2型糖尿病肥胖或超重患者血清成纤维细胞生长因子21水平及其临床价值研究  

Clinical Significance of Fibroblast Growth Factor 21 Levels for Obese or Overweight Patients with Type 2 Diabetes Mellitus

作　　者：张楠[1] 姜天[1] 孙莉[1] 代芳[1] 章秋[1] ZHANG Nan;JIANG Tian;SUN Li;DAI Fang;ZHANG Qiu(Department of Endocrinology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院内分泌科,安徽省合肥市230022

出　　处：《中国全科医学》2018年第5期521-525,共5页Chinese General Practice

基　　金：国家自然科学基金青年科学基金培养计划(2013KJ15);安徽省自然科学基金青年基金(1608085QH205)

摘　　要：目的研究2型糖尿病(T2DM)肥胖或超重患者血清成纤维细胞生长因子21(FGF21)的水平,并探讨其与体质指数(BMI)、稳态胰岛素抵抗指数(HOMA-IR)等因素的相关性。方法选取2014年1月—2016年7月安徽医科大学第一附属医院内分泌科住院治疗的T2DM患者213例,根据BMI分为T2DM肥胖超重组(BMI≥24.0 kg/m^2,127例)和T2DM非肥胖超重组(BMI<24.0 kg/m^2,86例),另选取同期本院体检健康者为健康对照组(114例)。记录受试者血压、BMI、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(Hb A1c)、空腹血糖(FBG)、空腹胰岛素(FINS)、HOMA-IR及FGF21水平。结果各组舒张压、体质量、BMI、TG、HDL-C、LDL-C、Hb A1c、FBG、FINS、HOMA-IR比较,差异均有统计学意义(P<0.05)。T2DM非肥胖超重组FGF21水平高于健康对照组,T2DM肥胖超重组FGF21水平高于健康对照组、T2DM非肥胖超重组(P<0.05)。Spearman相关分析显示,T2DM肥胖超重组FGF21水平与BMI、FINS、HOMA-IR呈正相关(rs=0.312、0.311、0.243,P<0.05)。多元线性回归分析显示,BMI[b=3.654,95%CI(1.543,5.764)]、FINS[b=1.310,95%CI(0.537,2.082)]是T2DM肥胖超重组FGF21水平的影响因素(P<0.05)。结论 T2DM肥胖或超重患者血清FGF21水平升高,且与BMI、胰岛素抵抗等因素有关;FGF21可能用于预测糖尿病、肥胖的发生,并成为治疗糖尿病、肥胖的新一代药物。Objective To investigate the levels of serum fibroblast growth factor 21(FGF21)in obese or overweight patients with type 2 diabetes mellitus(T2DM),and to explore its correlation with body mass index(BMI)and HOMA-insulin resistance index(HOMA-IR).Methods Patients of 213 cases with T2DM who were hospitalized in the Department of Endocrinology,the First Affiliated Hospital of Anhui Medical University from January 2014 to July 2016 were selected and subsequently divided into a T2DM obesity and overweight group(BMI≥24.0 kg/m2,127 cases),and a T2DM non-obesity or overweight group(BMI<24.0 kg/m2,86 cases)according to BMI.Healthy individuals in the same periods were selected as the control group(114 cases).A range of parameters were recorded,including blood pressure,BMI,total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoproteincholesterol(LDL-C),HbA1c,fasting blood glucose(FBG),fasting insulin(FINS),HOMA-insulin resistance index(HOMA-IR)and FGF21.Results Diastolic blood pressure(DBP),body mass,BMI,TG,HDL-C,LDL-C,HbA1c,FBG,FINS,HOMA-IR were significantly different among the three groups(P<0.05).FGF21 level in the T2DM non-obese or overweight group was higher than that in the control group(P<0.05).FGF21 level in the obesity and overweight T2DM group was higher than that in the control group,T2DM non-obese or overweight group(P<0.05).Spearman correlation analysis showed that,the level of serum FGF21 was positively correlated with BMI,FINS and HOMA-IR in obesity and overweight T2DM group(rs=0.312,0.311,0.243,P<0.05).Multivariate linear regression analysis showed that BMI〔b=3.654,95%CI(1.543,5.764)〕,FINS〔b=1.310,95%CI(0.537,2.082)〕were shown to be factors which influenced FGF21 levels in the obesity and overweight T2DM group(P<0.05).Conclusion Serum FGF21 levels were higher in the T2DM obesity and overweight patients,and were related to BMI,IR and other factors.Serum FGF21 may be used to predict the occurrence of diabetes and obesity,and represents a target for the dev

关 键 词：糖尿病 2型 肥胖症 成纤维细胞生长因子21 体脂肪率 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]