载脂蛋白 C-III 与类风湿关节炎中存在的胰岛素抵抗和β细胞功能障碍有关。
Apolipoprotein C-III is linked to the insulin resistance and beta-cell dysfunction that are present in rheumatoid arthritis.
机构信息
Division of Internal Medicine, Hospital Universitario de Canarias, Tenerife, Spain.
Department of Internal Medicine, University of La Laguna (ULL), Tenerife, Spain.
出版信息
Arthritis Res Ther. 2022 May 30;24(1):126. doi: 10.1186/s13075-022-02822-w.
BACKGROUND
Insulin resistance and beta-cell dysfunction are manifestations of rheumatoid arthritis (RA). Apolipoprotein C-III (ApoC3) has been associated with such insulin resistance and beta-cell dysfunction in the general population. Our purpose was to study whether ApoC3 is also related to the insulin resistance and beta-cell dysfunction that are present in patients with RA.
METHODS
Three hundred thirty-eight non-diabetic patients with RA who had a glycemia lower than 110 mg/dl were recruited. Insulin, C-peptide, and ApoC3 were assessed. Insulin resistance and beta-cell function were calculated using the Homeostasis Model Assessment (HOMA2) indices. A multivariable regression analysis was performed to study the relationship of ApoC3 with those molecules and indices adjusting for classic factors associated with insulin resistance that included glucocorticoids.
RESULTS
ApoC3 was related to significant higher levels of circulating insulin (beta coef. 0.37 [95%CI 0.01-0.73] µU/ml, p = 0.044) and C-peptide (beta coef. 0.13 [95%CI 0.05-0.22] ng/ml, p = 0.003), and higher insulin resistance -HOMA2-IR- (beta coef. 0.05 [95%CI 0.00-0.09], p = 0.041) and beta-cell dysfunction -HOMA2-%B- (beta coef. 2.94 [95%CI 0.07-5.80], p = 0.044) indices. This was found after a fully multivariable analysis that included, among others, prednisone intake and the classic factors associated with carbohydrate metabolism such as triglycerides, waist circumference, and obesity.
CONCLUSION
ApoC3, insulin resistance, and beta-cell dysfunction are independently associated in patients RA.
背景
胰岛素抵抗和β细胞功能障碍是类风湿关节炎（RA）的表现。载脂蛋白 C-III（ApoC3）与普通人群中的这种胰岛素抵抗和β细胞功能障碍有关。我们的目的是研究 ApoC3 是否也与 RA 患者存在的胰岛素抵抗和β细胞功能障碍有关。
方法
招募了 338 名血糖低于 110mg/dl 的非糖尿病 RA 患者。评估了胰岛素、C 肽和 ApoC3。使用稳态模型评估（HOMA2）指数计算胰岛素抵抗和β细胞功能。进行多变量回归分析，以研究 ApoC3 与这些分子和指数的关系，这些分子和指数通过调整与胰岛素抵抗相关的经典因素（包括糖皮质激素）进行了调整。
结果
ApoC3 与循环胰岛素（β系数 0.37 [95%CI 0.01-0.73] µU/ml，p=0.044）和 C 肽（β系数 0.13 [95%CI 0.05-0.22] ng/ml，p=0.003）水平显著升高有关，并且胰岛素抵抗-HOMA2-IR-（β系数 0.05 [95%CI 0.00-0.09]，p=0.041）和β细胞功能障碍-HOMA2-%B-（β系数 2.94 [95%CI 0.07-5.80]，p=0.044）指数也升高。这是在包括泼尼松摄入量和与碳水化合物代谢相关的经典因素（如甘油三酯、腰围和肥胖）在内的完全多变量分析后发现的。
结论
ApoC3、胰岛素抵抗和β细胞功能障碍在 RA 患者中独立相关。
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