Bravo Carolina, Cataldo Luis Rodrigo, Galgani José, Parada Javier, Santos José Luis
Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Carrera de Nutrición y Dietética, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
J Diabetes Res. 2017;2017:9031079. doi: 10.1155/2017/9031079. Epub 2017 May 25.
Plasma leptin/adiponectin ratio (LAR) is negatively associated with insulin sensitivity indexes. High-molecular-weight adiponectin (HMWA) was proposed as the most biologically active form of this insulin-sensitizing adipokine. There are no studies assessing the relative merits of leptin/HMWA ratio over LAR as a biomarker of systemic insulin sensitivity. A standard 2-hour oral glucose tolerance test (OGTT; 75 g of glucose) and a short minimal-model intravenous glucose tolerance test (IVGTT; 0.3 g/kg body weight) were performed in 58 Chilean normoglycemic women (age: 27 ± 6.3 years, BMI 23.6 ± 3.2 kg/m). LAR was negatively associated with HOMA-S ( = -0.49; < 0.0001), Matsuda-ISICOMP ( = -0.54; < 0.0001), and the calculated sensitivity index (CSi) derived from IVGTT ( = -0.38; = 0.007). In comparison to LAR, leptin/HMWA ratio did not increase neither the linear fit () nor the magnitude of association with insulin sensitivity indexes (slope of multiple linear regression). The discriminatory capacity of both ratios to classify insulin-resistant versus insulin-sensitive subjects was similar for HOMA-S ( = 0.84), Matsuda-ISICOMP ( = 0.43), or CSi ( = 0.50). In conclusion, LAR showed consistent negative associations with different systemic insulin sensitivity indexes. The use of HMWA to generate leptin/HMWA ratio did not show any advantage over LAR as a biomarker of systemic insulin sensitivity in normoglycemic women.
血浆瘦素/脂联素比值（LAR）与胰岛素敏感性指标呈负相关。高分子量脂联素（HMWA）被认为是这种具有胰岛素增敏作用的脂肪因子中最具生物活性的形式。目前尚无研究评估瘦素/HMWA比值相对于LAR作为全身胰岛素敏感性生物标志物的相对优势。对58名智利血糖正常的女性（年龄：27±6.3岁，体重指数23.6±3.2kg/m²）进行了标准的2小时口服葡萄糖耐量试验（OGTT；75g葡萄糖）和简短的最小模型静脉葡萄糖耐量试验（IVGTT；0.3g/kg体重）。LAR与HOMA-S呈负相关（r=-0.49；P<0.0001）、与松田-ISICOMP呈负相关（r=-0.54；P<0.0001），以及与IVGTT得出的计算敏感性指数（CSi）呈负相关（r=-0.38；P=0.007）。与LAR相比，瘦素/HMWA比值既未增加线性拟合度（r），也未增加与胰岛素敏感性指标的关联强度（多元线性回归斜率）。对于HOMA-S（AUC=0.84）、松田-ISICOMP（AUC=0.43）或CSi（AUC=0.50），这两种比值区分胰岛素抵抗与胰岛素敏感受试者的能力相似。总之，LAR与不同的全身胰岛素敏感性指标呈一致的负相关。在血糖正常的女性中，使用HMWA得出瘦素/HMWA比值作为全身胰岛素敏感性生物标志物，相对于LAR并未显示出任何优势。
