【摘要】  目的   探讨血清Chemerin与T2DM合并大血管病变患者体脂参数、糖脂代谢的关系。  方法   （1）新诊断T2DM患者80例按照有无下肢血管病变分为单纯T2DM组及T2DM合并下肢血管病变组，其中，T2DM合并下肢血管病变组再分为轻度亚组、中度亚组和重度亚组；另选取健康体检者（NGT）20名。ELISA检测各组血清Chemerin浓度、糖脂代谢参数和FIns等指标，稳态模型评估胰岛素抵抗指数(HOMA-IR)，计算BMI和腰身比(WSR)。（2）将研究对象分为WSR≤0.55组和WSR＞0.55组，比较两组Chemerin水平。   结果   T2DM合并下肢管病变中、重度亚组BMI、WSR、2 hPG、TG、Chemerin水平高于NGT组；重度亚组FPG、2 hPG、HbA₁c、HOMA-IR、TG高于中度亚组（P＜0.05）。WSR＞0.55组血清Chemerin水平高于WSR≤0.55组（P＜0.05)。血清Chemerin水平与BMI、WSR、FPG、2 hPG、HbA₁c、HOMA-IR和TG呈正相关（r=0.386、0.393、 0.298、0.388、0.387、0.391、0.175，P＜0.05)；与HDL-C呈负相关（r=-0.386，P＜0.05)；Logistic回归分析显示，BMI和下肢血管病变积分是血清Chemerin的独立影响因素（P＜0.05)，BMI、WSR、TG和Chemerin是下肢血管病变的独立影响因素（P＜0.05)。  结论  T2DM患者血清Chemerin水平升高，与IR、体脂分布、糖脂代谢相关，且随着T2DM大血管病变程度的加重，Chemerin水平逐渐升高。

【关键词】糖尿病，2型；大血管病变；Chemerin；腰身比

Correlation between serum chemerin levels and waist-to-stature ratio in type 2 diabetes with macroangiopathy  YANG Bo,YANG Meng-xue, GAO Lin ,et al. Department of Endocrinology, Affiliated Hospital of Zunyi Medical College, Zunyi 563003,China

Corresponding author：YANG Meng-xue，E-mail：yangmengxue01@126.com

【Abstract】  Objective  To investigate the correlation between serum chemerin level and body fat parameters and glucolipid metabolism in type 2 diabetes with macroangiopathy.  Methods Subjects with normal glucose tolerance (NGT) and patients with newly diagnosed T2DM were recruited and divided into three groups: NGT group, simple T2DM group, and T2DM combined with lower extremity macroangiopathy group. T2DM combined with lower extremity macroangiopathy group were further divided into three subgroups:  mild, moderate and severe lower extremity macroangiopathy. Serum chemerin concentration, glucolipid metabolic parameters, and fasting insulin levels were measured by enzyme-linked immunosorbent assays. HOMA-IR, body mass index (BMI), and waist-to-stature ratio (WSR) were also calculated.   Results  All the subjects were divided into two groups according to their WSR levels: WSR≤0.55 group and WSR＞0.55 group. Serum chemerin level was higher in WSR＞0.55 group than in WSR≤0.55 group（P＜0.05). BMI, WSR, 2 hPG, TG, and chemerin level were higher in severe lower extremity macroangiopathy subgroup than in NGT group (P<0.05). FPG, 2 hPG, HbA₁c, HOMA-IR, TG were higher in severe lower extremity macroangiopathy subgroup than in moderate lower extremity macroangiopathy subgroup (P<0.05). A positive correlation was found between serum chemerin level and BMI, WSR, FPG, 2 hPG, HbA₁c, HOMA-IR and TG (r=0.386,0.393,0.298,0.388,0.387,0.391,0.175，P＜0.05), while a negative correlation was found between serum chemerin level and HDL-C (r=-0.386，P＜0.05). Logisitc regression analysis showed that BMI and integration of lower extremity disease were independent factors for serum chemerin (P＜0.05).BMI, WSR, TG and serum chemerin were independent risk factors for the integral of lower extremity disease （P＜0.05) .  Conclusion   Serum chemerin level increased in T2DM patients and was associated with IR, body fat distribution, and glucolipid metabolism. serum chemerin increased with the severity of lower extremity macroangiopathy.

【Key Words】  Diabetes mellitus，type 2; Macroangiopathy; Chemerin ; Waist-to-Stature Ratio(WSR)