Koga Masafumi, Ishizaka Yuko, Yamakado Minoru
Department of Internal Medicine, Hakuhokai Central Hospital, Hyogo
Center for Multiphasic Health Testing and Services, Mitsui Memorial Hospital, Tokyo.
Ann Clin Lab Sci. 2019 Sep;49(4):529-533.
We reported that the body mass index (BMI) may exert a negative effect on glycated albumin (GA) in non-diabetic subjects and patients with type 2 diabetes mellitus. In addition, we suggested a mechanism in which chronic inflammation in obesity may enhance albumin catabolism, leading to a decrease in GA levels for non-diabetic subjects. In the present study, we examined whether GA levels increased with body weight reduction in obese, non-diabetic subjects. Among the subjects who underwent complete medical checkups in 2010 and in 2015, 101 subjects with BMIs of 25 kg/m or higher, without diabetes mellitus in 2010 were included in this study. Correlations of changes in BMI for five years (ΔBMI) with changes in various clinical laboratory test values [ΔC-reactive protein (CRP), ΔGA, ΔHbA1c, Δfasting plasma glucose (FPG), ΔGA/HbA1c and ΔGA/FPG] were investigated. ΔBMI significantly and positively correlated with ΔCRP, while ΔBMI did not significantly correlate with ΔGA. ΔBMI significantly and positively correlated with ΔHbA1c and ΔFPG. Furthermore, ΔBMI showed significant negative correlations with ΔGA/HbA1c and ΔGA/FPG. GA levels did not increase with body weight reduction in obese non-diabetic subjects. Such a phenomenon might be considered the result when the positive control of GA levels through decreases in chronic inflammation due to body weight reduction was counterbalanced by the negative control of GA levels through improvement in glucose tolerance.
我们曾报道，体重指数（BMI）可能对非糖尿病受试者及2型糖尿病患者的糖化白蛋白（GA）产生负面影响。此外，我们提出了一种机制，即肥胖中的慢性炎症可能会增强白蛋白分解代谢，导致非糖尿病受试者的GA水平降低。在本研究中，我们调查了肥胖非糖尿病受试者体重减轻时GA水平是否会升高。在2010年和2015年接受全面体检的受试者中，本研究纳入了101名2010年BMI为25kg/m或更高且无糖尿病的受试者。研究了五年内BMI的变化（ΔBMI）与各种临床实验室检查值的变化[ΔC反应蛋白（CRP）、ΔGA、Δ糖化血红蛋白（HbA1c）、Δ空腹血糖（FPG）、ΔGA/HbA1c和ΔGA/FPG]之间的相关性。ΔBMI与ΔCRP显著正相关，而ΔBMI与ΔGA无显著相关性。ΔBMI与ΔHbA1c和ΔFPG显著正相关。此外，ΔBMI与ΔGA/HbA1c和ΔGA/FPG显著负相关。肥胖非糖尿病受试者体重减轻时GA水平并未升高。这种现象可能被认为是由于体重减轻导致慢性炎症减少对GA水平的正向控制，与糖耐量改善对GA水平的负向控制相互抵消的结果。
