Xie Xiaomin, Bai Guirong, Liu Huili, Zhang Li, He YanTing, Qiang Dan, Zou Xiaoyan
Department of Endocrinology, The First People's Hospital of Yinchuan, Yinchuan, 750001, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Mar 31;14:1485-1492. doi: 10.2147/DMSO.S301352. eCollection 2021.
This study investigates the possible roles and potential prediction ability of metabolic parameters in the early development of T2D by detecting their serum levels at different fasting blood glucose (FBG) levels.
The subjects were included and divided into normal glucose tolerance (NGT), prediabetes (PD), and T2Dsubgroups. Apart from detecting the levels of routine biochemical parameters, fasting serum insulin (FINS), 25(OH)D, thioredoxin-interacting protein (TXNIP), thioredoxin (TRX), and NOD-like receptor family, pyrin domain-containing 3 (NLRP3) were detected. β-cell dysfunction (HOMA-β) and insulin resistance (HOMA-IR) were assessed by homeostasis model assessment. Both univariate and multivariate logistic regression analyses were used to estimate the risk of metabolic parameters, and their optimal cut-off values were obtained in the receiver operating characteristic (ROC) curve analysis and the Youden index.
Among the 207 subjects, aged from 20 to 60 years (44.62+12.92) contain 118 males and 89 females. There was a significantly lower trend of TRX, HOMA-β, and 25(OH)D following the higher FBG level among these three subgroups, while a significantly higher trend of all the other metabolic parameters. The multivariate analysis showed that subjects with higher values of TRX, HOMA-β, and 25(OH)D had a significantly lower risk for patients to be diagnosed as PD (aOR: 0.945, 0.961, and 0.543) and T2D (aOR: 0.912, 0.947, 0.434). Under the reliable 95% CI, TXNIP with a cut-off value of 119.27 showed the highest AUC value, sensitivity, and specificity (AUC: 0.981, 95% CI: 0.8524-0.9839, 91.49%, and 83.33%) to diagnose PD. FINS with a cut-off value of 28.1 also showed the highest ones (AUC=0.9872, 95% CI: 0.9753-0.9992, 100%, and 92.91%) to diagnose T2D.
Early prediction of T2D is vital for timely intervention. Based on the FBG ≥100.8 mg/dl, the results provide evidence that 25(OH)D might be the protective factor in the early development of T2D. Besides, TXNIP and FINS might be the predictor for PD and T2D, respectively.
本研究通过检测不同空腹血糖（FBG）水平下代谢参数的血清水平，探讨其在2型糖尿病（T2D）早期发展中的可能作用及潜在预测能力。
纳入研究对象并分为正常糖耐量（NGT）、糖尿病前期（PD）和T2D亚组。除检测常规生化参数水平外，还检测空腹血清胰岛素（FINS）、25（OH）D、硫氧还蛋白相互作用蛋白（TXNIP）、硫氧还蛋白（TRX）以及含吡啶结构域的NOD样受体家族成员3（NLRP3）。采用稳态模型评估法评估β细胞功能（HOMA-β）和胰岛素抵抗（HOMA-IR）。运用单因素和多因素逻辑回归分析评估代谢参数的风险，并通过受试者工作特征（ROC）曲线分析和尤登指数获得其最佳截断值。
207例年龄在20至60岁（44.62±12.92）的受试者中，男性118例，女性89例。在这三个亚组中，随着FBG水平升高，TRX、HOMA-β和25（OH）D呈显著降低趋势，而其他所有代谢参数呈显著升高趋势。多因素分析显示，TRX、HOMA-β和25（OH）D值较高的受试者被诊断为PD（调整后比值比：0.945、0.961和0.543）和T2D（调整后比值比：0.912、0.947、0.434）的风险显著较低。在可靠的95%置信区间下，截断值为119.27的TXNIP在诊断PD时显示出最高的曲线下面积（AUC）值、灵敏度和特异性（AUC：0.981，95%置信区间：0.8524 - 0.9839，91.49%，83.33%）。截断值为28.1的FINS在诊断T2D时也显示出最高的这些指标（AUC = 0.9872，95%置信区间：0.9753 - 0.9992，100%，92.91%）。
T2D的早期预测对于及时干预至关重要。基于FBG≥100.8mg/dl，结果表明25（OH）D可能是T2D早期发展中的保护因素。此外，TXNIP和FINS可能分别是PD和T2D 的预测指标。
