摘要
目的探讨糖尿病、高血压患者的糖脂代谢特点以及游离脂肪酸、细胞色素P450、瘦素、抵抗素、脂联素等脂肪内分泌激素的表达特征及其临床意义。方法从社区中招募并筛选出200名符合条件的单纯2型糖尿病(B组)、单纯高血压(D组)、2型糖尿病合并高血压患者(F组)和正常自愿者(N组)(每组50人),禁食12 h后于第2天早上空腹抽血检测血糖、胰岛素、血脂以及游离脂肪酸、细胞色素P450、瘦素、抵抗素、脂联素等脂肪内分泌激素的浓度并分析比较其特征。结果B组和F组的空腹血糖和胰岛素水平均显著高于N组和D组(P<0.05),D组的空腹胰岛素水平也显著高于N组(P<0.05)。B组、D组、F组的TG水平均显著高于N组(P<0.05),且F组的TG水平还显著高于D组(P<0.05);F组的HDL-C水平均显著低于N组、B组和D组(P<0.05);F组的LDL-C水平也显著高于N组(P<0.05);B组、D组和F组的游离脂肪酸水平均显著高于N组(P<0.05),D组的游离脂肪酸显著高于B(P<0.05);F组的细胞色素P450均显著高于N组、B组和D组(P<0.05),但N组、B组和D组的细胞色素P450水平比较无显著性差异(P>0.05)。三个观察组(B组、D组、F组)的瘦素和抵抗素水平均显著高于N组(P<0.05)。D组的瘦素水平显著低于B组(P<0.05);B组和F组的抵抗素水平均显著高于D组(P<0.05)。三组疾病人群的脂联素水平虽呈下降趋势,但差异无统计学意义(P>0.05)。结论糖尿病和高血压患者均存在胰岛素抵抗现象。糖尿病患者的血脂代谢异常比高血压患者明显,而糖尿病合并高血压患者血脂异常的程度明显增加。其中游离脂肪酸水平增高,细胞色素P450升高,瘦素和抵抗素水平的增加,脂联素水平的下降,都是糖尿病和高血压互为因果的共同发病机制。脂肪内分泌激素对于糖尿病、高血压的早诊断和干预治疗方面具有一定的临床意义。
Objective To explore the characteristic and clinical significance of glycaemic and lipid metabolism and fat hormone such as Free fatty acids, Cytochrome P450, Leptin, Resistin, and Adiponectin on the patients with hypertension and/or diabetes mellitus. Methods 200 people are recruited from communities , selected and grouped in terms of T2DM （B）, HP（D）, TD2M combined HP （F） and regular volunteers （N） （50 each group ）, fasting 12 hours before testing Glu, Insulin, HDL-C, LDL-C,TG and fat hormone such as Free fatty acids,Cytochrome P450, Leptin, Resistin and Andiponectin in blood. Analyzed and compared them among each group. Results The fasting blood-glucose and insulin level of group B and group F show remarkably higher than those of group N and group D （ P 〈 0.05 ）, the fasting insulin level of group D shows higher than that of group N （ P 〈 0. 05 ）. The TG level of group B, D and F show higher than that of group N （P 〈 0.05 ）, group F higher than group D （P 〈 0. 05 ）. The HDL-C of group F shows remarkably lower than those of group N, B and D（ P 〈 0.05 ）. the LDL-C level of group F shows higher than that of group N （P 〈 0. 05）. The Free fatty acids level of Group B, D and F show remarkably higher than that of group N （ P 〈 0.05 ）, the free fatty acids level of group D shows higher than that of group B （ P 〈 0.05 ）. The cytochrome P450 level of group F shows higher than those of groups N ,B and the D（P 〈0.05 ） , but the cytochrome P450 level among group N, B and D show no statistical difference（P 〉0.05）. the Leptin and Resistin level of group B, D and F show higher than that of group N （P 〈 0.05 ）. the Leptin level of group D shows lower than that of group B （P 〈 0.05 ） ,the Resistin level of group B and F show higher than that of group D（P 〈0.05）. the adiponectin level among the three patient＇ s groups presents a downtrend without the statistical difference（ P 〉 0.05）. Conclusion Both diabetes mellitus and hypertension patients have the phenomenon of insulinresistance. The Serum Lipids level of the diabetic patients is higher than that of the hypertension patients and the Serum Lipids level of patients with both diabetes mellitus and hypertension increased even remarkably. High level of free fatty acid, cytochrome P450, leptin , resistin and low level of adiponectin are the corporate reasons that cause to diabetes mellitus and hypertension. The detection of fat hormone could help to the diagnosis and therapy in early phase of diabetes mellitus and hypertension.
出处
《中华全科医学》
2009年第5期451-453,共3页
Chinese Journal of General Practice
基金
中国疾病预防控制中心"达能营养中心膳食营养宣教和科研基金"立项资助(DIC-200710)
深圳市科技局立项资助项目(200802002)
