不同糖耐量个体血浆Apelin、Visfatin的水平改变及其影响因素

Changes in plasma Apelin and Visfatin levels and relevant factors in the population with different glucose tolerance

摘要:

目的：探讨不同糖耐量人群血浆Apelin、Visfatin水平变化及其与体质指数（body mass index，BMI）、腰臀比（waist hip ratio，WHR）、血糖、血浆胰岛素水平等的关系。方法：采用酶联免疫法测定了2型糖尿病（type 2 diabetes mellitus，T2DM）糖耐量减低患者（impaired glucose tolerance，IGT）和正常健康人空腹血浆Apelin和Visfatin水平，并分析了血浆Apelin、Visfatin与BMI、WHR、胰岛素抵抗指数、血脂、血糖、血浆胰岛素水平等的关系。结果：（1）各组血浆Apelin水平差异无统计学意义（F=0.145，P >0.05）。T2DM 患者空腹血浆Visfatin水平明显低于正常对照组和IGT组[（11.88±8.33） μg/L vs. （18.10±5.83） μg/L，P=0.000 和（11.88±8.33） μg/L vs. （17.83±11.88） μg/L，P=0.000]；IGT组血浆Vistatin水平明显低于正常对照组（17.83±11.88 vs. 18.10±5.83，P=0.024）。（2）相关性研究显示，血浆Apelin水平与总胆固醇（total cholesterol，TC）、低密度脂蛋白-胆固醇、空腹血糖（fasting plasma glucose，FPG）呈明显正相关（r=0.30，P=0.021；r=0.32，P=0.015；r=0.29，P=0.027），与收缩压（systolic blood pres－sure，SBP）、舒张压（diastolic blood pressure，DBP）呈负相关（r=－0.36，P=0.006；r=－0.30，P=0.020）。血浆Visfatin水平与WHR呈正相关（r=0.51，P=0.000），与糖化血红蛋白A1c（glycosylated hemoglobin A1c，HbA1c）呈明显负相关（r=－0.29，P=0.025）。（3）多元逐步回归分析表明SBP、FPG、Visfatin、TC、游离脂肪酸分别是血浆Apelin水平的独立相关因素，而 WHR、HbA1c、Apelin、DBP分别是Visfatin的独立相关因素。结论：血浆Apelin、Visfatin水平与糖代谢状态有关，可能在肥胖和T2DM的发生和发展中具有一定的作用。

Abstract:

Objective：To investigate the changes in plasma Apelin and Visfatin levels in the population with different glucose toler－ance and to explore their correlation with body mass index（BMI），waist hip ratio（WHR），blood glucose，plasma insulin levels as well as other factors. Methods：Plasma levels of Apelin and Visfatin levels in the fasting plasma were assayed by ELISA in patients with type 2 diabetes mellitus（T2DM），impaired glucose tolerance（IGT），and controls. Relationship between plasma Apelin，Visfatin levels and BMI，HOMA-insulin resistance index，blood lipid，fasting plasma glucose（FPG），plasma insulin levels were also analyzed. Re－sults：（1）There was no difference in plasma Apelin levels among groups（F=0.145，P >0.05）. Levels of plasma Visfatin in T2DM pa－tients were significantly reduced compared with those in controls and IGT patients（11.88±8.33（μg/L） vs. 18.10±5.83（μg/L），P=0.000；11.88±8.33（μg/L） vs. 17.83±11.88（μg/L），P=0.000） and levels of plasma Visfatin in IGT patients were significantly re－duced compared with those of controls（17.83±11.88（μg/L） vs. 18.10±5.83（μg/L），P=0.024）. （2）Plasma Apelin levels were posi－tively correlated with total cholesterol（TC），low density lipoprotein-cholesterol and FPG（r=0.30，P=0.021；r=0.32，P=0.015；r=0.29，P=0.027） and were negatively with systolic blood pressure（SBP）and diastolic blood pressure（DBP）（r=-0.36，P=0.006；r=-0.30，P=0.020）. Visfatin levels were positively correlated with WHR（r=0.51，P=0.000） and were negatively with glycosylated hemoglobin A1c（HbA1c）（r=-0.29，P=0.025）. （3）Multiple regression analysis showed that SBP，FPG，Visfatin，TC and free fatty acids were indepen－dent related factors influencing plasma Apelin levels，and WHR，HbA1c，Apelin and DBP were independent related factors influenc－ing plasma Visfatin levels. Conclusions：Changes of Apelin and Visfatin levels are associated with glucose metabolism，and they may contribute，in part，to the pathogenesis of diabetes and obesity.