Martins Aline Stangherlin, Jansen Ann Kristine, Rodrigues Luiz Oswaldo Carneiro, Matos Camila Maria, Souza Marcio Leandro Ribeiro, Miranda Débora Marques, Rezende Nilton Alves de
Centro de Referência de Neurofibromatose, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Arch Endocrinol Metab. 2018 Feb;62(1):41-46. doi: 10.20945/2359-3997000000007.
Objects To compare insulin resistance (IR) and metabolic aspects of patients with neurofibromatosis type 1 (NF1) and individuals without the disease. Subjects and methods Forty patients with NF1 were matched by sex, age, and body mass index (BMI) to 40 controls from the community. Blood samples were collected for biochemical assessment. Homeostasis model assessment adiponectin (HOMA-AD), Homeostasis model assessment insulin resistance (HOMA-IR), and adiponectin/leptin ratio (ALR) were used to identify IR. Results The median HOMA-IR values were similar between the groups. However, the HOMA-AD value was significantly lower and the ALR significantly higher in the NF1 group. Fasting blood glucose (FBG), leptin, and visfatin levels of patients with NF1 were significantly lower, although adiponectin levels were significantly higher than those in the controls. Fasting insulin and blood glucose levels 2 hours after administration of 75 g of dextrose, glycated hemoglobin, and resistin showed no significant differences between groups. The HOMA-AD correlated with BMI, FBG, blood glucose levels 2 hours after administration of 75 g of dextrose, fasting insulin, glycated hemoglobin, adiponectin, leptin, visfatin, ALR, and HOMA-IR. The ALR correlated with BMI leptin, visfatin, and adiponectin. Conclusions Lower levels of FBG, leptin, visfatin, and HOMA-AD, and higher adiponectin levels and ALR may be related to increased insulin sensitivity and lower occurrence of type 2 diabetes mellitus in patients with NF1.
目的 比较1型神经纤维瘤病（NF1）患者与非NF1患者的胰岛素抵抗（IR）及代谢情况。对象与方法 40例NF1患者按性别、年龄和体重指数（BMI）与40名社区对照者进行匹配。采集血样进行生化评估。采用稳态模型评估脂联素（HOMA-AD）、稳态模型评估胰岛素抵抗（HOMA-IR）和脂联素/瘦素比值（ALR）来识别IR。结果 两组间HOMA-IR的中位数相似。然而，NF1组的HOMA-AD值显著更低，ALR显著更高。NF1患者的空腹血糖（FBG）、瘦素和内脂素水平显著更低，尽管脂联素水平显著高于对照组。口服75 g葡萄糖后2小时的空腹胰岛素和血糖水平、糖化血红蛋白和抵抗素在两组间无显著差异。HOMA-AD与BMI、FBG、口服75 g葡萄糖后2小时的血糖水平、空腹胰岛素、糖化血红蛋白、脂联素、瘦素、内脂素、ALR和HOMA-IR相关。ALR与BMI、瘦素、内脂素和脂联素相关。结论 FBG、瘦素、内脂素和HOMA-AD水平较低，脂联素水平和ALR较高，可能与NF1患者胰岛素敏感性增加及2型糖尿病发生率较低有关。
