Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No. 301 Middle Yanchang Road, Shanghai, 200072, China.
Shanghai Center of Thyroid Diseases, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China.
Obes Surg. 2023 Mar;33(3):780-788. doi: 10.1007/s11695-022-06426-w. Epub 2023 Jan 19.
To demonstrate the association of irisin levels with impaired glucose before and after laparoscopic sleeve gastrectomy (LSG) in patients with obesity.
Thirty-six patients with obesity undergoing LSG were included. We tested the irisin levels before and after LSG and conducted an evaluation of baseline irisin levels with elevated glucose as well as irisin changes with weight loss and its association with glucose control after LSG.
Anthropometric measurements, body fat index, and metabolic parameters were significantly improved in 3 months following LSG (all p < 0.05). Baseline irisin levels were significantly higher in obesity with elevated fasting glucose than that with normal glucose (2.98 [2.37, 3.63] vs. 3.72 [3.06, 5.32], p = 0.031). After adjustment for sex, gender, and body mass index (BMI), obesity with higher irisin levels was prone to have impaired fasting glucose (OR = 2.499, 95% CI = 1.047-5.964). According to receiver operating characteristic curve analysis, the diagnostic accuracy and sensitivity of baseline irisin levels on impaired fasting glucose were 75% and 77.8%. Irisin levels decreased from 3.29 (2.67, 4.43) to 2.82 (2.41, 3.25) ng/mL (p = 0.009) after LSG. The decreases of weight, BMI, and FFA were more in irisin changes group (△irisin ≥ 0.5) than in no irisin changes group (△irisin < 0.5). And △irisin was negatively associated with postprandial glucose (PG) at 3 months after LSG (0.5 h-PG, r = - 0.478, p = 0.029; 2 h-PG, r = - 0.406, p = 0.017).
Elevated baseline irisin levels indicated the impaired glucose in obesity. The decrease of irisin with weight loss provided more evidence for the contribution of serum irisin secretion by fat mass in obesity.
在肥胖患者中，证明了鸢尾素水平与腹腔镜袖状胃切除术（LSG）前后葡萄糖受损有关。
纳入 36 名接受 LSG 的肥胖患者。我们检测了 LSG 前后的鸢尾素水平，并对基线时葡萄糖升高的鸢尾素水平进行了评估，以及体重减轻和其与 LSG 后血糖控制的关系。
LSG 后 3 个月，体重、体脂指数和代谢参数均显著改善（均 P<0.05）。与空腹血糖正常的肥胖患者相比，空腹血糖升高的肥胖患者的基础鸢尾素水平显著升高（2.98[2.37, 3.63] vs. 3.72[3.06, 5.32]，P=0.031）。在调整性别、性别和体重指数（BMI）后，较高鸢尾素水平的肥胖患者更易出现空腹血糖受损（OR=2.499, 95%CI=1.047-5.964）。根据受试者工作特征曲线分析，基础鸢尾素水平对空腹血糖受损的诊断准确性和敏感性分别为 75%和 77.8%。LSG 后，鸢尾素水平从 3.29（2.67, 4.43）降至 2.82（2.41, 3.25）ng/ml（P=0.009）。在鸢尾素变化组（△鸢尾素≥0.5）中，体重、BMI 和 FFA 的降低更为明显，而在无鸢尾素变化组（△鸢尾素<0.5）中则不然。LSG 后 3 个月，△鸢尾素与餐后血糖（PG）呈负相关（0.5 h-PG，r=−0.478，P=0.029；2 h-PG，r=−0.406，P=0.017）。
基础鸢尾素水平升高提示肥胖患者的葡萄糖受损。随着体重的减轻，鸢尾素的减少为肥胖患者的脂肪质量对血清鸢尾素分泌的贡献提供了更多证据。
