Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Front Endocrinol (Lausanne). 2022 May 16;13:881093. doi: 10.3389/fendo.2022.881093. eCollection 2022.
We aimed to investigate the association between obesity-related parameters and polyneuropathy (PN) and to evaluate inflammatory and fibrotic gene expression of fat as a potential mediator in subjects scheduled to undergo metabolic bariatric surgery (MBS).
This was a cross-sectional study of MBS cohort. Body composition and visceral fat area (VFA) were quantified by bioimpedance analysis and computed tomography scan. PN was defined by Michigan Neuropathy Screening Instrument-Physical Examination score was > 2. We measured mRNA expression level of , , , and in omental fat tissue.
Of 189 subjects (mean age, 39.4 years; 69 [36.5%] male; mean body mass index, 38.5 kg/m), prevalence of PN was 9.1% in subjects without diabetes (n = 110) and 20.3% in those with diabetes (n = 79). Nondiabetic subjects with PN had higher homeostatic model assessment-insulin resistance (6.8 ± 3.5 4.5 ± 2.8, = 0.041), and increased fat mass (58.5 ± 12.5 kg 50.5 ± 10.7 kg, = 0.034), and VFA (309.4 ± 117.6 cm 243.5 ± 94.2 cm, = 0.046) compared to those without PN. These obesity-related parameters were significantly associated with the presence of PN after adjusting for conventional risk factors of PN only in subjects without diabetes. In contrast, a fibrotic gene such as was independently associated with PN (adjusted odds ratio of 1.56; 95% confidence interval 1.06, 2.30) only in subjects with diabetes.
Increased adiposity was independently associated with PN in obese subjects without diabetes. In contrast, this association was not significant after adjusting conventional risk factors of PN in obese subjects with diabetes but increased fibrotic gene expression in fat was associated with PN in this group.
我们旨在研究肥胖相关参数与多发性神经病（PN）之间的关系，并评估脂肪的炎症和纤维化基因表达作为接受代谢减重手术（MBS）的受试者潜在的中介。
这是一项 MBS 队列的横断面研究。通过生物阻抗分析和计算机断层扫描定量检测身体成分和内脏脂肪面积（VFA）。PN 通过密歇根神经病筛查仪器-体格检查评分定义为>2。我们测量网膜脂肪组织中 、 、 、 的 mRNA 表达水平。
在 189 名受试者（平均年龄 39.4 岁；69 [36.5%] 男性；平均体重指数 38.5kg/m）中，无糖尿病受试者（n=110）PN 的患病率为 9.1%，糖尿病受试者（n=79）PN 的患病率为 20.3%。无糖尿病伴 PN 的受试者胰岛素抵抗的稳态模型评估（HOMA-IR）更高（6.8±3.5 vs 4.5±2.8，=0.041），脂肪量增加（58.5±12.5kg vs 50.5±10.7kg，=0.034），VFA（309.4±117.6cm 2 vs 243.5±94.2cm 2，=0.046）高于无 PN 的受试者。仅在无糖尿病的受试者中，在调整 PN 的常规危险因素后，这些肥胖相关参数与 PN 的存在显著相关。相比之下，仅在糖尿病患者中，一种纤维化基因如 与 PN 独立相关（调整后的优势比为 1.56；95%置信区间 1.06，2.30）。
在无糖尿病的肥胖受试者中，脂肪量增加与 PN 独立相关。相比之下，在肥胖伴糖尿病的受试者中，在调整 PN 的常规危险因素后，这种相关性不显著，但脂肪中纤维化基因的表达增加与该组的 PN 相关。
