Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China.
Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Institute of Endocrine and Metabolic Diseases, Shandong University, Jinan 250012, Shandong Province, China.
J Diabetes Complications. 2023 Oct;37(10):108567. doi: 10.1016/j.jdiacomp.2023.108567. Epub 2023 Jul 28.
BACKGROUND: Isthmin-1 (Ism-1) is a newly identified insulin-like adipokine that increases glucose uptake by adipocytes and inhibits hepatic lipid synthesis. Recent studies have shown that Ism-1 can improve the metabolic disorders associated with type 2 diabetes mellitus (T2DM) and improve lipid metabolism. The classic function of high-density lipoprotein cholesterol (HDL-C) is to transport cholesterol from extra-hepatic tissues to the liver for metabolism. In contrast, disorders of lipid metabolism and inflammation are the leading causes of atherosclerosis (As). Atherosclerosis often manifests as loss of elasticity, lipid accumulation, fibrous tissue proliferation and calcium deposits in the affected arteries, eventually forming plaques. AIM: To illustrate the correlation between HDL-C and Ism-1 in T2DM, and the relationship between lipoprotein cholesterol and carotid plaque. METHODS: A total of 128 patients with T2DM were enrolled in the study and basic information was collected. HDL-C levels were measured chemically. Serum Ism-1 levels were measured using an enzyme-linked immunosorbent assay (ELISA). Linear regression analysis was used to assess the correlation between serum Ism-1 levels and HDL-C in patients with T2DM. Basic information was again collected from 226 patients with T2DM. Independent sample t-tests were performed to explore the relationship between carotid plaque formation and lipids. RESULTS: HDL-C was divided into four groups according to quartiles and there was a between-group difference in Ism-1 (p = 0.040). Multivariable linear regression showed a negative association between Ism-1 and HDL-C in T2DM (β = -0.235, p < 0.001), even after adjusting for related factors (β = -0.165, p = 0.009). Low-density lipoprotein cholesterol (LDL-C) and HDL-C showed significant differences between the carotid plaque group and the non-carotid plaque group (p = 0.007, p = 0.003). CONCLUSION: Serum Ism-1 and HDL-C are negatively correlated in T2DM. LDL-C is significantly higher in carotid plaque group than non-carotid plaque group, while HDL-C is significantly lower than in the non-carotid plaque group.
背景：Isthmin-1（Ism-1）是一种新发现的胰岛素样脂肪因子，可增加脂肪细胞对葡萄糖的摄取，并抑制肝内脂质合成。最近的研究表明，Ism-1 可以改善 2 型糖尿病（T2DM）相关的代谢紊乱，并改善脂质代谢。高密度脂蛋白胆固醇（HDL-C）的经典功能是将胆固醇从肝外组织转运到肝脏进行代谢。相比之下，脂质代谢和炎症紊乱是动脉粥样硬化（As）的主要原因。动脉粥样硬化常表现为受影响动脉的弹性丧失、脂质堆积、纤维组织增生和钙沉积，最终形成斑块。
目的：阐明 T2DM 患者中 HDL-C 与 Ism-1 的相关性，以及脂蛋白胆固醇与颈动脉斑块的关系。
方法：共纳入 128 例 T2DM 患者并收集基本信息，采用化学法检测 HDL-C 水平，酶联免疫吸附试验（ELISA）检测血清 Ism-1 水平。采用线性回归分析评估 T2DM 患者血清 Ism-1 水平与 HDL-C 的相关性。从 226 例 T2DM 患者中再次收集基本信息，采用独立样本 t 检验探讨颈动脉斑块形成与血脂的关系。
结果：根据 quartiles 将 HDL-C 分为四组，Ism-1 存在组间差异（p=0.040）。多变量线性回归显示，T2DM 患者 Ism-1 与 HDL-C 呈负相关（β=-0.235，p<0.001），即使在调整相关因素后（β=-0.165，p=0.009）仍如此。颈动脉斑块组与无颈动脉斑块组的低密度脂蛋白胆固醇（LDL-C）和 HDL-C 差异有统计学意义（p=0.007，p=0.003）。
结论：T2DM 患者血清 Ism-1 与 HDL-C 呈负相关。颈动脉斑块组 LDL-C 明显高于无颈动脉斑块组，而 HDL-C 明显低于无颈动脉斑块组。
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