成纤维细胞生长因子21抵抗与2型糖尿病合并高血压患者的体型有关。
Fibroblast growth factor 21 resistance is associated with body shape in patients with type 2 diabetes complicating hypertension.
作者信息
Gan Jing, Duan Zikun, Tang Lu, Liu Zhen, Tian Huiying, Wu Maolan, Bi Yanxue, Pan Xingchao, Wang Wenjun, Gao Xiaotang, Wang Ningrui, Lin Zhuofeng, Yang Hong
机构信息
Department of Cardiology, the 1st affiliated Hospital of Wenzhou Medical Unversity, Wenzhou, China.
School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China.
出版信息
Front Cardiovasc Med. 2023 Jun 22;10:1168047. doi: 10.3389/fcvm.2023.1168047. eCollection 2023.
OBJECTIVES
Obesity, especially abdominal obesity, increases the prevalence of metabolic and cardiovascular disease (CVD). Fibroblast growth factor 21 (FGF21) has been identified as a critical regulator playing a therapeutic role in diabetes and its complications. This study aims to evaluate the relationship between serum FGF21 levels and body shape parameters in patients with hypertension (HP) and type 2 diabetes mellitus (T2DM).
METHODS
Serum FGF21 levels were determined in 1,003 subjects, including 745 patients with T2DM, and 258 individuals were selected as a healthy control in this cross-sectional study.
RESULTS
Serum FGF21 levels were significantly higher in T2DM patients with HP than those without [534.9 (322.6-722.2) vs. 220.65 (142.8-347.55) pg/ml, < 0.001], and levels in both of these two groups were significantly increased compared with that of healthy control [123.92 (67.23-219.32) pg/ml, all < 0.001]. These differences were also observed in body shape parameters, including weight, waistline, body mass index (BMI), body shape index (ABSI), and the percentage of abdominal obesity. Serum FGF21 levels in T2DM patients were positively correlated with body shape parameters, including weight, waistline, neck circumference, BMI, ABSI, percent of abdominal obesity, and triglyceride, while negatively with estimated glomerular filtration rate (all < 0.01). The significance remained stable when adjusted for age and T2DM duration. In addition, both serum FGF21 concentrations and waistline were independently associated with HP in T2DM patients after the adjustment for risk factors (all < 0.05). ROC analysis for FGF21 levels of 745 patients with T2DM identified 411.33 pg/ml as an optimal cut-off point to predict HP, with a sensitivity and specificity of 66.0% and 84.9%, respectively.
CONCLUSIONS
FGF21 resistance occurs in patients of HP in T2DM, and positively correlates with body shape parameters (especially waistline and BMI). High levels of FGF21 may be a compensatory reaction to offset HP.
目的
肥胖，尤其是腹型肥胖，会增加代谢性疾病和心血管疾病（CVD）的患病率。成纤维细胞生长因子21（FGF21）已被确定为在糖尿病及其并发症中起治疗作用的关键调节因子。本研究旨在评估高血压（HP）合并2型糖尿病（T2DM）患者血清FGF21水平与体型参数之间的关系。
方法
在这项横断面研究中，对1003名受试者进行了血清FGF21水平检测，其中包括745例T2DM患者，并选取258名个体作为健康对照。
结果
合并HP的T2DM患者血清FGF21水平显著高于未合并HP的患者[534.9（322.6 - 722.2）对220.65（142.8 - 347.55）pg/ml，P < 0.001]，且这两组患者的血清FGF21水平均显著高于健康对照[123.92（67.23 - 219.32）pg/ml，均P < 0.001]。在体型参数方面，包括体重、腰围、体重指数（BMI）、体型指数（ABSI）和腹型肥胖百分比，也观察到了这些差异。T2DM患者的血清FGF21水平与体型参数呈正相关，包括体重、腰围、颈围、BMI、ABSI、腹型肥胖百分比和甘油三酯，而与估计肾小球滤过率呈负相关（均P < 0.01）。在调整年龄和T2DM病程后，这种相关性仍然稳定。此外，在调整危险因素后，血清FGF21浓度和腰围在T2DM患者中均与HP独立相关（均P < 0.05）。对745例T2DM患者的FGF21水平进行ROC分析，确定411.33 pg/ml为预测HP的最佳切点，敏感性和特异性分别为66.0%和84.9%。
结论
T2DM合并HP患者存在FGF21抵抗，且与体型参数（尤其是腰围和BMI）呈正相关。高水平的FGF21可能是抵消HP的一种代偿反应。
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