空腹血浆内毒素水平与体质指数、胰岛素抵抗的相关性研究  

Relationship of fasting plasma LPS with BMI and insulin resistance

作　　者：周莹[1,2] 茅国芳[1,2] 付真真[1] 黄爱洁[1] 龚颖芸 杨盼盼[1] 胡文[1] 叶正芹[1] 王兴洲[1] 马祎喆 杨涛[1] 周红文[1] 

机构地区：[1]南京医科大学第一附属医院内分泌科,210029 [2]苏州科技城医院内分泌科

出　　处：《中国糖尿病杂志》2016年第11期978-982,共5页Chinese Journal of Diabetes

基　　金：国家自然科学基金(81170747);江苏省自然科学基金(SBK2016022587)

摘　　要：目的研究不同BMI人群的空腹血浆内毒素（LPS）水平，分析LPS影响因素及其与BMI、珉的关系。方法纳入99例受试者，根据OGTT结果分为NGT与T2DM组，以BMI=28kg／m2为切点，再分为肥胖（0B）与非肥胖（non-OB）亚组，检测血浆LPS、血清高敏C反应蛋白（hsC-RP）等。采用简单相关分析LPS与BMI、HOMA-IR等指标相关性、采用多元线性回归分析LPS及HOMA-IR的影响因素。结果无论是NGT还是T2DM，其肥胖亚组人群的空腹血浆LPS较非肥胖亚组高2-3倍，予以诊断为代谢性内毒素血症状态；LPS水平与BMI（r=0．307）、HbAc（r=0．454）、hsC-RP（r=0．254）、ALT（r=0．881）、AST（r=0．848）、HOMA-IR（r=0．509）、FPG（r=0．450）相关（P〈0．05）；多元线性回归分析发现，BMI、HbA1c是LPS的影响因素，BMI、LPS是HOMA-IR的影响因素。结论随着BMI的增加，血浆LPS水平逐渐升高，机体处于低度炎症、代谢性内毒素血症状态，可加重氓程度。Objective To compare the levels of fasting plasma lipopolysaccharide （LPS） in individuals with different body mass index （BMI） and to explore its influential factors and the relationship between LPS,BMI and insulin resistance. Methods 99 subjects were recruited and divided into normal glucose tolerance （NGT） and type 2 diabetes （T2DM） according to 75 g oral glucose tolerance test （OGTT）. And then,the two groups were classified into obesity subgroup （≥28 kg/m2） and non-obesity subgroup （〈 28 kg/m2 ） （ NGT-OB/NGT-non OB： 19/22 ; T2DM-OB/T2DM-non OB： 28/30）. Plasma LPS, serum high sensitivity C-reactive protein （hsC-RP） and biochemical parameters were detected. Insulin sensitivity was evaluated by homeostasis model assessment of insulin resistance （HOMA-IR）. Comparisons between groups were performed using independent samples T test or Mann-Whitney U test. The relationship between LPS and other variables were presented by the pearson correlation coefficients. Stepwise regression model was used to analyze the influence factors of LPS level and HOMA-IR. Results The mean LPS levels of OB subgroups in NGT group and T2DM group were two to three times higher than non-OB subgroups respectively [ NGT： （ 13.19 ±3.34） vs （ 5.01 ± 1.94） pg/ml, T2DM. （ 22.01 ±5.53） vs （8. 10±2.03）pg/ml], and were defined as metabolic endotoxemia. Plasma LPS level was positively correlated with BMI （ r = 0. 307 ）, HbA1 c （ r = 0. 454）, hsC-RP （ r = 0. 254 ）, alanine aminotransferase （ALT） （r = 0. 881）, aspartate aminotransferase （AST） （ r = 0, 848）, HOMA-IR （ r =0. 509） and fasting plasma glucose （FPG） （r= 0. 450, P〈0. 05）. Multiple linear regression analysis demonstrated that plasma LPS was influenced by BMI and HbA1 c. BMI and LPS were important influencing factors of HOMA-IR. Conclusion With the increment of BMI, the level of plasma LIDS gradually elevate, which may make human body in low-grade inflammation and metabolic endotoxemia

关 键 词：内毒素 体质指数 肥胖 胰岛素抵抗 

分 类 号：R446.1[医药卫生—诊断学]