不同糖代谢状态人群血清CTRP3和25(OH) D水平及其与胰岛素抵抗的关系

doi:10.13481/j.1671-587x.20190425

摘要/Abstract

摘要： 目的：测定不同糖代谢状态人群血清中C1q/肿瘤坏死因子相关蛋白3（CTRP3）和25羟维生素D[25（OH）D]的水平，探讨其影响因素并分析其与胰岛素抵抗（IR）的关系。方法：选择初诊2型糖尿病（T2DM）患者44例（T2DM组）、糖耐量减低（IGT）患者42例（IGT组）和体检健康者54人（正常对照组），测定各组受试者血清中CTRP3、空腹静脉血糖（FPG）、糖化血红蛋白（HbA1c）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹胰岛素（FIns）和25（OH）D水平，计算体质量指数（BMI）、稳态模型IR指数（HOMA-IR）、稳态模型胰岛素分泌指数（HOMA-β），两因素之间相关性分析采用Pearson相关分析法，采用多元逐步回归分析法分析HOMA-IR和HOMA-β的影响因素。结果：与正常对照组比较，IGT组患者血清中HDL-C、25（OH）D水平和HOMA-β值明显降低（P<0.05），T2DM组患者血清中FPG、HbA1c、TG、TC、FIns水平和BMI、HOMA-IR值明显升高（P<0.05），而血清中CTRP3、HDL-C、25（OH）D水平和HOMA-β值明显降低（P<0.05）；与IGT组比较，T2DM组患者血清中FPG、HbA1c、TG、FIns水平和HOMA-IR值明显升高（P<0.05），血清中HDL-C水平和HOMA-β值明显降低（P<0.05）。不同糖代谢状态人群血清中CTRP3水平与HbA1c、FIns水平和HOMA-IR呈负相关关系（r=-0.391，P<0.05；r=-0.198，P<0.05；r=-0.481，P<0.05）；25（OH）D水平与TG、FPG和HOMA-IR呈负相关关系（r=-0.209，P<0.05；r=-0.406，P<0.05；r=-0.306，P<0.05），与HOMA-β呈正相关关系（r=0.329，P<0.05）。HbA1c和CTRP3为HOMA-IR的独立影响因素，25（OH）D、FPG和HbA1c为HOMA-β的独立影响因素。结论：血清CTRP3和25（OH）D水平与IR呈负相关关系，在糖尿病发生发展过程中起抑制作用。

关键词: 葡萄糖代谢, C1q/肿瘤坏死因子相关蛋白3, 25羟维生素D, 胰岛素抵抗

Abstract: Objective:To detect the serum levels of CTRP3 and 25(OH) D in the individuals with different glucose metablism states,and to discuss the influence factors and analyze their relationships with insulin resistance(IR). Methods:Forty-four patients newly diagnosed T2DM(T2DM group),42 patients with impaired glucose regulation(IGT group),and 54 cases of normal controls(normal control group) were selected.The serum CTRP3, FPG,HbA1c,FIns,TG,TC,HDL-C, LDL-C,FIns of the subjects in various groups were determined, respectively;the BMI,HOMA-IR,HOMA-β were calculated.Pearson correlation analysis was used to analyze the correlation between two factors and multivariate stepwise regression analysis was used to analyze the influencing factors of HOMA-IR and HOMA-β. Results:Compared with normal control group, the serum levels of HDL-C, 25(OH)D and HOMA-β of the patients in IGT group were significantly decreased (P<0.05); the levels of serum FPG, HbA1c, TG, TC, FIns and BMI, HOMA-IR of the patients in T2DM group were significantly increased (P<0.05), while the levels of serum CTRP3, HDL-C, 25(OH)D and HOMA-β were significantly decreased(P<0.05). Compared with IGT group, the levels of serum FPG, HbA1c, TG, FIns, and HOMA-IR of the patients in T2DM group were significantly increased (P<0.05), and the level of serum HDL-C and HOMA-β were significantly decreased (P<0.05).The serum CTRP3 level was negatively correlated with the levels of HbA1c, FIns and HOMA-IR (r=-0.391, P<0.05; r=-0.198, P<0.05; r=-0.481, P<0.05); the 25(OH)D level was negatively correlated with the TG, FPG levels and HOMA-IR (r=-0.209, P<0.05; r=-0.406, P<0.05; r=-0.306, P<0.05), and positively correlated with HOMA-β (r=0.329, P<0.05) in the different glucose tolerance individuals. HbA1c and CTRP3 were the independent influencing factors of HOMA-IR, and 25(OH)D, FPG and HbA1c were the independent influencing factors of HOMA-β. Conclusion:The serum CTRP3 and 25(OH)D levels are negatively correlated with IR,and they have the inhibitory effects in the occurrence and development of diabetes mellitns.

Key words: glucose metabolism, C1q/TNF related protein 3, 25 hydroxy vitamin D, insulin resistance

中图分类号:

R587.2

廖鑫, 邓凡曲, 宋美潓, 高琳, 张晗, 张琳, 王雪梅, 章莹, 赵宇. 不同糖代谢状态人群血清CTRP3和25(OH) D水平及其与胰岛素抵抗的关系[J]. 吉林大学学报(医学版), 2019, 45(04): 887-892.

LIAO Xin, DENG Fanqu, SONG Meihui, GAO Lin, ZHANG Han, ZHANG Lin, WANG Xuemei, ZHANG Ying, ZHAO Yu. Relationship between serum levels of CTRP3, 25(OH)D and insulin resistance in individuals with different glucose metabolism states[J]. Journal of Jilin University(Medicine Edition), 2019, 45(04): 887-892.

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