CHANGES IN SERUM APN, LEP AND ITS RATIO IN MIDDLE-AGED AND ELDERLY PATIENTS WITH TYPE 2 DIABETES MELLITUS COMPLICATED WITH HYPERTRIGLYCERIDEMIA

Objective: To analyse changes in serum adiponectin (APN), leptin (LEP) and their ratios in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM) combined with hypertriglyceridemia. Methods: From May 2017 to February 2019, 65 patients with 12DM treated in the endocrinology department of our hospital were.selected as the observation group, and 65 healthy people who came to our hospital were selected as the control group. General data including height, weight, blood pressure, blood lipid level (total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and fasting blood glucose (FPG) were collected. The insulin resistance index (HOMA-IR) was calculated from the insulin level (FINS), and the ELISA method was used to detect changes in serum APN and LEP levels. Spearman's correlation analysis was used to analyse the correlation between serum APN, LEP and clinical indexes, and stepwise multiple regression analysis was used to evaluate the related factors of APN and LEP. Results: The age and BMI, SBP, DBP, HOMA-IR, FPG, LDL-C, TG, TC levels of the patients in the observation group were significantly higher than those in the normal control group, and the HDL-C levels in the observation group were significantly lower than those in the control group (P<0.05). The levels of serum APN in the observation group were significantly lower than that in the control group, while the levels of LEP were significantly higher than that in the control group. Additionally, the levels of APN/LEP were significantly lower in the observation group than that in the control group (P<0.01). Spearman's correlation analysis showed that APN levels were negatively correlated with BMI, SBP, HOMA-IR, FPG, TG, TC and LEP, and positively correlated with HDL-C. In the observation group, LEP levels were positively correlated with BMI, HOMA-IR, LDL-C, TG, TC and negatively correlated with HDL-C (P<0.05). Using APN as a dependent variable Y, the results of multiple regression analysis showed that HOMA-IR, TG entered the equation, Y = 8.433 - 0210 * XHOMA-IR -0.726* X-TG. Using LEP as a dependent variable Y, the results of multiple regression analysis showed that BMI, HOMA-IR, TG, LDL-C entered the equation, Y=-0.463*X-BMI +0.439*(HOMA-IR) +2.312*X-TG +1345* X-LDL - -C-12.654. Conclusion: There was a significant decrease of APN level and an increase of LEP level in patients with T2DM complicated with hypertriglyceridemia, which was closely related to lipid metabolism disorder and insulin resistance, indicating that APN, LEP may be involved in the progress of patients with T2DM complicated with hypertriglyceridemia.