单卵双生子血清胆红素水平与糖代谢异常的相关性分析  

Correlation between serum bilirubin level and abnormal glucose metabolism in monozygotic twins

作　　者：于可[1] 杨光燃[2] 杨毅[2] 赵冬[1] 杨金奎[2] 

机构地区：[1]首都医科大学附属北京潞河医院内分泌科,101149 [2]首都医科大学附属北京同仁医院内分泌科

出　　处：《中华糖尿病杂志》2015年第4期226-229,共4页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：北京市糖尿病防治重点实验室开放课题（市科委20147NBF03）

摘　　要：目的分析糖代谢状况不一致的单卵双生子之间血清胆红素水平的差异，探索新的糖代谢异常的标志物。方法自2014年1月至9月，由社会募集双生子55对，选择18-70岁、经口服葡萄糖耐量试验（OGTT）后确诊糖代谢情况不一致的单卵双生子，将其分为糖代谢异常组[包括糖尿病和糖耐量减低（IGT）]和血糖正常组。检测血液生化指标，以Spearman相关分析血清胆红素与血糖等参数之间的相关性。结果（1）入选9对双生子，均为女性，年龄50-62岁。其中，4对为1人患糖尿病（DM）、另1人糖耐量正常（NGT1）；5对为1人患IGT、另1人糖耐量正常（NGT2）。（2）糖代谢异常组血清直接胆红素水平（3.1±0.8）μmol/L明显低于血糖正常组（4.5±1.2）μmol/L（t=-5.26，P〈0.05），而腰臀比（0.89±0.05）、甘油三酯水平（2.3±1.4）mmol/L明显高于血糖正常组[（0.85±0.07）、（1.0±0.6）mmol/L （t=2.38、3.14，均P〈0.05）]。（3）Spearman相关性分析显示，糖代谢异常组血清直接胆红素水平与OGTT 2 h血糖呈负相关（r=－0.625，P〈0.05）。（4）Logistic回归分析显示直接胆红素水平与糖代谢异常相关（OR＝0.246，95％CI：0.660～0.922，P〈0.05），但校正甘油三酯、腰臀比后，未能发现直接胆红素与糖代谢异常有关（OR＝0.366，95％CI：0.050～2.665，P〉0.05）。结论在同卵双生子中，血清胆红素水平较低者可能是糖代谢异常的高危人群。Objective To analyze the different levels of serum bilirubin in different glucose metabolism status between monozygotic twins and to explore the new markers of abnormal glucose metabolism. Methods Fifty-five pairs of twins from January to September 2014 were registered in the cohort study, aged 18-70 yrs. Oral glucose tolerance test （OGTT） was performed and glucose level was recorded 2 hours （2 hPG） after taking 75 g glucose. The individuals with diabetes and impaired glucose tolerance （IGT） were pooled to be abnormal glucose metabolism group （DM＋IGT） while normal glucose subjects were pooled as NGT group. Serum biochemistry index was analyzed. Spearman correlation analysis was used to analyze the relationship of serum direct bilirubin and blood glucose in the subjects with abnormal glucose metabolism. Results （1）Enrolled nine pairs of twins were all females, aged 50-62 yrs. Nine pairs of twins whose abnormal glucose tolerance was different were analyzed in the study. Among nine pairs of twins, 4 pairs were characterized as one with type 2 diabetes mellitus （T2DM） and the other with normal glucose tolerance （NGT1）; 5 pairs were characterized as one with impaired glucose tolerance （IGT） and the other with normal glucose tolerance （NGT2）.（2）Compared with NGT group, DM/IGT group had higher waist-to-hip ratio（0.89 ± 0.05 vs 0.85 ± 0.07,t=2.38,P〈0.05）, higher triglyceride level（（2.3 ± 1.4）vs （1.0±0.6）mmol/L,t=3,14,P〈0.05）, but lower serum level of direct bilirubin（（3.1±0.8）vs（4.5±1.2）μmol/L, t=-5.26,P〈0.05）. （3）Spearman correlation analysis showed direct bilirubin level was negatively correlated with 2 hPG in DM/IGT group（r=-0.625, P〈0.05）. （4） Logistic regression analysis further confirmed the negative correlation between direct bilirubin and 2 hPG （OR=0.246,95%CI 0.66-0.922,P〈0.05）. After adjusting for triglyceride and waist-to-hip ratio, direct bilirubin was no related with abnormal glucose metabolism （OR=0.366,

关 键 词：糖尿病 2型 糖耐量异常 胆红素 单卵双生子 女性 DIABETES mellitus type 2 

分 类 号：R587.1[医药卫生—内分泌]