血清猪胆酸类胆汁酸与糖脂代谢的相关性研究  

Relationship of serum hyocholic acid species with glucose and lipid metabolism

作　　者：郑江菲 金力 彭丹凤[2] 郑晓皎[3] 陈天璐[3] 何珍 胡承[1] Zheng Jiangfei;Jin Li;Peng Danfeng;Zheng Xiaojiao;Chen Tianlu;He Zhen;Hu Cheng(Shanghai Diabetes Institute,Shanghai Jiao Tong University Affiliated Sixth People′s Hospital,Shanghai 200233,China;Department of Endocrinology and Metabolism,Shanghai Jiao Tong University Affiliated Sixth People′s Hospital,Shanghai 200233,China;Center for Translational Medicine,Shanghai Jiao Tong University Affiliated Sixth People′s Hospital,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院上海市糖尿病研究所,上海200233 [2]上海交通大学附属第六人民医院内分泌代谢科,上海200233 [3]上海交通大学附属第六人民医院转化医学中心,上海200233

出　　处：《中华糖尿病杂志》2022年第3期237-244,共8页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金面上项目(81974118);国家自然科学基金青年项目(81800728)。

摘　　要：目的探讨人群血清猪胆酸类胆汁酸(HCAs)水平与糖脂代谢的关系。方法选取2009年12月至2010年6月上海肥胖研究中的受试者进行横断面研究。收集其性别、年龄、身高、体重,并计算体重指数(BMI)。检测研究对象的空腹血糖(FPG)、空腹胰岛素(FINS)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等生化指标,检测受试者的血清胆汁酸谱[包括猪胆酸(HCA)、猪脱氧胆酸(HDCA)、甘氨猪胆酸(GHCA)和甘氨猪脱氧胆酸(GHDCA)等]并计算血清总猪胆酸类胆汁酸(总HCAs)。根据公式计算受试者的稳态模型评估β细胞功能指数(HOMA-β)及Gutt-胰岛素敏感性指数(Gutt-ISI)等。根据研究对象的BMI以及是否患有2型糖尿病(T2DM)将其分为3组:健康对照组、单纯超重/肥胖组及超重/肥胖T2DM组。采用Kruskal-WallisH检验、Mann-WhitneyU检验或χ2检验对组间相应指标进行比较。采用Spearman相关分析法和多重线性回归探讨HCAs与糖脂代谢指标的相关性。结果共纳入304例研究对象。其中,健康对照组127例,单纯超重/肥胖组107例,超重/肥胖T2DM组70例。与健康对照组相比,超重/肥胖T2DM组的总HCAs、HCA、GHCA、GHDCA均更低(P<0.05)。在校正性别、年龄和BMI后,HCA与LDL-C呈负相关(β=-0.006,P=0.011),而与Gutt-ISI呈正相关(β=0.496,P=0.003);HDCA与Gutt-ISI呈正相关(β=0.240,P=0.028);GHCA与FINS(β=0.048,P=0.011)、HOMA-β(β=0.582,P=0.032)均呈正相关。结论超重/肥胖T2DM患者的多个血清HCAs水平显著降低;HCAs水平的降低与超重/肥胖T2DM患者血脂异常、胰岛β细胞功能受损以及胰岛素抵抗密切相关。Objective To explore the relationship of serum level of hyocholic acid species(HCAs)with glucose and lipid metabolism on human.Methods Participants from Shanghai Obesity Study between December 2009 and June 2010 were enrolled for a cross-sectional study.The gender,age,height and weight of the subjects were collected and their body mass index(BMI)was calculated.Fasting blood glucose(FPG),fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and other biochemical indicators were tested.Serum bile acid spectrum[including hyocholic acid(HCA),hyodeoxycholic acid(HDCA),glycohyocholic acid(GHCA)and glycohyodeoxycholic acid(GHDCA),etc]were measured,then the serum total HCAs were calculated.Homeostasis model of assessment forβ-cell function(HOMA-β),Gutt insulin sensitivity index(Gutt-ISI)and other indexes were figured out according to formulas.Subjects were divided into healthy lean,healthy overweight/obese,and overweight/obese with type 2 diabetes(T2DM)based on their BMI and whether they had T2DM.Kruskal-wallis H test,Mann-Whitney U test orχ2 test were used to compare the corresponding indexes among the three or two groups.Spearman rank correlation analysis and multiple linear regression model were performed to analyze the association between serum HCAs and metabolic markers.Results A total of 304 subjects were included in this study,with 127 in healthy lean group,107 in healthy overweight/obese group,and 70 in overweight/obese with T2DM group.Total HCAs,HCA,GHCA and GHDCA were lower in overweight/obese with T2DM group than healthy lean group(P<0.05).After adjustment for gender,age and BMI,HCA was inversely correlated with LDL-C(β=-0.006,P=0.011),while positively with Gutt-ISI(β=0.496,P=0.003).HDCA was also positively correlated with Gutt-ISI(β=0.240,P=0.028).GHCA was positively correlated with FINS(β=0.048,P=0.011)and HOMA-β(β=0.582,P=0.032).Conclusions The levels of serum HCAs were decreased in overweight/obese patients with T2DM;and this decrease was close

关 键 词：糖尿病 2型 超重 肥胖症 猪胆酸类胆汁酸 糖脂代谢 

分 类 号：R587.1[医药卫生—内分泌]