比,并以稳态模型计算胰岛素抵抗指数(HOMA-IR)。结果校正年龄及性别后,2型糖尿病组血清apelin水平高于NGR组[(317.9±99.6 vs 279.0±66.8)ng/L,P<0.01],2型糖尿病组和NGR组中的超重/肥胖者均高于非肥胖者[(354.0±114.4 vs 274.1±53.0)ng/L,(299.2±74.5 vs 252.8±48.9)ng/L,均P<0.05],且2型糖尿病超重/肥胖组明显高于NGR肥胖组(P<0.01);偏相关分析显示,空腹血清apelin与BMI、ln (HOMA-IR)、FPG、总胆固醇(TC)呈正相关(r=0.353,r=0.355,r=0.224,r=0.241,均P<0.01),与腰围、收缩压呈正相关(r=0.263,r=0.183,P<0.05)。多元逐步回归分析发现,BMI、ln(HOMA-IR)和TC是血清apelin的独立相关因素。结论血清apelin水平在肥胖和初发的2型糖尿病人群中升高,且与BMI、HOMA-IR及脂代谢相关,推测apelin可能参与构成胰岛素抵抗综合征的病理生理基础。
Objective To determine the serum level of apelin in obese and newly diagnosed type 2 diabetic patients and to explore the correlation between apelin and body fat, sugar, lipid metabolism and insulin resistance. Methods Sixty-two patients with type 2 diabetes mellitus and 72 normal glucose regulators (NGR) were divided into overweight / obesity and normal weight subgroups according to body mass index (BMI) ≥25 kg / m ~ 2 or <25 kg / , Fasting serum apelin level was detected by radioimmunoassay, and fasting blood glucose (FPG), HbA_ (1C), blood lipid and fasting insulin (FINS) levels were measured at the same time. BMI and waist-hip ratio were calculated. Insulin resistance index (HOMA-IR). Results After adjusting for age and gender, serum apelin levels in type 2 diabetes mellitus group were significantly higher than those in NGR group [(317.9 ± 99.6 vs 279.0 ± 66.8) ng / L, P <0.01]. Patients with overweight / obesity in type 2 diabetes mellitus group and NGR group (354.0 ± 114.4 vs 274.1 ± 53.0) ng / L, (299.2 ± 74.5 vs 252.8 ± 48.9) ng / L, all P <0.05], and the type 2 diabetic overweight / obesity group was significantly higher than that of the non-obese group NGR group (P <0.01). Partial correlation analysis showed that fasting serum apelin was positively correlated with BMI, ln (HOMA-IR), FPG and total cholesterol (r = 0.353, r = 0.355, r = 0.224, r = 0.241, all P <0.01), and was positively correlated with waist circumference and systolic blood pressure (r = 0.263, r = 0.183, P <0.05). Multivariate stepwise regression analysis found that BMI, ln (HOMA-IR) and TC were independent correlates of serum apelin. Conclusions Serum apelin levels are elevated in obese and newly diagnosed type 2 diabetic patients and correlated with BMI, HOMA-IR and lipid metabolism. It is speculated that apelin may be involved in the pathophysiology of insulin resistance syndrome.