Yang Xiaoyue, Hu Rui, Wang Zhen, Hou Yilin, Song Guangyao
Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, 050017, People's Republic of China.
Endocrinology Department, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 May 19;16:1481-1491. doi: 10.2147/DMSO.S409291. eCollection 2023.
Adequate intake of folic acid (FA) has been proven essential for metabolism, cellular homeostasis, and antioxidant effects in diabetic patients. Our aim was to evaluate the association between serum folate levels and the risk of insulin resistance in patients with type 2 diabetes mellitus (T2DM) and to provide new ideas and approaches for reducing the risk of T2DM.
This was a case-control study involving 412 participants (206 with T2DM). Anthropometric parameters, islet function, biochemical parameters and body composition of T2DM group and control group were determined. Correlation analysis and logistic regression were used to evaluate the risk factors associated with the onset of insulin resistance in T2DM.
The folate levels in type 2 diabetic patients with insulin resistance were significantly lower than those in patients without insulin resistance. Logistic regression showed that FA and high-density lipoprotein were independent influencing factors for insulin resistance in diabetic patients ( < 0.05). After adjusting for confounding factors, the degree of insulin resistance in diabetic patients was in a significant inverse relationship with folate levels (< 0.05). We also found that below the serum FA threshold of 7.09 ng/mL insulin resistance was significantly more elevated.
Our findings suggest that the risk of insulin resistance increases with the decrease in serum FA levels in T2DM patients. Monitoring folate levels in these patients and FA supplementation are warranted preventive measures.
已证实充足的叶酸(FA)摄入对糖尿病患者的新陈代谢、细胞内稳态及抗氧化作用至关重要。我们的目的是评估2型糖尿病(T2DM)患者血清叶酸水平与胰岛素抵抗风险之间的关联,并为降低T2DM风险提供新思路和方法。
这是一项病例对照研究,涉及412名参与者(206名T2DM患者)。测定了T2DM组和对照组的人体测量参数、胰岛功能、生化参数及身体成分。采用相关性分析和逻辑回归评估与T2DM患者胰岛素抵抗发生相关的危险因素。
伴有胰岛素抵抗的2型糖尿病患者的叶酸水平显著低于无胰岛素抵抗的患者。逻辑回归显示,FA和高密度脂蛋白是糖尿病患者胰岛素抵抗的独立影响因素(<0.05)。在调整混杂因素后,糖尿病患者的胰岛素抵抗程度与叶酸水平呈显著负相关(<0.05)。我们还发现,血清FA阈值低于7.09 ng/mL时,胰岛素抵抗显著升高。
我们的研究结果表明,T2DM患者的胰岛素抵抗风险随血清FA水平的降低而增加。监测这些患者的叶酸水平并补充FA是必要的预防措施。