혈중 아디포넥틴 및 레지스틴 농도와 대사성 위험인자와의 상관관계 = The Relation of Serum Adiponectin and Resistin Concentrations with Metabolic Risk Factors

국문 초록 (Abstract)

연구배경: 아디포넥틴은 비만 및 인슐린저항성과 연관이 있으며, 혈당강하, 항염증, 항죽상경화작용 등의 긍정적인 효과를 보이는 것으로 알려져 있다. 이에반해 사람에서 레지스틴의 생리적 역할에 대해서는 아직까지 규명되지 않은 상태이다. 이에 본 연구에서는 정상인과 제2형 당뇨병환자에서 아디포넥틴 및 레지스틴과 인슐린 저항성, adiposity, 대사성 위험인자 등과의 관련성에 대해 알아보고자 하였다.
방법: 본원 내분비내과와 검진센터를 방문한 83명의 2형 당뇨병환자와 139명의 정상인을 대상으로 단면적 연구를 시행하였다. 대상인들의 키, 체중, 체지방량을 측정하였고, 총 콜레스테롤, 중성지방, 고밀도 지단백 콜레스테롤 농도, 아디포넥틴 및 레지스틴을 측정하였다. 인슐린 저항성은 공복 인슐린과 혈당을 측정하여 HOMA-IR법으로 계산하였다. 또한 복부단층촬영을 하여 복부피하지방면적과 내장지방면적을 구하였다.
결과: 아디포넥틴은 당뇨군에서 가장 낮고 대조군에서 가장 높았으며, 각 군에서 의미있는 차이를 보였다. 이에 반해 레지스틴은 각 군에서 비슷한 수치를 나타냈다. 로그 아디포넥틴은 나이, 성별, 당뇨유무를 보정한 후 수축기혈압 (r=-0.169, P<0.05), 체질량지수(r=-0.224, P<0.05), 복부내장지방면적(r=-0.413, P<0.001), 공복혈당(r=-0.285, P<0.05), HOMA-IR(r=-0.273, P<0.05), 중성지방(r=-0.352, P<0.001), 저밀도 콜레스테롤(r=-0.184, P<0.05)과 음의 상관관계를 보였고, 고밀도 콜레스테롤(r=0.324, P<0.001)과는 양의 상관관계를 보였다. 다중회귀분석상 당뇨군에서는 공복혈당, HOMA-IR 및 고밀도 콜레스테롤이, 비당뇨군에서는 성별, 체질량지수, 복부내장지방면적, HOMA-IR 및 고밀도 콜레스테롤이 독립적으로 혈중 아디포텍틴 농도에 영향을 미치는 것으로 나타났다. 이에반해 로그 레지스틴은 고밀도 콜레스테롤(r=-0.193, P<0.05)과 음의 상관관계를 보였으며 체질량지수, HOMA-IR등과는 상관관계를 보이지 않았다.
결론: 혈중 아디포넥틴은 당뇨유무와 상관없이 인슐린저항성의 지표인 HOMA-IR과 높은 상관성을 나타냈으나, 레지스틴은 인슐린저항성 및 비만지표와 상관관계를 나타내지 않았다.

다국어 초록 (Multilingual Abstract)

Background: Adiponectin is a fat cell-secreted cytokine, which has been reported to improve insulin sensitivity and have antiatherogenic properties. However, it is still unclear whether resistin plays a significant role in the development of insulin resistance in humans. The aim of this study was to investigate the relationship of the adiponectin and resistin concentrations with insulin resistance, metabolic markers and adiposity in healthy and type 2 diabetic subjects. Methods: Eighty-three type 2 diabetic and 139 healthy subjects were studied. Blood samples were drawn after fasting to determine the fasting plasma glucose, insulin, resistin, adiponectin, total cholesterol, triglyceride and HDL-cholesterol levels. The subcutaneous and visceral fat areas were measured at the umbilical level using computed tomography. Results: The serum adiponectin concentrations were significantly lower in the diabetic(6.7±2.3μg/mL) than in the obese(8.2±2.4μg/mL, P<0.01) and non-obese subjects(9.9±4.5μg/mL, P<0.01). The serum resistin concentrations were Similar between the non-obese, obese and type 2 diabetic subjects. From a multiple regression analysis, the fasting glucose, HDL-cholesterol and HOMA-IR were found to be independent determinants of the log of the adiponectin level in the diabetes group. In healthy subjects, the gender, BMI, HOMA-IR, visceral fat area and HDL-cholesterol were associated with the log of the adiponectin level. However, the log of the resistin level was not associated with the markers of insulin resistance and obesity.Conclusion: This study showed that the serum adiponectin concentration was closely related to the insulin resistance marker in both healthy and type 2 diabetic subjects. However, the resistin concentration was not associated with the markers of insulin resistance and/or obesity

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