目的 探讨2型糖尿病患者体重指数(body mass index, BMI)、胰岛素敏感指数(insulin sensibitity, SI )和血清脂联素、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)水平变化及其临床意义。方法 采用放射免疫分析法(RIA)和酶联免疫吸附试验(ELISA)分别测定100例2型糖尿病组, 101例正常对照组的空腹血清脂联素及TNF-α水平, 同时测定BMI、空腹血糖(fasting blood glucose, FBG)、空腹血胰岛素(fasting insulin FINS)、胰岛素抵抗指数(Homa-IR)等相关指标。结果 糖尿病组BMI、FBG、FINS、 Homa-IR均明显高于正常对照组(均P<0.05), 血清脂联素、SI均低于正常对照组(P<0.05)。血清TNF-α两组间无统计学意义(P＞0.05)。单因素相关分析显示, 血清脂联素与SI呈正相关(r=0.247, P<0.05), 与BMI呈负相关(相关系数为: r=-0.313, P<0.05), 与TNF-α无相关性。结论 血清脂联素与肥胖、SI相关, 与TNF-α无相关性, 脂联素的增高可能是有益的。

Objective To study the relationship between serum adiponectin levels and tumor necrosis factor-α(TNF-α), body mass index(BMI), insulin sensitivity (SI )and some related factors, for clarifying the effects and mechanism of these factors in the ocourrence and development of type 2 diseases mellitus(DM). Methods The levels of adiponectin in 101 normal control subjects and 100 patients with type 2 DM were measured by enzyme linked immunosorbent assay(ELISA). The levels of TNF-α and fasting insulin(FINS) were measured by radioimmunoassay (RIA), fasting blood glucose (FBG)were measured by automatic biochemistry analyer, and their body height and weight were measured for BMI. Results The BMI, levels of FBG, FINS, and insulin resistance(Homa-IR) were significantly higher in type 2 DM group than those in normal control group (P<0.01). The serum adiponectin levels and SI were significantly lower in type 2 DM group than in normal control group(P<0.01). There was no significant difference in the levels of TNF-αbetween type 2 DM group and normal control group(P>0.05). The serum adiponectin levels were positively correlated with SI(P<0.05), and negatively correlated with BMI (P<0.05), and did no correlate with TNF-α(P＞0.05). Conclusions The serum adiponectin levels correlate with SI and BMI, and does no correlate with TNF-α. Adiponectin may play an important role in the occurrence of type 2 DM.