Jain Neha Bindlish, Yadav Asha, Shankar Nilima, Ahmed Rafat
Department of Physiology, University College of Medical Sciences, Delhi, India.
Department of Biochemistry, University College of Medical Sciences, Delhi, India.
Int J Endocrinol Metab. 2019 Apr 17;17(2):e74250. doi: 10.5812/ijem.74250. eCollection 2019 Apr.
The current study aimed at investigating the correlation of circulating levels of serum C1q/TNF-related protein-3 (CTRP3) with cardiac autonomic functions and metabolic parameters in obesity.
Thirty drug naïve subjects newly diagnosed with obesity and body mass index (BMI) 25 - 35 kg/m of both genders aged 19 - 40 years, with no associated comorbidity were recruited as cases. Same number of age, gender and socioeconomic status matched subjects with BMI 19 - 23 kg/m were taken as controls. Autonomic function test results including heart rate variability (HRV) were recorded in both groups. Serum metabolic parameters -CTRP3, leptin, adiponectin, insulin, blood glucose, glycated hemoglobin (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, and triglycerides were also determined and compared between the groups.
Significantly lower circulating levels of CTRP3 (P ≤ 0.001) and adiponectin (P = 0.025), and significantly higher mean of BMI (P < 0.001), fasting blood glucose (P < 0.001), LDL-cholesterol (P < 0.05), serum triglycerides (P < 0.001), insulin (P = 0.003), HOMA-IR (homeostasis model assessment of insulin resistance) (P < 0.001), and leptin (P = 0.043) were observed in the group with obesity compared to the controls. CTRP3 levels inversely correlated with serum triglyceride (r = -0.09, P < 0.001), atherogenic index (r = -0.37, P = 0.04), leptin (r = -0.39, P = 0.02), and positively with adiponectin (r = 0.42, P = 0.02) in the group with obesity. Significant reduction in the results of parasympathetic autonomic function tests (pNN50, RMSSD, excitation: inhibition (E:I) ratio, 30:15 ratio, and Valsalva ratio) and an increase in sympathovagal balance (low frequency to high frequency (LF:HF) ratio) was also observed (P < 0.05). CTRP3 levels were also positively correlated with parasympathetic indices (pNN50: r = 0.17, P < 0.05); 30:15 ratio: (r = 0.62, P < 0.01), and inversely correlated with LF: HF ratio (r = -0.35, P < 0.01) in the group with obesity.
Higher circulating levels of CTRP3 promoted a favorable autonomic and metabolic profile in obesity. Hence, CTRP3 may be considered as a potential novel biomarker to facilitate the prognosis of obesity and its comorbidities.
本研究旨在探讨血清C1q/TNF相关蛋白-3（CTRP3）循环水平与肥胖患者心脏自主神经功能及代谢参数之间的相关性。
招募30例新诊断为肥胖且体重指数（BMI）为25 - 35 kg/m²、年龄在19 - 40岁、无合并症的未服用过药物的男女受试者作为病例组。选取相同数量的年龄、性别和社会经济地位相匹配、BMI为19 - 23 kg/m²的受试者作为对照组。记录两组的自主神经功能测试结果，包括心率变异性（HRV）。同时测定并比较两组的血清代谢参数——CTRP3、瘦素、脂联素、胰岛素、血糖、糖化血红蛋白（HbA1c）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、总胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇和甘油三酯。
与对照组相比，肥胖组CTRP3（P≤0.001）和脂联素（P = 0.025）的循环水平显著降低，而BMI均值（P < 0.001）、空腹血糖（P < 0.001）、LDL胆固醇（P < 0.05）、血清甘油三酯（P < 0.001）、胰岛素（P = 0.003）、HOMA-IR（胰岛素抵抗稳态模型评估）（P < 0.001）和瘦素（P = 0.043）显著升高。在肥胖组中，CTRP3水平与血清甘油三酯（r = -0.09，P < 0.001）、致动脉粥样硬化指数（r = -0.37，P = 0.分）、瘦素（r = -0.39，P = 0.02）呈负相关，与脂联素（r = 0.42，P = 0.02）呈正相关。此外，还观察到副交感神经自主功能测试结果（pNN50、RMSSD、兴奋：抑制（E:I）比值、30:15比值和瓦尔萨尔瓦比值）显著降低，交感迷走神经平衡（低频与高频（LF:HF）比值）增加（P < 0.05）。在肥胖组中，CTRP3水平与副交感神经指标（pNN50：r = 0.17，P < 0.05）、30:15比值（r = 0.62，P < 0.01）呈正相关，与LF:HF比值（r = -0.35，P < 0.01）呈负相关。
CTRP3较高的循环水平在肥胖中促进了良好的自主神经和代谢特征。因此，CTRP3可被视为一种潜在的新型生物标志物，有助于肥胖及其合并症的预后评估。
