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肢端肥大症患者血清原神经降压素(PNT)、凝乳蛋白酶和锌-α2-糖蛋白(ZAG)水平的研究。

A study on serum pro-neurotensin (PNT), furin, and zinc alpha-2-glycoprotein (ZAG) levels in patients with acromegaly.

机构信息

Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, 100730, China.

Central Research Laboratory, Chinese Academy of Medical Science and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, 100730, China.

出版信息

J Endocrinol Invest. 2022 Oct;45(10):1945-1954. doi: 10.1007/s40618-022-01827-1. Epub 2022 Jun 7.

Abstract

PURPOSE

Acromegaly caused by growth hormone cell adenoma is commonly associated with abnormal glucolipid metabolism, which may result from changes in adipocytokine secretion. This study aims to investigate serum adipokine levels, including pro-neurotensin (PNT), furin, and zinc alpha-2-glycoprotein (ZAG), in acromegalic patients and the correlation between the levels of these three adipokines and GH levels and glucolipid metabolism indices.

METHODS

Sixty-eight acromegalic patients and 121 controls were included, and their clinical data were recorded from electronic medical record system. Serum PNT, furin and ZAG levels were measured by ELISA.

RESULTS

Serum PNT levels in acromegalic patients were significantly higher than controls (66.60 ± 12.36 vs. 46.68 ± 20.54 pg/ml, P < 0.001), and acromegaly was an independent influencing factor of PNT levels (P < 0.001). Moreover, subjects with the highest tertile of PNT levels had a close correlation with acromegaly (OR = 22.200, 95% CI 7.156 ~ 68.875, P < 0.001), even in Model 1 adjusted for gender and age and Model 2 adjusted for gender, age and BMI. Additionally, serum PNT levels were positively correlated with BMI (r = 0.220, P = 0.002) and triglycerides (TGs, r = 0.295, P < 0.001), and TGs were an independent influencing factor of serum PNT levels in acromegalic subjects (P < 0.001). Furthermore, serum PNT levels in obese acromegalic patients were significantly higher than those with normal BMI (P < 0.05). However, serum furin levels were lower in acromegalic patients than controls (0.184 ± 0.036 vs. 0.204 ± 0.061 ng/ml, P < 0.001).

CONCLUSION

This study is the first to demonstrate that acromegalic patients have increased serum PNT levels. Moreover, serum PNT plays a potential role in abnormal lipid metabolism of acromegalic patients.

摘要

目的

生长激素细胞腺瘤引起的肢端肥大症常伴有异常的糖脂代谢,这可能是由于脂肪细胞因子分泌的改变所致。本研究旨在探讨肢端肥大症患者血清脂肪细胞因子水平,包括前神经降压素(PNT)、凝乳蛋白酶和锌-α2-糖蛋白(ZAG),以及这三种脂肪细胞因子水平与 GH 水平和糖脂代谢指标的相关性。

方法

纳入 68 例肢端肥大症患者和 121 例对照者,从电子病历系统中记录其临床资料。采用 ELISA 法检测血清 PNT、凝乳蛋白酶和 ZAG 水平。

结果

肢端肥大症患者血清 PNT 水平明显高于对照组(66.60±12.36 比 46.68±20.54 pg/ml,P<0.001),肢端肥大症是 PNT 水平的独立影响因素(P<0.001)。此外,血清 PNT 水平最高三分位的患者与肢端肥大症密切相关(OR=22.200,95%CI 7.156~68.875,P<0.001),即使在调整性别和年龄的模型 1 及调整性别、年龄和 BMI 的模型 2 中也是如此。此外,血清 PNT 水平与 BMI(r=0.220,P=0.002)和三酰甘油(r=0.295,P<0.001)呈正相关,且三酰甘油是肢端肥大症患者血清 PNT 水平的独立影响因素(P<0.001)。此外,肥胖肢端肥大症患者的血清 PNT 水平明显高于 BMI 正常者(P<0.05)。然而,肢端肥大症患者的血清凝乳蛋白酶水平低于对照组(0.184±0.036 比 0.204±0.061 ng/ml,P<0.001)。

结论

本研究首次证明肢端肥大症患者血清 PNT 水平升高,且血清 PNT 在肢端肥大症患者异常脂质代谢中发挥潜在作用。

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