中华皮肤科杂志 ›› 2009, Vol. 42 ›› Issue (9): 593-595.

• 论著 • 上一篇    下一篇

SLE患者胰岛素抵抗和血清抵抗素水平研究

刘伦飞1,王建有2,劳力民3,曹越兰4,郑敏5   

  1. 1. 浙江大学医学院附属第二医院
    2.
    3. 杭州浙江大学医学院附属第二医院皮肤科
    4. 杭州浙江医科大学附属第二医院皮肤科
    5. 杭州：浙江大学医学院附属第二医院
  • 收稿日期:2008-09-10 修回日期:2009-03-13 出版日期:2009-09-15 发布日期:2012-03-21
  • 通讯作者: 刘伦飞 E-mail:liulunfei@medmail.com.cn

Insulin resistance and serum resistin levels in patients with systemic lupus erythematosus

  • Received:2008-09-10 Revised:2009-03-13 Online:2009-09-15 Published:2012-03-21

PDF (PC)

264

赞

摘要： 目的 探讨SLE患者胰岛素抵抗与其抵抗素水平及疾病活动性的关系，以及糖皮质激素治疗的影响。方法 收集40例（共56份，其中活动期21份，非活动期35份；病程30天至22年）SLE患者及31例正常人对照血样，两组在年龄与性别构成上差异无统计学意义。分别测定空腹血糖、胰岛素水平，应用稳态模型评价方程（HOMA）计算胰岛素敏感性（HOMA-S）和胰腺β细胞功能（HOMA-B）。采用ELISA法检测血清抵抗素水平。结果 ①SLE患者空腹血清胰岛素水平（17.46 ± 15.65） IU/L高于正常人对照（8.57 ± 7.54） IU/L，胰岛素敏感性（0.42）明显低于正常人对照（0.78），胰腺β细胞分泌功能（167.47）明显高于对照组（84.10），差异均有统计学意义（P < 0.05）。②活动期SLE患者组血清抵抗素水平（10.90 mg/L）高于非活动期患者组（2.72 mg/L）及对照组（2.43 mg/L），非活动期组高于对照组，差异均有统计学意义（P < 0.05）。③经糖皮质激素治疗后SLE患者血胰岛素水平、胰腺β细胞分泌功能（Homa-B）及血清抵抗素水平下降，胰岛素敏感性（Homa-S）增加。④SLE患者组SLEDAI与Homa-S（r = －0.48，P < 0.01）、Homa-B（r = 0.29，P < 0.05）及血清抵抗素水平（r = 0.42，P < 0.01）均有一定相关性，SLE患者组Homa-S与血清抵抗素水平呈负相关（r = －0.56，P < 0.01）。结论 SLE患者中存在胰岛素抵抗以及胰腺β细胞高分泌状态，与疾病活动状态以及血清抵抗素水平相关。糖皮质激素治疗控制病情后，情况得到改善。

关键词: 红斑狼疮，系统性, 抵御素, 胰岛素, 糖皮质激素类

Abstract: Objective To investigate the state of insulin resistance and its relationship to serum resistin levels and disease activity in patients with systemic lupus erythematosus （SLE）, as well as the effects of corticosteroid therapy on RI and serum resistin levels. Methods Forty patients with SLE and 31 age- and sex-matched normal human controls were enrolled into this study with informed consent. A total of 56 blood samples were obtained from 21 cases of active SLE and 35 cases of inactive SLE together with 31 samples from the controls. Fasting blood glucose（FBG） and fasting serum insulin levels were measured. Homeostatic model assessment （HOMA） equation was used to calculate insulin sensitivity（HOMA-S） and pancreatic beta cell function （HOMA-B）. Serum resistin levels were measured by enzyme-linked immunosorbent assay （ELISA）. Results Compared with the normal controls, a significant increase was observed in patients with SLE in fasting serum insulin levels （17.46 ± 15.65 IU/L vs 8.57 ± 7.54 IU/L, P < 0.05） and HOMA-B （167.47 vs 84.10, P < 0.05）, along with a decrease in HOMA-S （0.42 vs 0.78）. The serum resistin level in patients with inactive SLE was significantly lower than that in patients with active SLE （2.72 mg/L vs 10.90 mg/L, P < 0.05）, but higher than that in normal controls （2.72 mg/L vs 2.43 mg/L, P < 0.05）. After corticosteroid therapy, a decrease was noted in HOMA-B and serum levels of insulin and resistin, together with an increase in HOMA-S in patients with SLE. The SLE disease activity index （SLEDAI） of patients was significantly correlated with HOMA-S （r = -0.48, P < 0.01）, HOMA-B （r = 0.29, P < 0.05） and serum resistin levels （r = 0.42, P < 0.01）, and a negative correlation was also observed between HOMA-S and serum resistin levels in patients with SLE （r = -0.56, P < 0.01）. Conclusions There is evidence of insulin resistance and increased secretory capacity of pancreatic beta cells, which are related to SLE disease activity and serum resistin levels. After corticosteroid therapy, the abnormality in these parameters was improved.

Key words: systemic lupus erythematosus