瘦素与脂联素比值 - 肥胖症代谢紊乱早期检测的替代生物标志物。

Leptin to adiponectin ratio - A surrogate biomarker for early detection of metabolic disturbances in obesity.

机构信息

Research Group of Gastroenterology and Nutrition, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.

出版信息

Nutr Metab Cardiovasc Dis. 2018 Nov;28(11):1114-1121. doi: 10.1016/j.numecd.2018.06.020. Epub 2018 Jul 3.

DOI:10.1016/j.numecd.2018.06.020

PMID:30145019

Abstract

AIM

To study if the leptin to adiponectin (L:A) ratio, can be a potential biomarker for postprandial triglyceride clearance, insulin resistance (IR) or leptin resistance (LR) in apparently healthy obese, and obese individuals with established metabolic disease.

METHODS AND RESULTS

Fifty adult subjects with obesity (BMI ≥30); of which 36 metabolic healthy obese (MHO), and 14 metabolic dysregulated obese (MDO), with clinical and/or biochemical signs of metabolic disease were included. Seventeen healthy, normal weight subjects represented the control group. Postprandial triglyceride (TG) levels were measured in an 8 h oral fat tolerance test (OFTT). IR by HOMA-IR, L:A ratio and indirect LR were measured. In the MHO group, 71.4%, 69.4% and 86.1%, had delayed TG clearance, IR and LR, respectively; whereas in the MDO group this was detected in 85.7%, 71.4% and 91.7%, respectively. A combination of all three metabolic risk factors was found in 39.8% of the MHO and in 42.9% of the MDO patients. Receiver operating characteristics (ROC) analysis revealed that a cut-off value for the L:A ratio of >1.65 for the control group (PPV 1.0, NPV 0.91) and >3.65 for the obese subjects (PPV 0.86, NPV 0.48) predicted the delayed TG clearance with a good specificity and sensitivity. Detecting a combined risk with at least 2/3 metabolic risk factors, the ROC yielded the most suitable L:A ratio cut-off at >1.88.

CONCLUSION

L:A ratio was able to detect early metabolic disturbances in obese individuals, and may be a potential useful clinical surrogate biomarker of metabolic disorders.

摘要

目的

研究瘦素与脂联素（L:A）比值是否可作为餐后甘油三酯清除率、胰岛素抵抗（IR）或瘦素抵抗（LR）的潜在生物标志物，用于表型健康肥胖者和合并代谢疾病的肥胖者。

方法和结果

共纳入 50 例肥胖成年人（BMI≥30），其中 36 例为代谢健康肥胖者（MHO），14 例为代谢失调肥胖者（MDO），有临床和/或生化代谢疾病的表现。17 例健康、体重正常的受试者为对照组。通过 8 小时口服脂肪耐量试验（OFTT）检测餐后甘油三酯（TG）水平。采用 HOMA-IR、L:A 比值和间接 LR 评估 IR。在 MHO 组中，71.4%、69.4%和 86.1%分别存在 TG 清除延迟、IR 和 LR；而在 MDO 组中，分别有 85.7%、71.4%和 91.7%存在这些情况。在 39.8%的 MHO 和 42.9%的 MDO 患者中发现了三种代谢危险因素的联合存在。受试者工作特征（ROC）分析显示，对照组 L:A 比值>1.65（PPV 1.0，NPV 0.91）和肥胖组 L:A 比值>3.65（PPV 0.86，NPV 0.48）的切点值预测 TG 清除延迟具有较好的特异性和敏感性。检测至少有 2/3 种代谢危险因素的联合风险时，ROC 得到的最佳 L:A 比值切点值为>1.88。