Gao Jie, Re YanMu Rouzi Mai, Yang Haofan, Zheng Wenhao, Wang Liang, Lei Tao, Lu Jun
Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 LanXi Road, Shanghai, 200062, China.
School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Diabetol Metab Syndr. 2025 Aug 1;17(1):308. doi: 10.1186/s13098-025-01860-z.
This study aimed to examine the association between branched-chain amino acids/branched-chain α-keto acids (BCAAs/BCKAs) and adipose tissue insulin resistance (Adipo-IR) in patients with type 2 diabetes mellitus (T2DM).
A total of 506 patients with T2DM were included in this cross-sectional study. Participants were categorized into two groups based on Adipo-IR levels (non-Adipo-IR: Adipo-IR<7.68; Adipo-IR: Adipo-IR ≥ 7.68). Serum BCAA/BCKA concentrations were measured using ELISA kits. Correlations between BCAAs/BCKAs and Adipo-IR or HOMA-IR were evaluated using Spearman correlation analysis. Binary logistic regression was used to examine the associations of BCKAs with both indices of insulin resistance.
Median serum BCKA levels were significantly higher in the Adipo-IR group than in the non-Adipo-IR (128.27 vs. 121.16, p < 0.001), while there was no significant difference in median serum BCAA levels between the two groups (2.54 vs. 2.52, p = 0.714). BCKAs were positively correlated with both Adipo-IR and HOMA-IR (both p < 0.01), and the association with Adipo-IR was stronger. Binary logistic regression analysis revealed that BCKAs were associated with Adipo-IR regardless of adjustment for influencing factors, with increasing odds ratios across BCKAs quartiles (p for trend < 0.01). However, after adjusting for covariates, the association between BCKAs and HOMA-IR was no longer significant.
Serum BCKA levels were elevated in T2DM patients with Adipo-IR and were more strongly correlated with Adipo-IR than HOMA-IR. BCKAs may serve as sensitive biomarkers for Adipo-IR. Consequently, we would promote their clinical usage in the early screening of individuals with obesity, insulin resistance and a high risk of T2DM.
本研究旨在探讨2型糖尿病（T2DM）患者中支链氨基酸/支链α-酮酸（BCAAs/BCKAs）与脂肪组织胰岛素抵抗（Adipo-IR）之间的关联。
本横断面研究共纳入506例T2DM患者。根据Adipo-IR水平将参与者分为两组（非Adipo-IR组：Adipo-IR<7.68；Adipo-IR组：Adipo-IR≥7.68）。使用酶联免疫吸附测定试剂盒测量血清BCAA/BCKA浓度。采用Spearman相关分析评估BCAAs/BCKAs与Adipo-IR或HOMA-IR之间的相关性。采用二元逻辑回归分析来检验BCKAs与两种胰岛素抵抗指标之间的关联。
Adipo-IR组血清BCKA水平中位数显著高于非Adipo-IR组（128.27对121.16，p<0.001），而两组血清BCAA水平中位数无显著差异（2.54对2.52，p=0.714）。BCKAs与Adipo-IR和HOMA-IR均呈正相关（均p<0.01），且与Adipo-IR的相关性更强。二元逻辑回归分析显示，无论对影响因素进行何种调整，BCKAs均与Adipo-IR相关，随着BCKAs四分位数增加，比值比升高（趋势p<0.01）。然而，在对协变量进行调整后，BCKAs与HOMA-IR之间的关联不再显著。
伴有Adipo-IR的T2DM患者血清BCKA水平升高，且与Adipo-IR的相关性强于HOMA-IR。BCKAs可能是Adipo-IR的敏感生物标志物。因此，我们提倡在肥胖、胰岛素抵抗和T2DM高风险个体的早期筛查中推广其临床应用。
