Zhang Kun, Pan Hui, Wang Linjie, Yang Hongbo, 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, People's Republic of China.
Department of Endocrinology, Shijiazhuang People's Hospital, The People Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Mar 12;14:1117-1128. doi: 10.2147/DMSO.S291350. eCollection 2021.
Adipose tissue insulin resistance is a common feature of obesity-related metabolic diseases. However, the relationship between adipose tissue insulin resistance and metabolic syndrome (MS) has not been fully elucidated. Here, we explored the relationship between the adipose tissue insulin resistance index (Adipo-IR) (fasting insulin × free fatty acids) and MS and the predictive power of Adipo-IR for MS in northern Chinese populations.
A total of 312 subjects, 186 subjects with MS, 80 nonmetabolic syndrome (NMS) subjects with central obesity, and 46 normal controls were recruited. The general clinical information, biochemical measurements, and oral glucose tolerance tests were evaluated. Serum adiponectin levels were determined using enzyme linked immunosorbent assay (ELISA).
Adipo-IR was 2.32-fold higher in NMS subjects and 2.62-fold higher in MS subjects than in normal controls in male subjects; in female subjects, it was 1.75-fold and 3.58-fold higher, respectively ( < 0.05). Female subjects with MS had higher Adipo-IR than male subjects ( < 0.001). Adipo-IR was independently positively correlated with waist circumference, triglyceride, aspartate aminotransferase, and fasting blood glucose and negatively correlated with adiponectin ( < 0.05). Subjects with the highest Adipo-IR tertile had a 2.758-fold higher risk of MS than subjects with the lowest tertile after adjusting for potential confounders (95% confidence interval: 1.552-9.096; = 0.003). Receiver operating characteristic curve analysis showed that the predictive power of Adipo-IR for MS was 73.1% and 79.2% in male and female subjects, respectively, with optimal cutoff values of 3.84 and 5.92 mU/L×mmol/L.
Adipo-IR provides a simple method to study adipose tissue insulin sensitivity. Adipo-IR is associated with MS and is an important predictor of MS.
脂肪组织胰岛素抵抗是肥胖相关代谢性疾病的常见特征。然而，脂肪组织胰岛素抵抗与代谢综合征（MS）之间的关系尚未完全阐明。在此，我们探讨了中国北方人群中脂肪组织胰岛素抵抗指数（Adipo-IR）（空腹胰岛素×游离脂肪酸）与MS的关系以及Adipo-IR对MS的预测能力。
共招募了312名受试者，其中186名患有MS的受试者、80名患有中心性肥胖的非代谢综合征（NMS）受试者和46名正常对照者。评估了一般临床信息、生化指标和口服葡萄糖耐量试验。使用酶联免疫吸附测定（ELISA）法测定血清脂联素水平。
男性受试者中，NMS受试者的Adipo-IR比正常对照者高2.32倍，MS受试者比正常对照者高2.62倍；女性受试者中，分别高1.75倍和3.58倍（<0.05）。患有MS的女性受试者的Adipo-IR高于男性受试者（<0.001）。Adipo-IR与腰围、甘油三酯、天冬氨酸转氨酶和空腹血糖呈独立正相关，与脂联素呈负相关（<0.05）。在调整潜在混杂因素后，Adipo-IR最高三分位数的受试者患MS的风险比最低三分位数的受试者高2.758倍（95%置信区间：1.552 - 9.096；=0.003）。受试者工作特征曲线分析表明，Adipo-IR对男性和女性受试者MS的预测能力分别为73.1%和79.2%，最佳截断值分别为3.84和5.92 mU/L×mmol/L。
Adipo-IR为研究脂肪组织胰岛素敏感性提供了一种简单方法。Adipo-IR与MS相关，是MS的重要预测指标。
