·胰岛素抵抗及其相关疾病·

　　解婧 蒋志华 成兴波

　　作者单位：215006苏州大学附属第一医院内分泌科(解婧、成兴波);苏州金闾医院(蒋志华)

　　通讯作者：蒋志华

　　【摘要】目的探讨T2DM患者血清锌α2糖蛋白(ZAG)的水平与胰岛素抵抗(IR)的相关性，探索其潜在的作为肥胖或代谢综合征血清指标的可能性。方法166名受试者分为T2DM组和正常糖耐量(NGT)组,根据BMI又分为正常体重组(NW)和超重肥胖组(OW-OB)两个亚组,均测定空腹血清ZAG水平和相关临床指标。结果T2DM组比NGT组空腹血清ZAG水平明显升高(t=2.228，P=0.028)。T2DM组患者空腹血清ZAG水平分别与HOMA-IR,WC,HbA1c,TG正相关(r分别为0.543, 0.442, 0.385, 0.437,P<0.05)，与HDL-C,TNF-a负相关(r分别为-0.447,-0.501,P<0.05)。多元逐步线性回归显示在T2DM组，WC和HDL-C是其的独立影响因素。结论T2DM患者血清ZAG显著高于NGT患者，超重肥胖和正常体重亚组间差异无统计学意义。T2DM组中ZAG与HOMA-IR， WC，HbA1c，TG正相关，与HDL-C，TNF-α负相关;其中WC和HDL-C是血清ZAG的独立影响因素。

　　【关键词】Zinc-α2-glycoprotein;胰岛素抵抗;肥胖;糖尿病，2型

　　doi:10.3969/j.issn.1006-6187.2012.02.004

　　Changes of serum ZAG(Zinc-α2-glycoprotein) level and its relative factors in type 2 diabetic patientsXIE Jing，JIANG Zhi-hua, CHENG Xing-bo. Department of Endocrinology & Metabolism, the First Affiliated Hospital of Suchow University, Suzhou 215006, China

　　Correspoding author: JIANG Zhi-hua

　　【Abstract】ObjectiveTo investigate the changes of serum ZAG level and its relative factors in type 2 diabetes mellitus. Methods56 healthy participants with normal glucose tolerance (NGT) and 110 cases with T2DM were divided into two subgroups: normal weight and overweight-obese group. Fasting serum ZAG level and related clinical variables were detected. And HOMA-IR was calculated. ResultsThe serum level of ZAG was higher in T2DM than in NGT (t=2.228,P=0.028). Partial correlation analysis showed that ZAG was positively correlated with HOMA-IR , WC , HbA1c and TG in T2DM group (r=0.543, 0.442,0.385,0.437,P<0.05 respectively). negatively correlated with HDL-C and TNF-a (r=-0.447, r=-0.501,P<0.05 respectively). Multiple stepwise linear regression model revealed that WC (r=0.361, P=0.023) and HDL-C (r=-0.377, P=0.018) were significant determinants of serum ZAG levels in T2DM group. ConclusionSerum level of ZAG is higher in T2DM than in NGT, and there is no significant difference in ZAG level between OW-OB versus normal weight in T2DM, ZAG level is positively correlated with HOMA-IR, WC, HbA1c and TG, and negatively correlated with HDL-C and TNF-α, among which WC and HDL-C are the independent influencing factors.

　　【Key words】Zinc-α2-glycoprotein; Insulin resistance; Diabetes mellitus, type 2