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新型蛋白聚糖衍生的全身炎症标志物及与血糖、胰岛素抵抗和胰岛素分泌相关的C反应蛋白

Novel Protein Glycan-Derived Markers of Systemic Inflammation and C-Reactive Protein in Relation to Glycemia, Insulin Resistance, and Insulin Secretion.

作者信息

Lorenzo Carlos, Festa Andreas, Hanley Anthony J, Rewers Marian J, Escalante Agustin, Haffner Steven M

机构信息

Department of Medicine, University of Texas Health Science Center, San Antonio, TX.

Eli Lilly and Company, Vienna, Austria

出版信息

Diabetes Care. 2017 Mar;40(3):375-382. doi: 10.2337/dc16-1569. Epub 2016 Dec 28.

Abstract

OBJECTIVE

N-acetylglucosamine/galactosamine (GlycA) and sialic acid (GlycB) moieties of glycosylated serum proteins are nonspecific measures of inflammation, but conclusive data on their relationship with insulin resistance or insulin secretion are missing. Therefore, we aimed to examine the relation of GlycA, GlycB, and C-reactive protein (CRP) to direct measures of insulin sensitivity (insulin sensitivity index [S]) and insulin secretion (acute insulin response [AIR]).

RESEARCH DESIGN AND METHODS

This study used cross-sectional analyses and included 1,225 participants with and without type 2 diabetes in the Insulin Resistance Atherosclerosis Study (IRAS). S and AIR were measured using the frequently sampled intravenous glucose tolerance test, and GlycA and GlycB were measured using nuclear magnetic resonance spectroscopy.

RESULTS

GlycA and GlycB had a strong correlation with CRP ( = 0.60 [ < 0.001] and = 0.46 [ < 0.001], respectively). In a linear regression model with both GlycA and CRP as independent variables, GlycA (β × 1 SD, -0.04 ± 0.02; < 0.01) and CRP (-0.06 ± 0.02; < 0.001) were independently associated with S even after adjusting for demographics, smoking, physical activity, plasma glucose, and BMI. However, neither CRP nor GlycA had an independent relationship with AIR.

CONCLUSIONS

GlycA may complement CRP in evaluating the relationship between inflammation, glucose tolerance, and insulin resistance.

摘要

目的

糖基化血清蛋白的N-乙酰葡糖胺/半乳糖胺(糖基A)和唾液酸(糖基B)部分是炎症的非特异性指标,但关于它们与胰岛素抵抗或胰岛素分泌关系的确切数据尚缺。因此,我们旨在研究糖基A、糖基B和C反应蛋白(CRP)与胰岛素敏感性(胰岛素敏感指数[S])和胰岛素分泌(急性胰岛素反应[AIR])直接指标之间的关系。

研究设计与方法

本研究采用横断面分析,纳入了胰岛素抵抗动脉粥样硬化研究(IRAS)中1225名有或无2型糖尿病的参与者。使用频繁采样静脉葡萄糖耐量试验测量S和AIR,使用核磁共振波谱法测量糖基A和糖基B。

结果

糖基A和糖基B与CRP密切相关(分别为r = 0.60 [P < 0.001]和r = 0.46 [P < 0.001])。在以糖基A和CRP作为自变量的线性回归模型中,即使在调整了人口统计学、吸烟、体力活动、血浆葡萄糖和BMI后,糖基A(β×1 SD,-0.04±0.02;P < 0.01)和CRP(-0.06±0.02;P < 0.001)仍与S独立相关。然而,CRP和糖基A与AIR均无独立关系。

结论

在评估炎症、糖耐量和胰岛素抵抗之间的关系时,糖基A可能补充CRP的作用。

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