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中国2型糖尿病患者血清内脂素水平降低,且与体重指数呈负相关。

Serum adropin levels are decreased in Chinese type 2 diabetic patients and negatively correlated with body mass index.

作者信息

Zang Huanhuan, Jiang Fusong, Cheng Xingbo, Xu Hong, Hu Xingna

机构信息

Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.

Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.

出版信息

Endocr J. 2018 Jul 28;65(7):685-691. doi: 10.1507/endocrj.EJ18-0060. Epub 2018 Apr 17.

Abstract

Adropin has been identified as potent regulatory hormone implicated in insulin sensitivity and the maintenance of energy homeostasis. The aim of current study was to investigate serum adropin concentrations of type 2 diabetes mellitus (T2DM) patients in the fasting status, especially those overweight/obese and evaluate the relationships between adropin levels and metabolic parameters. A total of 116 T2DM patients and 60 controls with normal glucose tolerance (NGT) were recruited to the study. Adropin concentration was determined using commercial ELISA kits. Anthropometric characteristics were collected and biochemistry, glycosylated hemoglobin Ac (HbAc) and fasting insulin (FIns) were detected by clinical laboratory. Insulin resistance was estimated by homeostasis model 2 assessment of insulin resistance (HOMA2-IR). Serum adropin levels in Chinese T2DM patients were decreased compared with the controls [3.8 (3.0-5.5) vs. 5.5 (3.7-7.9) ng/mL, p < 0.01]. Meanwhile, overweight/obese patients had more considerably reduced levels of adropin. Adropin level was negatively correlated with body mass index (BMI), high-sensitive C reactive protein (hs-CRP), triglycerides (TG), fasting plasma glucose (FPG), FIns, HOMA2-IR and HbAc, while positively with high-density lipoprotein cholesterol (HDL-C) in study participants (p < 0.01). The correlations of adropin with glucolipid variables (TG, HDL-C, FPG, FIns, HOMA2-IR, HbAc) still existed after adjusting the effect of BMI. Besides, HOMA2-IR and HbAc were independent factors associated with serum adropin levels. Binary logistic regression analyses showed that adropin was significantly associated with T2DM after removing confounding factors (p < 0.01). Receiver operating characteristic (ROC) curve demonstrated adropin concentration of 5.8 ng/mL could be used as a possible optimal cut-off value to identify T2DM from non-T2DM with sensitivity of 81.9% and specificity of 46.7%. Serum adropin concentrations are decreased in Chinese T2DM patients, especially those overweight/obese. Adropin, associated with glucolipid homeostasis and insulin sensitivity, may implicate in the pathogenesis of T2DM.

摘要

内脂素已被确认为一种强效调节激素,与胰岛素敏感性和能量稳态的维持有关。本研究的目的是调查2型糖尿病(T2DM)患者空腹状态下的血清内脂素浓度,尤其是超重/肥胖患者,并评估内脂素水平与代谢参数之间的关系。本研究共招募了116例T2DM患者和60例糖耐量正常(NGT)的对照者。使用商业ELISA试剂盒测定内脂素浓度。收集人体测量学特征,并通过临床实验室检测生化指标、糖化血红蛋白Ac(HbAc)和空腹胰岛素(FIns)。采用稳态模型2评估胰岛素抵抗(HOMA2-IR)来估计胰岛素抵抗。与对照组相比,中国T2DM患者的血清内脂素水平降低[3.8(3.0 - 5.5)对5.5(3.7 - 7.9)ng/mL,p < 0.01]。同时,超重/肥胖患者的内脂素水平降低更为明显。在研究参与者中,内脂素水平与体重指数(BMI)、高敏C反应蛋白(hs-CRP)、甘油三酯(TG)、空腹血糖(FPG)、FIns、HOMA2-IR和HbAc呈负相关,而与高密度脂蛋白胆固醇(HDL-C)呈正相关(p < 0.01)。在调整BMI的影响后,内脂素与糖脂变量(TG、HDL-C、FPG、FIns、HOMA2-IR、HbAc)之间的相关性仍然存在。此外,HOMA2-IR和HbAc是与血清内脂素水平相关的独立因素。二元逻辑回归分析显示,在去除混杂因素后,内脂素与T2DM显著相关(p < 0.01)。受试者工作特征(ROC)曲线表明,内脂素浓度为5.8 ng/mL可作为从非T2DM中识别T2DM的可能最佳截断值,敏感性为81.9%,特异性为46.7%。中国T2DM患者的血清内脂素浓度降低,尤其是超重/肥胖患者。内脂素与糖脂稳态和胰岛素敏感性相关,可能参与T2DM的发病机制。

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