摘要
目的:比较肥胖合并或不合并2型糖尿病患者血清单核细胞趋化蛋白-1(MCP-1)浓度与葡萄糖钳夹试验中胰岛素敏感性的关系。方法:分别对20例正常糖耐量者和40例肥胖患者(其中合并2型糖尿病者20例,无糖尿病者20例)进行高胰岛素-葡萄糖钳夹试验,以钳夹稳态期胰岛素介导的葡萄糖利用率(Rd)来判定周围组织胰岛素敏感性。同时用酶联免疫吸附法(ELISA)测定血清MCP-1水平,并测定其他临床指标,分析各指标之间的相关性及与胰岛素敏感性的关系。结果:与正常体质量组相比,肥胖患者外周血MCP-1水平明显升高(P<0.01),Rd值明显降低(P<0.01),合并糖尿病者其变化明显大于无糖尿病者。两指标呈明显负相关(r=-0.440,P=0.004)。MCP-1是胰岛素敏感性的独立影响因素。结论:外周血MCP-1是胰岛素抵抗的独立影响因素,又与腰围紧密联系,促进胰岛素抵抗的发展。预防和控制腹型肥胖将有助于降低MCP-1水平,改善胰岛素抵抗。
Objective：To evaluate the serum MCP-1 in relation to insulin sensitivity in the glucose clamp study in obese patients and type 2 diabetic patients with obesity. Methods：Hyperinsulinemic euglysemic clamp was performed in 20 normal weight and 40 cases of obesity （including 20 type 2 diabetic patients with obesity and 20 obesity without diabetes）. The rate of insulin-mediated glucose disposal（Rd）during the steady state of glucose clamp was used to assess the peripheral tissue insulin sensitivity. Before the clamp study ,Serum MCP-1 was determined by Enzyme Linked ImmunoSorbent Assay（ELISA） and other clinical parameters were determined to analyse the relationship between them.Results：In obese patients ,serum MCP-1 were higher remarkedly than those in normal weight and Rd were lower. MCP-1 in obesity with type 2 diabetes were higher than that in obesity without diabetes （P0.01） and Rd were lower（P0.05）. They were negative correlation significantly （r=-0.440,P=0.004）. MCP-1 was the independent contributing factor for Rd. Conclusions：The serum MCP-1 level is the independent contributing factor for insulin sensitivity and it contributes to the development of insulin resistance with waist. Preventing abdominal obesity will contribute to decrease MCP-1 levels.
出处
《中国临床医学》
2010年第2期216-219,共4页
Chinese Journal of Clinical Medicine
关键词
单核细胞趋化蛋白-1
2型糖尿病
葡萄糖钳夹技术
胰岛素抵抗
Monocyte chemoattractant protein-1
Type 2 diabetes mellitus
Glucose clamp technique
Iusulin resistance
