摘要目的 分析新诊断2型糖尿病患者血清C1q/肿瘤坏死因子相关蛋白6(CTRP6)水平与胰岛素抵抗的相关性.方法 采用横断面研究,纳入2016年4月至2017年3月于本院门诊就诊的新诊断2型糖尿病患者167例,以165名健康体检者作为对照组.采用酶联免疫吸附法检测血清CTRP6、肿瘤坏死因子α(TNF-α)、白细胞介素6( IL-6)、单核细胞趋化蛋白 1( MCP-1)水平.结果 调整年龄和体重指数(BMI)后,与对照组相比,2型糖尿病组血清CTRP6水平显著升高[(652.54 ± 132.57)对(521.28 ± 119.93) μg/L, P＜0.01].在所有人群中,CTRP6水平与BMI、腰围、空腹血糖、糖负荷后2h血糖、HbA1C、空腹胰岛素、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、超敏C反应蛋白(hs-CRP)、TNF-α、IL-6、MCP-1以及三酰甘油(TG)呈显著正相关,与高密度脂蛋白胆固醇呈负相关( P＜0.01).多元线性回归分析显示,TG、HOMA-IR及IL-6是血清CTRP6的独立相关因素.调整潜在混杂因素后,CTRP6仍然为2型糖尿病的独立危险因素.趋势检验显示,CTRP6水平的升高与2型糖尿病的发生呈显著线性关系(P＜0.01).受试者工作特征曲线分析显示,血清CTRP6预测2型糖尿病的曲线下面积为0.730.结论 CTRP6可能与胰岛素抵抗有关.

abstractsObjective To explore the relationship between serum C1q and tumor necrosis factor related protein 6 ( CTRP6 ) level and insulin resistance in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Methods A total of 167 patients with newly diagnosed T2DM in the outpatient department of our hospital were recruited from April 2016 to March 2017 and 165 subjects with normal glucose tolerance were used as the control group. The concentrations of CTRP6, interleukin 6 (IL-6), monocyte chemoattractant protein-1 ( MCP-1), and tumor necrosis factor a( TNF-α) were determined by ELISA. Results Circulating CTRP6 level was significantly higher in T2DM group than that in control group [(652.54 ± 132.57) vs ( 521.28 ± 119.93) μg/L, P＜0.01] after adjusting age and body mass index (BMI). Overweight/obese subjects revealed much higher CTRP6 levels compared with those in lean individuals. In addition, circulating CTRP6 level was positively correlated with BMI, waist circumference, fasting plasma glucose, postprandial 2h plasma glucose, HbA1C, fasting insulin, homeostasis model assessment insulin resistance index ( HOMA-IR), triglyceride ( TG), IL-6, MCP-1, highly sensitive C-reactive protein ( hs-CRP ), and TNF-α, while it was inversely correlated with high-density lipoprotein-cholesterol ( P＜0.01). Multiple linear regression analysis showed that TG, HOMA-IR, and IL-6 were independent factors for CTRP6 level. After adjusting for potential confounders, CTRP6 remains an independent risk factor for T2DM. Trend detection showed that the increase in CTRP6 level was significantly linear with the occurrence of T2DM. The analysis of receiver operating characteristic curves revealed that the area under the curve for circulating CTRP6 to predict T2DM was 0.730. Conclusions CTRP6 may be associated with insulin resistance.