机构地区:[1]陕西省咸阳市第一人民医院呼吸内科,712099 [2]湖北省第三人民医院肿瘤科
出 处:《河北医药》2023年第5期684-687,共4页Hebei Medical Journal
基 金:湖北省卫生健康委员会科研项目(编号:WJ2019M238)。
摘 要:目的探讨胎球蛋白A(Fetuin-A)、视黄醇结合蛋白4(RBP4)在慢性阻塞性肺疾病(COPD)患者血清中的表达以及二者与气道炎症及胰岛素抵抗(IR)的关系。方法收集2020年1月至2022年1月确诊的COPD患者112例作为COPD组,根据病情分为稳定期组68例和急性加重期组44例;同期选取无肺部疾病的体检者104例作为对照组,收集各研究对象一般资料。采用酶联免疫吸附法检测血清Fetuin-A、RBP4及炎性指标肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)和IL-12水平;肺功能检测仪检测肺功能指标1 s用力呼气容积(FEV1)、用力肺活量(FVC),计算FEV1/FVC;采用葡萄糖氧化酶法检测空腹血糖,采用全自动生化分析仪检测空腹胰岛素,计算胰岛素抵抗指数(HOMA-IR);Pearson法分析COPD患者血清Fetuin-A、RBP4表达与炎症指标、肺功能指标、IR指标的相关性。结果COPD组血清RBP4及空腹血糖、空腹胰岛素、HOMA-IR、TNF-α、IL-1β、IL-12高于对照组,Fetuin-A、FEV1、FEV1/FVC低于对照组(P<0.05)。COPD患者血清Fetuin-A与RBP4表达呈负相关(r=-0.506,P<0.05);FEV1、FEV1/FVC与Fetuin-A呈正相关,与RBP4呈负相关(P<0.05);TNF-α、IL-1β、IL-12、空腹血糖、空腹胰岛素、HOMA-IR与Fetuin-A呈负相关,与RBP4呈正相关(P<0.05)。急性加重期组血清RBP4及TNF-α、IL-1β、IL-12、空腹血糖、空腹胰岛素、HOMA-IR高于稳定期组,Fetuin-A及FEV1、FEV1/FVC低于稳定期组(P<0.05)。结论COPD患者伴有一定的IR,血清Fetuin-A、RBP4与气道炎症及IR存在一定的相关性。Objective To measure the expression levels of serum fetuin-A and retinol binding protein 4(RBP4)in patients with chronic obstructive pulmonary disease(COPD)and their correlation with airway inflammation and insulin resistance(IR).Methods From January 2020 to January 2022,totally 112 COPD patients were recruited and assigned to the stable group(n=68)and the acute exacerbation group(n=44)according to their disease conditions.Meantime,subjects who participated in the physical examinations without lung diseases were included in the control group(n=104).The general information was collected.Enzyme-linked immune sorbent assay(ELISA)was implemented to detect contents of serum fetuin-A,RBP4 and inflammatory indexes(tumor necrosis factor-α[TNF-α],interleukin-1β[IL-1β]and IL-12).lung function testing was performed to detect the pulmonary function indexes,including the forced expiratory volume in 1 s(FEV1),forced vital capacity(FVC),and FEV1/FVC.Fasting blood glucose(FBG)was measured via the glucose oxidase method.Fasting insulin and homeostasis model assessment-insulin resistance(HOMA-IR)were measured using the automatic biochemical analyzer.The correlation between the expression levels of serum fetuin-A and RBP4 with inflammatory indexes,pulmonary function indexes and IR indexes was analyzed using the Pearson correlation test.Results Compared with those of control group,RBP4 level,FBG,fasting insulin,HOMA-IR,contents of TNF-α,IL-1βand IL-12 were significantly higher in COPD group,while fetuin-A level,FEV1,and FEV1/FVC were significantly lower(P<0.05).Serum fetuin-A was negatively correlated with RBP4 expression in COPD patients(r=-0.506,P<0.05).FEV1 and FEV1/FVC were positively correlated with fetuin-A level,but negatively correlated with RBP4 level(P<0.05).TNF-α,IL-1β,IL-12,FBG,fasting insulin and HOMA-IR were negatively correlated with fetuin-A level,but positively correlated with RBP4 level(P<0.05).Serum RBP4,TNF-α,IL-1β,IL-12,FBG,fasting insulin,and HOMA-IR in acute exacerbation group were significantly high
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