脂肪细胞型脂肪酸结合蛋白与不同糖耐量人群胰岛细胞功能的相关性研究  

Relationship between serum adipocyte fatty acid-binding protein and islet beta cell function in individuals with different glucose tolerance

作　　者：白婧[1] 雷营 祁范范 王雪[1] 王战建[1] 周亚茹[1] 

机构地区：[1]河北医科大学第三医院内分泌科,河北石家庄050051

出　　处：《河北医科大学学报》2017年第1期1-5,10,共6页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20120108)

摘　　要：目的探讨不同糖耐量人群血循环中脂肪细胞型脂肪酸结合蛋白(adipocyte fatty acid-binding protein,A-FABP)的水平及其与肥胖程度、血压、血糖、血脂、胰岛素抵抗程度及胰岛素分泌功能之间的相关性。方法选取于河北医科大学第三医院就诊、并行口服葡萄糖耐量试验者120例,按照WHO制定的糖尿病诊断与分型标准将受试对象分为3组:2型糖尿病组(type 2 diabetes mellitus,T2DM,n=62)、葡萄糖调节受损组(impaired glucose regulation,IGR,n=32)、正常对照组(normal glucose tolerance,NGT,n=26)。根据《中国成人超重和肥胖症预防控制指南》确立的肥胖标准将T2DM组分为非肥胖组(A组,n=30,BMI<28,男性16例,女性14例)和肥胖组(B组,n=32,BMI≥28,男性22例,女性10例)。测定身高、体质量、腰围、臀围、收缩压、舒张压,计算体质量指数(body mass index,BMI)、腰臀比,测定胆固醇(total cholesterol,TC)、三酰甘油(concentrations of triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、血糖、Hb A1c、胰岛素水平,并计算胰岛素曲线下面积(AUCINS)、血糖曲线下面积(AUCGLU)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)。结果 T2DM组血清A-FABP水平最高,明显高于IGR及NGT组(P<0.05);IGR组血清A-FABP水平明显高于NGT组(P<0.05);T2DM B组BMI、WC、HC、UA、FINS、HOMAIR、HOMA-β均高于T2DM A组(P<0.05);2型糖尿病肥胖组血清A-FABP水平明显高于非肥胖组(P<0.05);血清A-FABP水平与BMI、WC、HC、UA、TC、TG、FPG、2 h PG、AUCGLU、HOMA-IR呈显著正相关(P<0.05),与LDL-C、HDL-C、SBP、DBP、FINS、AUCINS、HOMA-β无相关(P>0.05)。多元逐步回归分析显示,BMI、Hb A1c和UA为血清A-FABP水平的独立影响因素。结论血清A-FABP与肥胖、胰岛素抵抗和糖脂代谢密切相关,是代谢综合征的异常标志。Objective To investigate the level of serum adipocyte fatty acid-binding protein （A-FABP） and the relationship between serum A-FABP and body mass index（BMI）, blood pressure, blood glucose, blood lipid, HOMA-insulin resistance index（HOMA-IR）, insulin levels in Han Chinese population with different glucose tolerance. Methods A total of 120 subjects were enrolled in this study. They were divided into 3 groups according to 75 g oral glucosetolerance-test（OGTT）, including normal glucose tolerance（NGT, n = 26）, impaired glucose regulation（IGR, n=32）, and type 2 diabetes mellitus（T2DM, n =62）. The T2DM group was divided into 2 subgroups by BMI according to the guidelines of the prevention and treatment adiposity in China, which included group A（non-obese subjects） and group B（obese subjects）. Clinical and biochemical metabolic parameters were measured. Results The levels of serum A- FABP were significantly higher in T2DM subjects than those of IGR and NGT subjects（P〈 0.01）. Compared with NGT group, fasting serum A-FABP levels were significantly increased in IGR group （P〈 0.01）. Compared with T2DM group, BMI. WC. HC. UA. FINS, HOMA-IR, HOMA-/31evels were significantly increased in IGR group（P〈0.05）. The level of serum A-FABP was significantly higher in T2DM obese subjects than T2DM non-obese subjects（P〈0. 01）. Serum A-FABP was correlated positively with BMI. WC. HC. UA. TC. TG. FPG. 2 hPG. AUCGLU and HOMA-IR（all P〈0.05）. There was no correlation between serum AFABP and LDL-C, HDL-C, SBP. DBP. FINS, AUCINS. H OMA-β （all P 〉 0.05）. Multiple regression analysis showed that BMI, HbAlc and UA were independently related factors for serum A-FABP levels. Conclusion The level of A-FABP is associated with obesity, insulin resistance, abnormal glucose and lipid metabolism. Measurement of serum A-FABP concentrations might be useful for diagnosis and prevention of T2DM.

关 键 词：糖尿病 2型 葡糖耐量试验 肥胖症 

分 类 号：R587.1[医药卫生—内分泌]