Serum Irisin In Elderly Patients With Type 2 Diabetes And Related Factors

Objective Type 2 diabetes(T2DM) in the elderly population cause a higher incidence of morbidity, mortality. Not only seriously affect the quality of life of elderly patients, but also increased social burden. Since irisin may promote browning of white fat, a "fat burning" and so on, which is expected to be used to treat diabetes. Although there are many studies on irisin and diabetes, but these studies have not considered the impact of age. In this study, by comparing the elderly and elderly patients with type 2 circulating irisi control population of diabetic patients, and to explore the influencing factors irisin, trying to explore the role of elderly T2 DM in irisin and possible mechanisms.Methods 71 elderly subjects with type 2 diabetes mellitus(T2DM) were selected from patients in General Hospital of the Ministry of Health and Medical metabolic ward Tianjin Medical University during January 2014-- June 2015, including 56 males and 15 females. These patients have to undergo OGTT experiments and related examination confirmed T2 DM, excluding groups of type 1 diabetes, impaired fasting glucose, impaired glucose tolerance, acute complications of diabetes and other endocrine and metabolic diseases. Meanwhile, selecting 107 healthy cases without T2 DM people in our department as control group, including 76 males and 31 females. In this study consisting of 178 subjects, they can provide accurate complete medical history, no serious heart, liver, kidney, lung function disorders, no recent surgery, infection and other stress conditions, and have ruled out cancer patients combined. All subjects underwent a physical examination, liver and kidney function and other biochemical parameters and serum irisin detection. T2 DM group study B-plus measure kidney measured hemodynamic parameters. Variance General information and irisin like comparison T2 DM group and control group, to explore the factors that may affect the irisin. Then according to BMI and whether to merge DKD. T2 DM secondary grouping its subgroup analysis, application SPSS19 statistical software, according to different studies were selected t test, Pearson correlation and linear regression model analysis, explore obesity and hemodynamics on irisin impact.Result 1. Gender, age, BP, BMI, STB, ALB, TC, TG, BUN, SCr, UA, LDL, Hb was no significant difference between two groups(all P> 0.05); FBG DM group, 2h PG, Hb A1 c, WHR was significantly higher in T2 DM group, existing statistically significant differences(P <0.05); irisin T2 DM group, SOD, ALT in T2 DM group is lower than the control group, the difference was statistically significant(P < 0.05). 2. Irisin serum concentration in elderly patients with T2 DM group has negative correlation with 2h PG, SOD, HOMA-IR(r =-0.56,-0.69,-0.48, P <0.05); has positive correlated with Course(r = 0.29, P <0.01); has no significant correlation with age, BMI, BP(max), BP(min), ALT, STB, ALB, Scr, FBG, 2h PG, TC, TG, HDL, LDL(r =-0.13,-0.14, 0.28,-0.08,-0.22, 0.13, 0.17,-0.13,-0.05,-0.56,-0.03,-0.19,-0.14, 0.09, P> 0.05). 3. Hypothesis irisin serum concentration as the dependent variable(Y), gender, age, BMI, ALT, STB, ALB, Scr, UA, FBG, 2h PG, TG, TC, HDL, LDL, SOD is the independent variable(X) be Multiple linear regression analysis(table 3). After exclusion of other interference factors as age, gender, disease duration, blood pressure, etc., in the patient population T2 DM group, ALT, 2h PG, SOD, HOMA-IR is an independent negative impact on the level of serum irisin factor(standardized regression coefficient =-0.19,- 0.27,-0.39,-0.29), UA were excluded. 4. Packet T2 DM group according to the level of BMI, BMI ? 25 is obese group, 28 people, 23 men and five women; 19 ? BMI <25 as the normal group, 40 people, 28 men and 12 women. Its t and ?2 test found that two groups of gender, age, BP, STB, ALB, TC, TG, BUN, UA, LDL, Hb was no significant difference(all P> 0.05); BMI of obese patients are higher than the normal group(t = 8.38, P <0.01); Scr of obese patients are lower than the normal group(t =-2.38, P <0.05), statistically significant differences. 5. Packet T2 DM group according to whether emerge DKD, Its t and ?2 test found that two groups of gender, age, BP, STB, ALB, TC, TG, BUN, UA, LDL, Hb was no significant difference(all P> 0.05); obese patients have a higher level in SOD, HOMA-IR, duration, RI significantly than the normal group(t = 8.38, P <0.01); DKD patients circulating irisin levels is lower than the normal group(t =-2.38, P <0.05), statistically significant differences.Conclusions Circulating irisin in elderly type 2 diabetes patients is less than that in healthy elderly control population, and have a negative correlation with 2h PG, SOD, HOMA-IR, regardless of obesity, and associated with hemodynamic irisin of DKD.