Liu Meijuan, Zhang Kun, Wang Linjie, Yang Hongbo, Yan Kemin, Pan Hui, Zhu Huijuan, Gong Fengying
Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Aug 26;13:3099-3112. doi: 10.2147/DMSO.S257643. eCollection 2020.
To explore serum zinc-α2-glycoprotein (ZAG) and adiponectin in metabolically healthy non-obese (MHNO), metabolically healthy obesity (MHO), metabolically abnormal obesity (MAO) and metabolically abnormal diabetic obese (MADO) subjects and the relationship with metabolically phenotypes of obesity.
Two hundred twenty-five subjects including 32 with MHNO, 40 with MHO, 104 with MAO and 49 with MADO were enrolled. Baseline clinical data and biochemical variables were collected. Serum ZAG and adiponectin levels were measured by enzyme-linked immunosorbent assay (ELISA) kits. Metabolically healthy (<3 metabolic abnormalities) or abnormal (≥3 metabolic abnormalities) subjects were classified based on the National Cholesterol Education Program-Adult Treatment Panel III (NCEP/ATP III) criteria. Obesity (body mass index ≥28 kg/m) was recommended by China Obesity Task Force.
Serum ZAG levels were higher in the MHO group, but were progressively lower in MAO and MADO groups ( all<0.05). In all subjects, total cholesterol, 2-hour postprandial blood glucose and homeostasis model assessment of adiponectin were independent variables to serum ZAG levels. Compared with subjects in the highest tertile of ZAG, the odds ratio (OR) of metabolically abnormal risks of subjects in the lowest and median tertiles of ZAG were higher both in a univariate and three adjustment models ( all<0.05). Serum ZAG could discriminate the metabolically abnormal phenotype with receiver operating characteristic (ROC) curve area of 0.622 (95% CI, 0.539-0.706, <0.05). Combination of ZAG and adiponectin had improved diagnosis value accuracy, with ROC curve area of 0.703 (95% CI, 0.629-0.776, <0.05), and 62.7% sensitivity and 73.6% specificity.
Serum ZAG levels were higher in MHO subjects, but lower in MAO and MADO subjects. The decreased serum ZAG levels were closely related to the metabolically abnormal phenotype of obese patients. Serum ZAG, especially the combination with adiponectin might be the potential diagnostic biomarkers for metabolically abnormal obese patients.
探讨代谢健康非肥胖（MHNO）、代谢健康肥胖（MHO）、代谢异常肥胖（MAO）和代谢异常糖尿病肥胖（MADO）受试者的血清锌-α2-糖蛋白（ZAG）和脂联素，以及它们与肥胖代谢表型的关系。
招募了225名受试者，包括32名MHNO受试者、40名MHO受试者、104名MAO受试者和49名MADO受试者。收集基线临床数据和生化变量。采用酶联免疫吸附测定（ELISA）试剂盒测定血清ZAG和脂联素水平。根据美国国家胆固醇教育计划成人治疗小组第三次报告（NCEP/ATP III）标准，将代谢健康（<3种代谢异常）或异常（≥3种代谢异常）的受试者进行分类。中国肥胖问题工作组建议将肥胖定义为体重指数≥28kg/m²。
MHO组血清ZAG水平较高，但在MAO组和MADO组中逐渐降低（均P<0.05）。在所有受试者中，总胆固醇、餐后2小时血糖和脂联素稳态模型评估是血清ZAG水平的独立影响因素。与ZAG最高三分位数的受试者相比，ZAG最低和中间三分位数的受试者在单因素和三因素调整模型中代谢异常风险的比值比（OR）均较高（均P<0.05）。血清ZAG能够区分代谢异常表型，其受试者工作特征（ROC）曲线面积为0.622（95%CI，0.539-0.706，P<0.05）。ZAG和脂联素联合使用可提高诊断价值准确性，ROC曲线面积为0.703（95%CI，0.629-0.776，P<0.05），敏感性为62.7%，特异性为73.6%。
MHO受试者血清ZAG水平较高，但MAO和MADO受试者血清ZAG水平较低。血清ZAG水平降低与肥胖患者的代谢异常表型密切相关。血清ZAG，尤其是与脂联素联合使用，可能是代谢异常肥胖患者潜在的诊断生物标志物。
