Study Of Serum Adiponectin And Related Fators In Type 2 Diabetes Patients

ObjectiveAdiponectin is a recently discovered protrin produced exclusively by adipo-cytes and it reacts with extracellular matrix. At present, we have known some of the physiological function of adiponectin. When the endothelial function is disturbed , adiponectin can aggradiate at the vascular wall and dose - dependently suppresses the expression of TNF - α induced adhesive proteins in arterial endothelial cells. It is generally accepted that adiponectin has the property of anti -atherogenic. A number of studies have shown that obesity, type 2 diabetes and cardiovascular disease are accompanied by decreased adiponectin levels. And insulin resistance and hyperinsulinemia cause a significant correlation of serum adiponectin level decrease. During the pathogenesis of type 2 diabetes, the decrease of serum adiponectin parallel with the decline of the insulin sensitivity. . The replacement of adiponectin may be a treatment to insulin resistance and type 2 diabetes.The following test is designed to compare the vatiaty of serum adiponectin in separate group of type 2 diabets and healthy people in Liaoning Hans. The aim is to analysize the correlation between serum adiponectin and insulin resistance and to discuss the possible mechanism of adiponectin effect in the obesity and diabetes.Methods1. Cases selection and grouping: All patients are selected in the Hans of Liaoning area and are divided into case and control. The case groupe is type 2 dia-betes (the diagnosis standards made by WHO in 1999). The subgroup is divided according to the obesity diagnosis standards made by the Asia - Pacific region in 2000 into obesity and non - obesity subgroup.Exclusion standards: ( 1) age less than 30 or older than 70 ( 2 ) acute stress and infection within one month ( 3) with serious accomplication such as DKA, coronary heart disease, nephropathy et al. (4) the blood pressure is controlled above 140/90mmHg. (5) accepting the treatment of TDZs in the type 2 diabetes patients.2. Assay the serum adiponectin: To prepare serum samples, whole blood is directly drawn into a centrifuge tube that contains no anti - coagulant. Let blood clot at room temperature for 30 mins. Promptly centrifuge the clotted blood at 3, 000 x g for 15 minutes at 4 °C. Transfer and store serum samples in separate tubes. Date and identify each sample. For long -term storage, keep at -70 °C. Avoid freeze/thaw cycles. The serum adiponection level was assayed using ELISA.3. Biochemical indexes;including fasting plasm glucose, blood lipid,uric acid,insulin and C -peptide.4. Insulin secretion and insulin effect: according to the typical HOMA model insulin resistance index was calculated.5. Statistical analysis;All statistical analysis was performed with Windows SPSS11.0. Continuous datas are presented as mean SD if there is normally distributed, q and t test were used. The correlation of adiponectin and other cari-ables is analysis with simple correlation analysis. The degree of the correlation was analysied in step regression analysis. Statistical significance was defined as p <0.05.Results1. The clinical datas and biochemical datas of the four groups: 1. 1 The age and gender of the non - obesity subgroup and obesity subgroup of type 2 diabetes are each matching to those of the control group. Cam-pare the BMI and WHR, there is significant difference between obesity subgroupof the control and non - obesity type 2 diabetes p <0.05. The level of BMI and WHR in the obesity subgroup of type 2 diabetes are significant higher than the o-besity subgroup of control group, also higher than those of non - obesity diabetes p <0.05.1. 1 The FBGNFINS^TC^TG of type 2 diabetes are significantly higher than control group p <0.05.2. Comparison the insulin sensitivity: The HOMA - IR is significant difference between diabetes and control group p <0. 01;the level of HOMA - IR of the non - obesity and obesity subgroups of diabetes is significant higher than the control group p <0.01. There is no significant difference between obesity subgroup of diabetes and obesity of diabetes p >0.05.3. Comparison of the adiponectin levels of each group: the serum adiponec-tin level of subgroup of type 2 diabetes is lower than each subgroup of control group p <0.05. the adiponectin level of obesity subgroup of type 2 diabetes is lower than in the non - obesity subgroup of diabetes p <0. 05.4. The correlation between serum adiponectin level and other variables: In the simple correlation analysis adiponectin is as independent variable. It shows that serum adiponectin is significantly negative relation to BMI WHR FBG LDL- C HOMA - IR( r = - 0. 293 r = - 0. 342 r = - 0. 580 r = - 0. 345 r = -0.473 each p <0.01) ,and is negative relation to TG and UC(r = -0. 116 r = -0. 189 each p <0.05). serum adiponectin is positive relation to HDL - C( r = 0.417 p <0.01).5. The step regression analysis of serum adiponectin: Adiponectin is as the independent variable and the dependent variable is all the other variables in the model. It shows that BMI? HOMA - IR remained significantly related to serum adiponectin (each of the adjustment R2 0. 343 N0. 229).Conclution1. Adiponectin as a peculiar protein produced by adipose tissue, its level is intimitely related to obesity and type 2 diabetes.2. Adiponectin can improve insulin resistance and has the ability of anti -atherogenic. So the determination of serum adiponectin can assess the degree of insulin resistance and predict the risk of cardiovascular disease.