·糖尿病与肥胖、脂代谢异常·

　　【摘要】 目的 探讨T2DM患者血清富含半胱氨酸的酸性分泌蛋白(SPARC)与血脂的关系。 方法 选取T2DM合并血脂异常组(T2DM+血脂异常)42例，单纯T2DM(T2DM)组40例，单纯血脂异常组42例及正常对照(NC)组38名，采用ELISA测定各组血清SPARC浓度，并分析其与BMI、WHR、HbA1c、血脂和胰岛素抵抗指数(HOMA-IR)等的关系。 结果 T2DM+血脂异常组、T2DM组、单纯血脂异常组血清SPARC水平均高于NC组[(5.43±1.32) vs (4.57±1.62) vs (3.23±0.65) vs (2.93±0.53) μg/L， P<0.05]。Pearson相关分析显示，SPARC与BMI、WHR、FIns、TG、HbA1c、HOMA-IR呈正相关(P均<0.05),与FPG、TC、HDL-C、LDL-C无相关性(P>0.05)。Logistic回归分析显示，TG、HOMA-IR是血清SPARC的独立影响因素。 结论 T2DM合并血脂异常患者SPARC水平升高，其与糖尿病患者TG、HOMA-IR相关。

　　【关键词】 SPARC;胰岛素抵抗;血脂;糖尿病，2型

　　【Abstract】Objective To study the relationship of the serum secreted protein acidic and rich in cysteine(SPARC)and blood lipid in type2 diabetes mellitus(T2DM) patients. Methods A total of 155 subjects were divided into four groups: T2DM with dyslipidemia group (n=42),T2DMgroup(n=40), dyslipidemia group (n=35) and normal control group(n=38).Serum SPARC level was measured using ELISA. The relationships of serum SPARC with BMI, WHR, HbA1c,blood lipids and other factors were also assessed. Results The level of serum SPARC was significantly higher in T2DM group ,dyslipidemia group and T2DM with dyslipidemia group than in normal control group[(5.43±1.32)vs(4.57±1.62)vs(3.23±0.65)vs(2.93±0.53)μg/L，P<0.05].Pearson correlation analysis showed that SPARC level was positively correlated with BMI, WHR, fasting serum insulin(FIns), triglyceride (TG), HbA1c、HOMA-IR (P<0.05).However there were no correlations of serum SPARC with fasting plasma glucose(FPG),total cholesterol(TC), High density lipoprotein-cholestel(HDL-C),Low density lipoprotein-cholestel(LDL-C)(P>0.05). Multivariate regression analysis showed that TG and HOMA-IR were independentfactors influencing plasma SPARC level.Conclusion The level of serum SPARC in 2 diabetes mellitus with dyslipidemia is increased obviously,and is correlated with the levels of serum TG and HOMA-IR.

　　【Key words】 Secreted protein acidic and rich in cysteine;Insulin resistance ;Blood lipid ; diabetes mellitus, type 2