Lee Jie-Eun, Oh Tae Jung, Moon Jae Hoon, Park Kyong Soo, Jang Hak Chul, Choi Sung Hee
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Front Endocrinol (Lausanne). 2019 Feb 28;10:43. doi: 10.3389/fendo.2019.00043. eCollection 2019.
The purpose of this study was to measure the serum neopterin according to glucose metabolism and to evaluate neopterin as a predictor of type 2 diabetes (T2D) in a hospital-based cohort. A 75-g oral glucose tolerance test (OGTT) was performed by people who visited the outpatient clinic in Seoul National University Bundang Hospital for suspected abnormal glucose tolerance or a strong family history of T2D. Neopterin was measured using an enzyme-link immunosorbent assay with baseline samples from the OGTT. Neopterin was measured in 184 participants. Indices related to glucose metabolism, such as the HOMA-IR, disposition index, etc. were calculated based on the results of the OGTT. The classifications for the 184 participants were: 24 (13%) had NGT, 89 (48.4%) prediabetes, and 60 (38.6%) T2D. Neopterin increased with deterioration of glucose metabolism (0.55 ± 0.25 vs. 0.58 ± 0.27 vs. 0.67 ± 0.27 ng/ml, = 0.041; NGT, prediabetes, and T2D, respectively). Neopterin also correlated with fasting plasma glucose, 30-min and 120-min glucose of OGTT and HbA1c ( = 0.251, 0.259, 0.184, and 0.270, all < 0.05). The HOMA-IR and disposition index correlated with neopterin ( = 0.291 and -0.170, respectively, both < 0.05). When combined with C-peptide level, neopterin was as powerful as HOMA-IR in predicting future T2D. Serum neopterin appears to be related to impaired insulin secretion and insulin resistance in the development of T2D. Further investigation of the relationship between neopterin and glucose metabolism would be helpful to understand the pathophysiology for the development of T2D.
本研究的目的是根据葡萄糖代谢情况测定血清新蝶呤，并在一个以医院为基础的队列中评估新蝶呤作为2型糖尿病（T2D）预测指标的价值。对因疑似糖耐量异常或有T2D家族史而到首尔国立大学盆唐医院门诊就诊的患者进行了75克口服葡萄糖耐量试验（OGTT）。使用酶联免疫吸附测定法对OGTT的基线样本进行新蝶呤测定。对184名参与者进行了新蝶呤测定。根据OGTT结果计算与葡萄糖代谢相关的指标，如HOMA-IR、处置指数等。184名参与者的分类情况为：24人（13%）为正常糖耐量（NGT），89人（48.4%）为糖尿病前期，60人（38.6%）为T2D。随着葡萄糖代谢恶化，新蝶呤水平升高（分别为0.55±0.25、0.58±0.27、0.67±0.27 ng/ml，P = 0.041；分别对应NGT、糖尿病前期和T2D）。新蝶呤还与空腹血糖、OGTT的30分钟和120分钟血糖以及糖化血红蛋白相关（P分别为0.251、0.259、0.184和0.270，均P < 0.05）。HOMA-IR和处置指数与新蝶呤相关（P分别为0.291和 -0.170，均P < 0.05）。当与C肽水平结合时，新蝶呤在预测未来T2D方面与HOMA-IR一样有效。血清新蝶呤似乎与T2D发生过程中胰岛素分泌受损和胰岛素抵抗有关。进一步研究新蝶呤与葡萄糖代谢之间的关系将有助于理解T2D发生的病理生理学机制。
