Drabsch Theresa, Holzapfel Christina, Stecher Lynne, Petzold Julia, Skurk Thomas, Hauner Hans
Institute for Nutritional Medicine, University Hospital Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
ZIEL Institute for Food and Health, Technical University of Munich, Munich, Germany.
Front Endocrinol (Lausanne). 2018 Sep 20;9:556. doi: 10.3389/fendo.2018.00556. eCollection 2018.
Long-term positive energy balance promotes the development of obesity, a main risk factor for type 2 diabetes mellitus (T2DM). While an association between increased resting metabolic rate (RMR) and insulin sensitivity (IS) was shown previously, the underlying mechanisms remain unclear. Aim of the mediator analysis was to investigate the role of inflammation within the association between RMR and IS. Anthropometric, clinical, and lifestyle data were collected according to standard operating procedures. RMR was measured using indirect calorimetry. Homeostasis model assessment for insulin resistance (HOMA-IR) was used as an IS parameter and C-reactive protein (CRP) was measured to represent the inflammatory status. Statistical analyses were performed using SPSS. The analysis included 782 adults (517 females) with a mean age of 32.4 ± 12.0 years and a mean body mass index (BMI) of 24.6 ± 5.2 kg/m. Regression analysis indicated a significant evidence for associations between RMR and HOMA-IR (ß = 39.3 ± 7.3 kcal/d; ≤ 0.001) and CRP and HOMA-IR (ß = 0.5 ± 0.1; ≤ 0.001) after adjustment for fat-free mass, sex, age, and study site. Results of the mediator analysis did not support the hypothesis that CRP is a mediator for the association between RMR and HOMA-IR. These results did not change after participant stratification according to sex or BMI. A significant evidence for an association between RMR and IS was shown in a large cohort. However, the inflammatory status, determined via CRP levels, was not a mediator within this association.
长期正能量平衡会促进肥胖的发展，肥胖是2型糖尿病（T2DM）的主要危险因素。虽然先前已显示静息代谢率（RMR）增加与胰岛素敏感性（IS）之间存在关联，但其潜在机制仍不清楚。中介分析的目的是研究炎症在RMR与IS关联中的作用。根据标准操作程序收集人体测量、临床和生活方式数据。使用间接测热法测量RMR。采用胰岛素抵抗稳态模型评估（HOMA-IR）作为IS参数，并测量C反应蛋白（CRP）以代表炎症状态。使用SPSS进行统计分析。该分析纳入了782名成年人（517名女性），平均年龄为32.4±12.0岁，平均体重指数（BMI）为24.6±5.2kg/m²。回归分析表明，在调整无脂肪量、性别、年龄和研究地点后，RMR与HOMA-IR之间（β=39.3±7.3kcal/d；P≤0.001）以及CRP与HOMA-IR之间（β=0.5±0.1；P≤0.001）存在显著关联证据。中介分析结果不支持CRP是RMR与HOMA-IR关联中介的假设。根据性别或BMI对参与者进行分层后，这些结果没有改变。在一个大型队列中显示了RMR与IS之间存在关联的显著证据。然而，通过CRP水平确定的炎症状态并非该关联中的中介因素。
