摘要本研究旨在探讨脂肪因子分泌型卷曲相关蛋白5(sfrp5)与体脂参数、糖脂代谢、胰岛素抵抗及炎症的关系。89例正常糖耐量者及87例新诊断2型糖尿病患者,根据2000年世界卫生组织推荐的亚洲成年人肥胖诊断标准,各分为非肥胖和肥胖亚组。测量体脂参数,计算体重指数、腰臀比。检测血糖、血脂指标及空腹胰岛素水平,计算稳态模型评估的胰岛素抵抗指数( HOMA-IR)。用酶联免疫吸附测定血浆sfrp5和白细胞介素6的含量。结果显示血浆sfrp5含量在2型糖尿病组中低于正常糖耐量组[(8.35±3.38对11.35±3.69)ng/ml, P<0.01],正常糖耐量组和2型糖尿病组内肥胖者均低于非肥胖者[(9.46±2.70对13.12±3.62)ng/ml和(6.70±2.34对10.12±3.45)ng/ml,均P<0.01],且2型糖尿病-肥胖组明显低于正常糖耐量-肥胖组(P<0.01)。(2)相关分析显示血浆sfrp5水平与腰臀比、HbA1C、空腹胰岛素、甘油三酯、腰围、空腹血糖、白细胞介素6、ln(HOMA-IR)及体重指数均呈负相关(P<0.01或P<0.05)。(3)多元逐步回归分析发现血浆 sfrp5水平与 ln(HOMA-IR)、体重指数、甘油三酯独立相关(r2=0.216、0.177、0.113,均P<0.05)。 sfrp5在肥胖及2型糖尿病者中表达明显降低,且与体脂分布、糖脂代谢、胰岛素抵抗及炎症相关；sfrp5可能参与了肥胖及2型糖尿病的病理生理过程。

abstracts To investigate the relationships among plasma secreted frizzled-related protein ( sfrp) 5 level and body fat parameters, glucolipid metabolism, insulin resistance index, and inflammation. 89 subjects with normal glucose tolerance(NGT) and 87 patients with type 2 diabetes mellitus (T2DM) were enrolled and each group was divided into no-obese and obese subgroups. Obesity was defined as body mass index ( BMI)≥25 kg/m2 according to the World Health Organization -Western Pacific Region diagnostic criteria ( 2000 ) . Body fat parameters were measured and BMI, waist-hip ratio were evaluated, meanwhile, the levels of blood glucose-lipid parameters and fasting insulin were also determined. Insulin resistance index ( IR) was assessed by homeostasis model assessment ( HOMA) . The concentrations of plasma sfrp5 and interleukin 6 were detected by enzyme-linked immunosorbent assay. Plasma sfrp5 level in T2DM group was significantly lower than that in NGT group [(8. 35±3. 38 vs 11. 35±3. 69)ng/ml, P<0. 01]. The levels of plasma sfrp5 in subjects with obesity were also lower than those in subjects with no-obesity in both NGT and T2DM groups [(9. 46±2. 70 vs 13. 12±3. 62)ng/ml and(6. 70±2. 34 vs 10. 12±3. 45) ng/ml, both P<0. 01]. Plasma concentrations of sfrp5 in T2DM-obese group were significantly lower than that in NGT-obese group(P<0. 01). Correlation analysis showed that plasma sfrp5 levels were negatively correlated with waist-hip ratio, HbA1C, fasting insulin, triglycerides, waist circumference, fasting plasma glucose, interleukin 6, natural logarithm of HOMA-IR [ln(HOMA-IR)], and BMI(P<0. 01 or P<0. 05). Multiple linear regression showed that ln(HOMA-IR), BMI, triglycerides were independent related factors in influencing the levels of plasma sfrp5 (r2=0. 216, 0. 177, 0. 113, all P<0. 05). Plasma sfrp5 levels were decreased in obesity and T2DM subjects and were correlated with body fat disposition, glucose-lipid metabolism, insulin resistance and inflammation. Lack of sfrp5 may contribute to the pathophysiology of obesity and T2DM.