The Relationships Between Adiponectin And Dyslipidoses In Type 2 Diabetes Mellitus And The Effect Of Them On Diabetic Cardiovascular Disease

【Objective】　To investigate the relationships between serum adiponectin levels, dyslipidemia , plasm plasminogen activator inhibitor-1(PAI-1) and body mass index (BMI), age, gender, insulin sensibitity and some related factors in 61 patients with type 2 diabetes accompanied with or without cardiovascular disease, elucidate the role and mechanisms of these factors in development of type 2 diabetic cardiovascular diseases and discuss the effect of lipid intervention on them.【Methods】 By using radioimmunoassay (RIA) and enzyme linked immunosorbent assay(ELISA) methods,the fasting levels of serum adiponectin and plasm PAI-1 we remeasured in 30 healthy subjects, 25 patients with type 2 diabetes accompanied without cardiovascular disease( DM1) and 36 patients with type 2 diabetes accompanied with ischemic heart disease( DM2). BMI, waist circumference,blood pressure,the fasting blood glucose (FBG), fasting serum insulin(FINS),C peptide(FCP) ,total cholesterol(TC), triglyceride(TG) , LDL-C, HDL-C, HbA1c and urine albumin excretory rate (UAE) were reassayed simultaneously. On the basis of reducing blood glucose and blood pressure positively ,all patients were taken low-lipid and diabetic diet and administrated with some medicines which can normolize blood lipid level,who act as lipid intervention therapy. Serum glucose and lipid were measured regularly,and after 12 weeks'treatment serum lipid,serum adiponectin and plasm PAI-1 were remeasured.With respect to the reference standard maken by ATPIII of NCEP, all patients were divided into two groups according to the levels of remeasured blood lipids after 12 weeks treatments.Satisfactory groups(A group):The concentrations of serum TC,TG,LDL-C and HDL-C were all controlled well(TC≤5.2mmol/L,TG≤1.7 mmol/L,LDL-C≤2.6 mmol/L,HDL-C≥1.2 mmol/L).Unsatisfactory group(B group):At least one lipid marker were not in a satisfactory coverage. 【Results】 1.There was obvious difference between the levels of adiponectin, TC,TG, TG/HDL-C, Homa-IR,ISI and plasm PAI-1 in patients with type 2 diabetes mellitus and the normal control group. The serum adiponectin levels and ISI were significantly lower in type 2 diabetes mellitus group than in normal control group(6.89±2.52μg/ml,5.24±1.49μg/ml vs 12.31±4.71μg/ml, P< 0.001; -4.08±0.90, -4.18±0.77 vs -3.44±0.59, P< 0.001, respectively).Besides,the serum adiponectin levels were significantly lower in DM2 group than in DM1 group (P< 0.05). The levels of PAI-1, TC,TG,TG/HDL-C and Homa-IR were significantly higher in type 2 diabetes mellitus group than in normal control group ( P< 0.01), the levels of TG and TG/HDL-C were significantly higher in DM2 group than in DM1 group (2.23±1.02 mmol/L vs1.61±0.81 mmol/L, P< 0.05;2.30±1.29 vs 1.53±0.75,P< 0.05,respectively). The levels of PAI-1,TC and Homa-IR were higher in DM2 group than in DM1 group but not significantly. 2.The serum adiponectin levels were significantly higher in women of every group than in men of the same groups ( 16.73±3.28μg/ml vs10.96±4.26μg/ml,t = -3.086,P< 0.01;9.05±1.32μg/ml vs5.87±2.31μg/ml ,t = -3.351, P< 0.01;6.38±1.36μg/ml vs 4.92±1.38μg/ml,t = -2.572, P< 0.05, respectively) .The serum adiponectin levels were significantly lower in diabetic patients with overweight and obesity(BMI≥25kg/m2)than those non-obesity (BMI< 25kg/m2) (4.30±1.25μg/ml vs 8.11±1.98μg/ml,t = 5.308,P< 0.001;4.68±1.66μg/ml vs 5.65±1.25μg/ml,t =2.974,P< 0.05, respectively ) .There was no significant difference in the levels of plasm PAI-1 between different sex groups,same results were found in obesity and non-obesity groups (p> 0.05). 3.The serum adiponectin levels were negatively correlates with waist circumference ,hip circumference, WHR,systolic pressure, diastolic pressure, fasting glucose,Homa-IR, TG,TG/HDL-C and plasm PAI-1, and positively correlated with ISI(P< 0.05) after adjusting such confounding factors as sex,age,BMI,etc. The results of multi-factor stepwise regression analysis indicate there were an indepandent correlation between serum adi...