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脂肪细胞脂肪酸结合蛋白和C反应蛋白水平作为胰岛素抵抗发展的指标

Adipocyte fatty acid binding protein and C-reactive protein levels as indicators of insulin resistance development.

作者信息

Horakova Dagmar, Pastucha Dalibor, Stejskal David, Kollarova Helena, Azeem Katerina, Janout Vladimir

机构信息

Department of Preventive Medicine, Palacky University Olomouc, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011 Dec;155(4):355-9. doi: 10.5507/bp.2011.042.

Abstract

BACKGROUND

Adipocyte fatty acid-binding protein (aFABP) has recently been identified as a potential circulating marker for metabolic syndrome. C-reactive protein (CRP), a sensitive marker of inflammation, is increased in individuals with diabetes and metabolic syndrome due to the development of subclinical inflammation. The study uses logistic regression models to analyze the relations between aFABP and CRP along with other parameters of insulin resistance. The objective was to investigate the potential use of aFABP and CRP levels as tools in the diagnosis of the metabolic syndrome.

METHODS AND RESULTS

The following groups were studied: healthy individuals (A, n=122), obese individuals (B, n=213) and patients diagnosed with metabolic syndrome (C, n=79). Obese persons in Group B had parameters suggestive of early insulin resistance: hypertension, hyperglycaemia, QUICKI (0.305) and higher aFABP levels as compared with the healthy subjects. Group C individuals were diagnosed with metabolic syndrome, as evidenced by the QUICKI markers for insulin resistance (0.293), high aFABP levels (35.3 mg/l). CRP concentrations were lowest in Group A healthy individuals (0.67 mg/l), higher in Group B obese subjects (2.65 mg/l) and highest in Group C patients with metabolic syndrome (3.62 mg/l). Logistic regression models showed an association of aFABP and CRP with BMI (OR 1.12 and 1.39, compared Group A vs C). An association of aFABP and CRP with the QUICKI index showed OR 1.48 and 1.37 (Group A vs C); with triglyceride levels showed OR 1.68 and 1.52 (Group A vs C). An association of aFABP and CRP with glycaemia showed OR 1.48 and 1.51 (Group A vs C), with insulinaemia showed OR 1.44 and 1.38 (Group A vs C) respectively.

CONCLUSIONS

AFABP levels were higher in obese individuals and highest in those with metabolic syndrome. CRP concentrations were increased in obese persons whereas individuals with metabolic syndrome were found to have high-risk CRP levels. Logistic regression models showed an association of aFABP and CRP with BMI as well as an association of aFABP and CRP with parameters of insulin resistance, namely the QUICKI index, triglyceride levels, glycaemia and insulinaemia. Both methods are of diagnostic benefit for predicting metabolic syndrome, especially in previously untreated patients.

摘要

背景

脂肪细胞脂肪酸结合蛋白(aFABP)最近被确定为代谢综合征的一种潜在循环标志物。C反应蛋白(CRP)是一种敏感的炎症标志物,由于亚临床炎症的发展,在糖尿病和代谢综合征患者中升高。本研究使用逻辑回归模型分析aFABP与CRP以及胰岛素抵抗的其他参数之间的关系。目的是研究aFABP和CRP水平作为代谢综合征诊断工具的潜在用途。

方法与结果

研究了以下几组:健康个体(A组,n = 122)、肥胖个体(B组,n = 213)和诊断为代谢综合征的患者(C组,n = 79)。B组肥胖者有提示早期胰岛素抵抗的参数:高血压、高血糖、定量胰岛素敏感性检查指数(QUICKI,0.305),且与健康受试者相比aFABP水平更高。C组个体被诊断为代谢综合征,胰岛素抵抗的QUICKI标志物(0.293)、高aFABP水平(35.3 mg/l)可证明。CRP浓度在A组健康个体中最低(0.67 mg/l),在B组肥胖受试者中较高(2.65 mg/l),在C组代谢综合征患者中最高(3.62 mg/l)。逻辑回归模型显示aFABP和CRP与体重指数相关(A组与C组相比,比值比分别为1.12和1.39)。aFABP和CRP与QUICKI指数相关,比值比分别为1.48和1.37(A组与C组);与甘油三酯水平相关,比值比分别为1.68和1.52(A组与C组)。aFABP和CRP与血糖相关,比值比分别为1.48和1.51(A组与C组),与胰岛素血症相关,比值比分别为1.44和1.38(A组与C组)。

结论

肥胖个体中aFABP水平较高,代谢综合征患者中最高。肥胖者CRP浓度升高,而代谢综合征患者CRP水平处于高风险。逻辑回归模型显示aFABP和CRP与体重指数相关,以及aFABP和CRP与胰岛素抵抗参数相关,即QUICKI指数、甘油三酯水平、血糖和胰岛素血症。两种方法对预测代谢综合征均有诊断价值,尤其是在未经治疗的患者中。

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