超重/肥胖患者血清netrin-1水平及其影响因素分析  

Changes of serum netrin-1 levels and related factors in patients with overweight/obesity

作　　者：杨奇超[1] 王苏[1] 俞淑琴 蒋丹[1] 刘媛馨 薛灏颖 洪霞飞[1] 庄若[1] 王东[1] 杨玲[1] 尹卫[1] 周丽斌[2] 袁国跃[1] 

机构地区：[1]江苏大学附属医院内分泌代谢科,江苏镇江212001 [2]上海交通大学医学院附属瑞金医院内分泌代谢科,上海200025

出　　处：《江苏大学学报（医学版）》2016年第2期159-163,共5页Journal of Jiangsu University：Medicine Edition

基　　金：国家自然科学基金资助项目(81570721;81370965);江苏省自然科学基金资助项目(BK20151331;BK2009208);江苏省卫生厅国际交流支撑计划及面上科技项目(H201247);江苏省六大高峰人才项目(2015-WSN-006);镇江市卫生科技重点专项项目(SHW2015017);镇江市社会发展项目(SH2015028;SH2013035;SH2015042)

摘　　要：目的：观察超重/肥胖患者血清神经导向因子netrin-1水平,探讨其与肥胖、糖脂代谢及胰岛素抵抗的关系。方法：以体质量指数（BMI）25 kg/m2为切点将150例研究对象分为正常体质量组76例和超重/肥胖组74例,再根据75 g口服葡萄糖耐量试验（OGTT）结果将两组患者分为正常糖耐量（NGT）和新诊断2型糖尿病（T2DM）亚组。检测各组腰围、腰臀比、糖化血红蛋白（Hb A1c）、血糖、胰岛素、血脂及netrin-1水平。结果：超重/肥胖组血清netrin-1水平[367.87（268.42-545.09）ng/m L]明显低于正常体质量组[444.95（372.69-668.16）ng/m L,P〈0.01]。超重/肥胖组的NGT亚组和T2DM亚组netrin-1水平分别低于正常体质量组的NGT亚组和T2DM亚组（P〈0.01）。随着血清netrin-1水平增加,BMI及腰围水平下降。相关性分析显示,血清netrin-1水平与年龄呈正相关（P〈0.05）,与BMI及腰围呈负相关（P〈0.01）。多元逐步回归分析提示,年龄及BMI是血清netrin-1水平的独立影响因素。结论：血清netrin-1水平与BMI水平密切相关,其水平下降可能参与了肥胖的发生发展。Objective： To investigate the change of serum netrin-1 level in overweight/obesity patients and investigate the relationships of serum netrin-1 level with obesity, glycolipid metabolism and insulin re- sistance. Methods： A total of 150 Chinese subjects were enrolled in the study, including seventy-six sub- jects with normal weight （NW） and seventy-four patients with overweight/obesity （OW/OB）. NW and OW/OB groups were further divided into normal glucose tolerance （NGT） and patients with newly-diag- nosed T2DM subgroups separately. OW/OB was defined as BMI〉25 kg/m2 according to the WHO-Western Pacific Region diagnostic set forth in 2000. 75 g oral glucose tolerance test （OGTF） was performed in all subjects. Waist circumference （ WC）, waist-to-hip ratio （ WHR）, HbA1 c, blood glucose, blood insulin, blood lipids and netrin-1 level were also determined. Results： The serum netrin-1 level was significantly lower in OW/OB group than that in NW group [ 367.87 （268.42 to 545.09） ng/mL vs 444.95 （372.69 to 668.16） ng/mL,P 〈0.011. Subjects in the upper and middle serum netrin-1 levels had lower levels of BMI and WC, when compared to subjects in the lower serum netrin-1 levels. Pearson correlation analysis showed that serum netrin-1 level was negatively correlated with BMI and WC （ P 〈 0.01 ）, and positivelycorrelated with age （P 〈 0.05 ）. Multiple linear regression analysis showed that age and BMI were inde- pendently related to serum netrin-1 level（ P 〈 0.05 or P 〈 0. 01 ）. Conclusion： Circulating levels of netrin- 1 were decreased in subjects with overweight/obesity. Serum netrin-1 level was significantly negatively cor- related with BMI. It suggested that the netrin-1 might play an important role in the pathogenesis of obesity.

关 键 词：肥胖 NETRIN-1 2型糖尿病 体质量指数 

分 类 号：R589.2[医药卫生—内分泌]