在美国超重/肥胖的糖尿病患者人群中，糖化血清蛋白和白蛋白与 BMI 呈负相关，而糖化白蛋白则不然。
Glycated serum proteins and albumin but not glycated albumin show negative correlation with BMI in an overweight/obese, diabetic population from the United States.
机构信息
Division of Endocrinology, Metabolism, and Lipid Research, Department of Medicine, 660 S. Euclid Ave., Washington University School of Medicine, St. Louis, MO 63110, USA.
Center for Biostatistics and Data Science, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
出版信息
Clin Biochem. 2023 Oct;120:110654. doi: 10.1016/j.clinbiochem.2023.110654. Epub 2023 Sep 26.
BACKGROUND AND AIMS
Multiple previously published studies have shown a weak to medium, negative correlation between BMI and glycated albumin (GA). However, many of these studies were in populations with a narrow range of BMI. It is unknown whether this trend exists if a wider BMI range is used. This is an important question for proper interpretation of GA levels in obese populations.
MATERIALS AND METHODS
A retrospective analysis of clinical trial data (NCT02519309) was performed. After appropriate exclusions, 334 subjects remained. These included 73.7% with type 2 diabetes (T2D) diagnosis and 26.3% with prediabetes. BMI ranged from 24.8-86.9 kg/m. Laboratory data were measured in a CLIA-certified laboratory using commercially available, automated methods.
RESULTS
No significant, negative correlation was seen between GA and BMI. However, individual components (glycated serum proteins and albumin) as well as the GA/HbA1c ratio show a weak, negative correlation with BMI for all subjects and those with T2D. The strongest negative correlation was with albumin. Examination by traditional BMI subgroups also showed statistically significant differences for those with T2D, but not for the prediabetic cohort. Correlations between BMI and C-reactive protein were similar in those with diabetes and prediabetes; however, correlation between BMI and insulin was stronger in those with diabetes.
CONCLUSION
Negative correlations between BMI and albumin or BMI and glycated serum proteins persist in diabetic populations that are obese and overweight, even when a statistically significant negative correlation is not observed between BMI and GA. Inflammation or insulin-mediated changes in protein synthesis could be contributors to these negative correlations, but BMI-related changes to the glomerulus could also affect clearance of albumin or glycated proteins and should be examined.
背景与目的
多项已发表的研究表明，BMI 与糖化白蛋白（GA）之间存在弱至中度的负相关。然而，这些研究中的许多研究对象 BMI 范围较窄。如果使用更宽的 BMI 范围，这种趋势是否存在尚不清楚。对于肥胖人群中 GA 水平的正确解读，这是一个重要的问题。
材料与方法
对临床试验数据（NCT02519309）进行回顾性分析。经过适当的排除后，仍有 334 例受试者。其中 73.7%的患者患有 2 型糖尿病（T2D），26.3%的患者患有糖尿病前期。BMI 范围为 24.8-86.9 kg/m²。实验室数据使用商业上可用的自动化方法在 CLIA 认证的实验室中进行测量。
结果
GA 与 BMI 之间未见显著负相关。然而，对于所有受试者以及 T2D 患者，个体成分（糖化血清蛋白和白蛋白）以及 GA/HbA1c 比值与 BMI 呈弱负相关。与 BMI 相关性最强的是白蛋白。对 T2D 患者的传统 BMI 亚组检查也显示出统计学显著差异，但对糖尿病前期患者亚组则没有。糖尿病和糖尿病前期患者的 BMI 与 C 反应蛋白之间的相关性相似；然而，在糖尿病患者中，BMI 与胰岛素之间的相关性更强。
结论
在肥胖和超重的糖尿病人群中，BMI 与白蛋白或 BMI 与糖化血清蛋白之间存在负相关，即使 BMI 与 GA 之间未观察到统计学显著的负相关。炎症或胰岛素介导的蛋白质合成变化可能是这些负相关的原因，但与 BMI 相关的肾小球变化也可能影响白蛋白或糖化蛋白的清除，应进行检查。
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