·胰岛素抵抗及其相关疾病·

　　【摘要】 目的 比较不同糖耐量状态下的血清脂联素(APN)水平及与其相关的影响因素。方法 选取糖耐量正常(NGT组)者403名、糖调节异常(IGR组)者454例及新诊断T2DM患者(T2DM)366例。测其空腹状态下APN、FBG、FIns及血脂水平。 结果 不同糖耐量状态下，女性血清APN水平均高于男性(P<0.01)。T2DM组与IGR组FBG、FIns、TG及LDL-C水平均高于NGT组，血清APN和HDL-C水平下降(P均<0.05)。T2DM组与IGR组比较，T2DM组TG水平升高， HDL-C水平下降，血清APN水平较IGR组高(P均<0.05)，两组的FIns水平及LDL-C水平比较差异无统计学意义。性别、BMI、FIns、TG及HDL-C水平是血清APN的独立相关因素(P<0.05)。 结论 血清APN水平在糖尿病前期阶段即呈下降趋势，且与肥胖、血脂异常和IR有关，血清APN水平的测定有助于T2DM的早期预测，及时检查和诊断。

　　【关键词】2型糖尿病;糖调节异常;脂联素;胰岛素抵抗

Study on the adiponectin levels in different glucose intolerance statuses and their related factors ZHANG Xiu-ying, ZHOU XIANG-hai, LUO Ying-ying, et al. Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing 100044, China

Corresponding author: JI Li-nong, E-mail: jiln@bjmu.edu.cn

　　【Abstract】 Objective To compare the adiponectin (APN)levels in different glucose intolerance statuses and study on their related factors. Methods Those people with normal glucose tolerance (NGT, n = 403), those subjects with impaired glucose regulation (IGR, n = 454), and those patients newly diagnosed type 2 diabetes (T2DM, n = 366) were involved in this study. The levels of APN, FBG, FIns, and blood lipid in a fasting condition of all participants were measured for observation. Results The fasting serum APN level in women was significantly higher than in men in different glucose tolerance statuses (P<0.01). Compared with the NGT group, the levels of FBG，FIns, TG, and LDL-C were significantly higher in newly diagnosed T2DM and IGR patients, whereas their HDL-C and APN levels were significantly decreased (all P<0.05). Compared with the IGT group, the level of TG in the newly diagnosed T2DM patients was increased, the level of HDL-C was decreased, and the level of APN was higher (all P<0.05). There were no significant differences in FIns and LDL-C levels between participants in the T2DM and IGR groups. The gender and the BMI, FIns, TG, and HDL-C levels were all independent relevant factors of circulating APN concentrations (P<0.05). Conclusions The serum ANP level shows a downward trend early in the pre-diabetes stage. It is associated with obesity, dyslipidemia, and insulin resistance. Determination of serum APN levels might contribute to the early prediction and diagnosis of T2DM.

　　【Key words】 Diabetes mellitus, type 2; Impaired glucose regulation; Adiponectin; Insulin resistance