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目的:探讨2型糖尿病(T2D M)家系正常糖耐量一级亲属(简称一级亲属)血清脂联素水平的变化,研究脂联素与胰岛素抵抗(IR)的关系及其临床意义。方法:收集T2D M家系45个。在排除糖尿病和糖耐量减退的前提下,选择一级亲属为观察组(83例),先证者或其同胞的配偶为正常对照组(76例),检测所有受试者的空腹脂联素、血糖、胰岛素、胰岛素原、血脂水平。采用稳态模型法(H O M A)计算胰岛素抵抗指数(H O M A-IR)。结果:一级亲属组的脂联素显著低于正常对照组(P<0.01),H O M A-IR显著高于正常对照组(P<0.05)。相关分析显示脂联素与收缩压、舒张压、血糖、年龄、体重指数、H O M A-IR呈负相关(P<0.05或P<0.01)。多元线性逐步回归分析显示,脂联素是影响T2D M家系一级亲属IR的独立危险因素。结论:T2D M家系一级亲属在未发生糖尿病时已存在IR、低脂联素血症,脂联素可能影响T2D M家系一级亲属IR的程度。
Objective: To investigate the changes of serum adiponectin levels in type 2 diabetes mellitus (T2DM) normal first-degree relatives (first-degree relatives) and to investigate the relationship between adiponectin and insulin resistance (IR) and its clinical significance. Methods: Forty-five T2D M families were collected. On the premise of eliminating diabetes and impaired glucose tolerance, the first-degree relatives were selected as the observation group (83 cases), the spouse of the proband or his sibling as the normal control group (76 cases), all subjects were tested for fasting adiponectin , Blood sugar, insulin, proinsulin, blood lipid levels. Insulin resistance index (H O M A-IR) was calculated using the steady-state model (H O M A). Results: Adiponectin in first-degree relatives was significantly lower than that in normal controls (P <0.01), and HOMA-IR was significantly higher than that in normal controls (P <0.05). Correlation analysis showed that adiponectin was negatively correlated with systolic blood pressure, diastolic blood pressure, blood glucose, age, body mass index and HOMA-IR (P <0.05 or P <0.01). Multivariate linear stepwise regression analysis showed that adiponectin was an independent risk factor affecting IR of T2D M family first-degree relatives. Conclusion: The first degree relatives of T2D M family had IR and low adiponectin in the absence of diabetes, and the level of IR may be affected by adiponectin in first degree relatives of T2D M family.