血清二肽基肽酶4酶活性与脂代谢异常相关性研究  

Correlation between serum dipeptidyl peptidase 4 activity and abnormal lipid metabolism

作　　者：屠晓芳 钮忆欣[1] 秦利[1] 苏青[1] 张洪梅[1] Tu Xiaofang;Niu Yixin;Qing Li;Su Qing;Zhang Hongmei(Department of Endocrinology,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院内分泌科,200092

出　　处：《中华内分泌代谢杂志》2020年第5期387-392,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：上海市科委重点项目(10411956600、15411953200)。

摘　　要：目的二肽基肽酶4(DPP4)是肠促胰素的裂解酶,目前其抑制剂已作为降糖药物在临床上应用。血清DPP4酶和心血管疾病、肥胖等代谢性疾病相关,而脂代谢障碍是代谢综合征重要的一环,本研究旨在探索它和DPP4酶的关系。方法研究对象来自上海崇明区城桥镇,共纳入3644个40~70岁既往无糖尿病病史、同时未服用过降脂药物的常住居民。观察指标包括血糖、血脂、血胰岛素水平、DPP4酶活性和肝酶活性等;同时记录身高、体重、血压等参数。结果血清DPP4酶活性以其四分位值为截点分成4组(Q1-Q4)。随着血清DPP4酶活性增加,人群三酰甘油、总胆固醇和血糖水平升高,三酰甘油从(1.23±0.70)mmol/L升高到(2.31±1.89)mmol/L。和胆固醇水平相比,三酰甘油水平和DPP4酶活性的相关性更高[三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)相关系数分别为0.424、0.281、0.142、0.027],在校正了混杂因素(年龄、性别、BMI)后,结果仍成立。随着DPP4酶活性的增高,Q4组和Q1组相比有更高的罹患高三酰甘油血症(OR=5.25)的风险,在校正了混杂因素及血糖水平后结果不变(OR=4.90)。结论血清DPP4酶活性与血脂水平独立相关,与血三酰甘油水平关系尤为密切。Objective Dipeptidyl peptidase 4(DPP4)is an incretin lyase,while DPP4 inhibitors have been used clinically as hypoglycemic drugs.Serum DPP4 is related to metabolic diseases such as cardiovascular disease and obesity,and lipid metabolic disorder is an important part of metabolic syndrome.This study was designed to explore the relationship between DPP4 and lipid metabolic disorder.Methods There were 3644 participants from Chengqiao Town,Chongming District,Shanghai.All of the subjects recruited were residents between 40-70 years old,who have not diagnosed as diabetes mellitus(DM)and who have never used any lipid-lowering drugs.Glucose,insulin,lipid level,DPP4 activity and liver enzymes in serum of all participants were tested.In addition,height,weight and blood pressure were also recorded.Results Participants were divided into four groups(Q1-Q4)according to the quartile value of serum DPP4 activities.Along with the increase of serum DPP4 activity,triglyceride,total cholesterol,and blood glucose levels increased,and triglyceride increased from(1.23±0.70)mmol/L to(2.31±1.89)mmol/L.Compared with cholesterol levels,the triglyceride was more closely related to DPP4 activity[the correlation coefficients of triglyceride,total cholesterol,low-density lipoprotein-cholesterol(LDL-C),and high-density lipoprotein-cholesterol(HDL-C)were 0.424,0.281,0.142,and 0.027,respectively].After adjusting for confounding factors(age,gender,BMI),the result was similar.With the increase of DPP4 enzyme activity,the Q4 group had a higher risk of developing hyperglyceridemia(OR=5.25)than the Q1 group,and the result was almost unchanged after adjusting for confounding factors and blood glucose levels(OR=4.90).Conclusion Serum DPP4 activity is independently related to blood lipid levels,and is particularly closely related to blood TG levels.

关 键 词：二肽基肽酶4 酶活性 血脂 三酰甘油 血糖 

分 类 号：R589[医药卫生—内分泌]