高组织钠与肥胖个体的全身炎症和胰岛素抵抗有关。
High tissue-sodium associates with systemic inflammation and insulin resistance in obese individuals.
机构信息
Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
Nutr Metab Cardiovasc Dis. 2023 Jul;33(7):1398-1406. doi: 10.1016/j.numecd.2023.03.024. Epub 2023 Apr 10.
BACKGROUND AND AIMS
High sodium intake is associated with obesity and insulin resistance, and high extracellular sodium content may induce systemic inflammation, leading to cardiovascular disease. In this study, we aim to investigate whether high tissue sodium accumulation relates with obesity-related insulin resistance and whether the pro-inflammatory effects of excess tissue sodium accumulation may contribute to such association.
METHODS AND RESULTS
In a cross-sectional study of 30 obese and 53 non-obese subjects, we measured insulin sensitivity determined as glucose disposal rate (GDR) using hyperinsulinemic euglycemic clamp, and tissue sodium content using Na magnetic resonance imaging. Median age was 48 years, 68% were female and 41% were African American. Median (interquartile range) BMI was 33 (31.5, 36.3) and 25 (23.5, 27.2) kg/m in the obese and non-obese individuals, respectively. In obese individuals, insulin sensitivity negatively correlated with muscle (r = -0.45, p = 0.01) and skin sodium (r = -0.46, p = 0.01). In interaction analysis among obese individuals, tissue sodium had a greater effect on insulin sensitivity at higher levels of high-sensitivity C-reactive protein (p-interaction = 0.03 and 0.01 for muscle and skin Na+, respectively) and interleukin-6 (p-interaction = 0.024 and 0.003 for muscle and skin Na+, respectively). In interaction analysis of the entire cohort, the association between muscle sodium and insulin sensitivity was stronger with increasing levels of serum leptin (p-interaction = 0.01).
CONCLUSIONS
Higher muscle and skin sodium are associated with insulin resistance in obese patients. Whether high tissue sodium accumulation has a mechanistic role in the development of obesity-related insulin resistance through systemic inflammation and leptin dysregulation remains to be examined in future studies.
CLINICALTRIALS
gov registration: NCT02236520.
背景与目的
高钠摄入与肥胖和胰岛素抵抗有关，细胞外钠含量升高可能会引发全身炎症，从而导致心血管疾病。本研究旨在探讨组织内钠蓄积是否与肥胖相关的胰岛素抵抗有关，以及细胞外钠蓄积的促炎作用是否与这种关联有关。
方法与结果
在一项横断面研究中，纳入 30 名肥胖患者和 53 名非肥胖患者，我们通过高胰岛素正葡萄糖钳夹试验测量葡萄糖处置率（GDR）来确定胰岛素敏感性，并采用 Na 磁共振成像测量组织内钠含量。患者中位年龄为 48 岁，68%为女性，41%为非裔美国人。肥胖患者的 BMI 中位数（四分位间距）为 33（31.5，36.3）kg/m²，而非肥胖患者的 BMI 中位数（四分位间距）为 25（23.5，27.2）kg/m²。在肥胖患者中，胰岛素敏感性与肌肉（r=-0.45，p=0.01）和皮肤钠（r=-0.46，p=0.01）呈负相关。在肥胖患者的交互分析中，组织钠对胰岛素敏感性的影响在高敏 C 反应蛋白（hs-CRP）水平较高时（肌肉和皮肤 Na+的 p 交互值分别为 0.03 和 0.01）和白细胞介素-6（IL-6）水平较高时（肌肉和皮肤 Na+的 p 交互值分别为 0.024 和 0.003）更大。在整个队列的交互分析中，随着血清瘦素水平的升高（p 交互值=0.01），肌肉钠与胰岛素敏感性的相关性更强。
结论
在肥胖患者中，较高的肌肉和皮肤钠与胰岛素抵抗有关。在未来的研究中，需要进一步探讨组织内钠蓄积是否通过全身炎症和瘦素失调在肥胖相关胰岛素抵抗的发生发展中发挥机制作用。
临床试验
gov 注册号：NCT02236520。
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