The Investigation On The Relationgship Between Adiponenctin And The Pancreatic β-CELLFUNCTIONAND It′s Mechanism In Type 2 Diabetes Mellitus Patiens

PartⅠThe investigation on the relationship between adiponectin and the first-phase of pancreaticβ-cell insulin secretionobjective: To investigate the relationgship between adiponectin and the first-phase of pancreaticβ-cell insulin secretion in subjects with different glucose tolerances .Methods: 37 patients with newly diagnosed type 2 diabetes mellitus (DM group), 30 patients with Impaired glucose regulation (IGR group), 40 subjects of normal glucose tolerance (NGT group) were conducted by intravenous glucose tolerance test (IVGTT).Fasting adiponectin (APN) and proinsulin (PI) was assayed by ELISA.Insulin area under the curve (AUC) ,incremental AUC (iAUC) from 0min to 10 min ,AIR3-5, HOMA-IR and HOMA-B were calculated to explore the relationship between adiponectin and AUC,iAUC,AIR3-5,proinsulin, HOMA-IR.Results:(1)The AUC,iAUC,AIR3-5,APN in DM group and IGR group was significantly lower than those in NGT group (P<0.05), and which more dramatically reduced in DM group compared with those in IGR group(P <0.05)。(2) PI in DM group and IGR group was significantly higher than those in NGT (P <0.05).(3) adiponectin was positively correlated to HOMA-B,AUC,iAUC,AIR3-5,HDL-C and negatively correlated to proinsulin, HOMA-IR, LDL-C (4) Proinsulin was positively correlated to HOMA-IR .(5)multiple regression stepwise analysis showed that adiponectin was indepentely associated with the AUC.Conclusion: adiponectin was a independent factor effecting the first phase of pancreaticβ-cell insulin secretion.low levels of adiponectin could be predicted the first phase dysfunction of pancreaticβ-cell and insulin resistance in patients wth type 2 diabetes. PartⅡThe investigation on the relationship between free fatty acids,adiponectin and the pancreaticβ-cell functionObjective: To study the relationship between adiponectin,free fatty acids and isletβ-cell function in individuals with different glucose tolerance.Methods:The level of Fasting and 120 minutes free fatty acid after glucose loading was measured by colorimetry (FFA, FFA120). Insulin area under the curve of 0-10 minutes (AUC), AIR0-10, HOMA-IR and HOMA-B were calculated to explore the relationship between free fatty acids and the AUC, AIR0-10, APN, HOMA-B HOMA-IR calculated with Spearson correlation。Results: (1)The level of Fasting plasma FFA,FFA120 in DM group and IGT group was significantly higher than those in NGT group (P <0.05). (2) FFA was negatively correlated with AUC, AIR0-10, HOMA-B, APN, HDL-C and positively correlated with FFA120, TG, FBG, LDL-C.(3) adiponectin was negative correlation with FFA, FFA120, TG, LDL-C.(4) Multiple stepwise regression analysis showed that fasting FFA was indepentely associated with AIR0-10.Conclusion: The fasting FFA was a independent factor effecting the first phase of pancreaticβ-cell insulin secretion .The level of fasting and postprandial FFA can be predicted first phase dysfunction of pancreaticβ-cell in patients with type 2 diabetes. Increase adiponectin levels may reduce the free fatty acid levels, improve lipotoxicity.