摘要检测2型糖尿病及腹型肥胖患者血清环磷酸腺苷反应元件结合蛋白调节转录辅激活因子3(CRTC3)水平,探讨其与糖脂代谢及胰岛素抵抗的关系.入组170例2型糖尿病患者(T2DM组)和80名正常非糖尿病个体(NC组),同时以腰围男性≥90 cm,女性≥85 cm为切点分成非腹型肥胖和腹型肥胖亚组,检测空腹血糖、糖负荷后2 h血糖(2hBG)、血脂、HbA1C、空腹胰岛素、空腹C肽、CRTC3和脂联素水平,测量血压、身高、体重、腰围、臀围,计算体重指数和腰臀比,以及改良稳态模型评估的胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-β).相关性分析提示血清CRTC3水平与腰围、体重指数、腰臀比、收缩压、舒张压、空腹血糖、2hBG、HbA1C、总胆固醇、三酰甘油、空腹C肽、HOMA-IR呈显著正相关(P<0.05或P<0.01),与高密度脂蛋白胆固醇、脂联素和HOMA-β呈负相关(P<0.01).多元线性回归分析显示腰臀比、脂联素、总胆固醇、空腹血糖及HOMA-IR是血清CRTC3水平的独立影响因素(P<0.05或P<0.01).2型糖尿病及腹型肥胖患者血清CRTC3水平升高,其升高程度与糖脂代谢紊乱、脂联素降低的程度以及胰岛素抵抗密切相关.

abstractsTo detect serum cAMP-responsive element-binding protein-regulated transcription coactivator 3 ( CRTC3) level in subjects with type 2 diabetes mellitus and abdominal obesity and to investigate the relationship of serum CRTC3 level with glycolipid metabolism and insulin resistance. One hundred and seventy patients with type 2 diabetes ( T2DM group) and 80 normal controls ( NC group) were recruited in the study. They were divided into non-abdominal obesity ( NAO ) and abdominal obesity ( AO ) subgroup. Abdominal obesity was defined as waist circumference≥90 cm in men and ≥85 cm in women. Body fat parameters were measured and body mass index, waist-to-hip ratio were determined. Fasting blood glucose ( FBG ) , 2 h postload blood glucose ( 2hBG ) , lipids, HbA1C , fasting insulin, fasting C-peptide, CRTC3, and adiponectin were also detected. Insulin resistance and pancreasβcell function were assessed by modified homeostasis model assessment for insulin resistance ( HOMA-IR) andβ cell function ( HOMA-β) . Bivariate correlation analysis showed that serum CRTC3 level was positively correlated with waist circumference, body mass index, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, FBG, 2hBG, HbA1C , total cholesterol, triglyceride, fasting C-peptide, and HOMA-IR ( P<0. 05 or P<0.01) , and was negatively correlated with high density lipoprotein-cholesterol, adiponectin, and HOMA-β ( P<0.05). Multivariate linear regression analysis showed that waist-to-hip ratio, adiponectin, total cholesterol, FBG, and HOMA-IR were independently related to serum CRTC3 level ( P<0.05 or P<0.01) . Serum CRTC3 level was increased in patients with type 2 diabetes as well as in abdominal obesity, and was closely related with glycolipid metabolism, adiponectin, and insulin resistance.