Lindarto Dharma, Darmadi Darmadi
Department of Internal Medicine, Universitas Sumatera Utara Hospital. Medan Baru, Kota Medan, Sumatera Utara. Indonesia.
Med Arch. 2025;79(2):117-121. doi: 10.5455/medarh.2025.79.117-121.
Obesity and Type 2 diabetes mellitus (T2DM) are growing public health concerns in Southeast Asia, including Indonesia. Obesity promotes insulin resistance and metabolic irregularities, increasing the risk for T2DM. CTLA-4, an immune checkpoint receptor, plays a role in immune regulation, but its involvement in obesity, dyslipidemia, and T2DM remains unclear.
The aim of this study was to evaluate the association between CTLA-4 levels and obesity, dyslipidemia, and T2DM.
A cross-sectional study was conducted at Universitas Sumatera Utara Hospital and affiliated hospitals, including 100 adult participants from the endocrine clinic. Participants with coronary heart disease, kidney issues, heart problems, and cancers were excluded. Fasting blood glucose, A1C levels, LDL cholesterol, triglycerides, and CTLA-4 expression were measured. BMI was calculated from age, gender, height, and weight data. Statistical analysis was performed using SPSS 26.0, applying the Mann-Whitney U-test and Spearman correlation for variable relationships. Statistical significance was set at p < 0.05. Among 100 participants, 36% were obese, 42% had dyslipidemia, and 31% had T2DM. The median CTLA-4 serum level was 93.3 pg/mL (range 36-264). CTLA-4 levels were significantly lower in obese individuals (67.2 pg/mL) compared to non-obese individuals (106.8 pg/mL, p = 0.019). No significant differences in CTLA-4 levels were found for dyslipidemia (p = 0.839) or T2DM (p = 0.351). A significant negative correlation was found between CTLA-4 levels and BMI (r = -0.329, p = 0.001).
CTLA-4 levels negatively correlate with BMI, indicating its potential involvement in obesity-related metabolic changes. No significant link was found with dyslipidemia or T2DM, warranting further research.
肥胖和2型糖尿病（T2DM）在包括印度尼西亚在内的东南亚地区日益成为公共卫生问题。肥胖会促进胰岛素抵抗和代谢紊乱，增加患T2DM的风险。CTLA-4是一种免疫检查点受体，在免疫调节中发挥作用，但其在肥胖、血脂异常和T2DM中的作用尚不清楚。
本研究旨在评估CTLA-4水平与肥胖、血脂异常和T2DM之间的关联。
在北苏门答腊大学医院及其附属医院进行了一项横断面研究，纳入了100名来自内分泌门诊的成年参与者。排除患有冠心病、肾脏问题、心脏问题和癌症的参与者。测量空腹血糖、糖化血红蛋白（A1C）水平、低密度脂蛋白胆固醇、甘油三酯和CTLA-4表达。根据年龄、性别、身高和体重数据计算体重指数（BMI）。使用SPSS 26.0进行统计分析，应用曼-惠特尼U检验和斯皮尔曼相关性分析变量关系。设定统计学显著性为p<0.05。在100名参与者中，36%为肥胖，42%患有血脂异常，31%患有T2DM。CTLA-4血清水平中位数为93.3 pg/mL（范围36 - 264）。与非肥胖个体（106.8 pg/mL，p = 0.019）相比，肥胖个体的CTLA-4水平显著降低（67.2 pg/mL）。血脂异常（p = 0.839）或T2DM（p = 0.351）患者的CTLA-4水平未发现显著差异。CTLA-4水平与BMI之间存在显著负相关（r = -0.329，p = 0.001）。
CTLA-4水平与BMI呈负相关，表明其可能参与了与肥胖相关的代谢变化。未发现与血脂异常或T2DM有显著关联，需要进一步研究。
