血浆氨基酸和脂肪酸与2型糖尿病及胰岛素抵抗的关联  

Associations of plasma amino acids and fatty acids with type 2 diabetes and insulin resistance

作　　者：胡丽坤 刘宇虹 李艳玲 董晶[2] 褚熙[2] 闫宇翔 HU Likun;LIU Yuhong;LI Yanling;DONG Jing;CHU Xi;YAN Yuxiang(School of Public Health,Capital Medical University,Beijing 100069,China;Health Management Center,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Municipal Key Laboratory of Clinical Epidemiology,Beijing 100069,China)

机构地区：[1]首都医科大学公共卫生学院流行病与卫生统计学系,北京100069 [2]首都医科大学宣武医院健康管理中心,北京100053 [3]临床流行病学北京市重点实验室,北京100069

出　　处：《中国医院药学杂志》2023年第12期1320-1325,共6页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金(编号:81773511)。

摘　　要：目的:探索血浆中谷氨酸(glutamate, GLU)、天冬酰胺(asparagine, ASN)、棕榈酸(palmitic acid, PA)和油酸(oleic acid, OA)与2型糖尿病(type 2 diabetes, T2D)及胰岛素抵抗的关联。方法:采用巢式病例对照研究设计,以2017年为基线,以随访4年后的新发T2D者为T2D组(213人),按1∶1个体匹配方法匹配健康对照者作为对照组。应用超高效液相色谱串联质谱技术对血浆氨基酸和脂肪酸进行定量检测。利用多因素回归模型分析基线血浆氨基酸和脂肪酸水平与T2D发病和胰岛素抵抗的关联。结果:T2D组与对照组的基线血浆氨基酸和脂肪酸水平的差异有统计学意义。基线血浆PA (OR=1.04,95%CI:1.02~1.06)、OA (OR=1.04,95%CI:1.02~1.06)、GLU (OR=1.37,95%CI:1.06~1.78)和ASN (OR=0.77,95%CI:0.67~0.88)水平均与T2D发病风险存在显著关联。PA、OA和GLU与胰岛素抵抗均呈正相关,而ASN与胰岛素抵抗呈负相关。添加PA、OA、GLU和ASN的T2D预测模型的受试者工作特征(ROC)曲线下面积从0.653增加至0.738。结论:血浆PA、OA、GLU和ASN水平与T2D发病及胰岛素抵抗有关。添加PA、OA、GLU和ASN的T2D预测模型可以更好地预测T2D发病风险。OBJECTIVE To explore the association of plasma glutamate(GLU),asparagine(ASN),palmitic acid(PA)and oleic acid(OA)with type 2 diabetes(T2D)and insulin resistance.METHODS A nested case-control study was conducted,with 2017 as the baseline and 213 newly diagnosed T2D patients after 4 years of follow-up as the case group.Healthy controls were matched according to 1∶1 individual matching method.Quantitative determination of plasma amino acids and fatty acids was carried out by ultra-performance liquid chromatography tandem mass spectrometry.Multivariate regression models were used to analyze the association between baseline amino acids and fatty acids levels and the incidence of T2D and insulin resistance.RESULTS There were statistically significant differences in baseline plasma amino acids and fatty acids levels between T2D group and control group.Baseline plasma PA(OR=1.04,95%CI:1.02-1.06),OA(OR=1.04,95%CI:1.02-1.06),GLU(OR=1.37,95%CI:1.06-1.78)and ASN(OR=0.77,95%CI:0.67-0.88)levels were significantly associated with the incidence risk of T2D.PA,OA and GLU were all positively correlated with insulin resistance,while ASN was negatively correlated with insulin resistance.The area under the Receiver Operating Characteristic curve(ROC curve)for the T2D prediction model with the addition of PA,OA,GLU and ASN increased from 0.653 to 0.738.CONCLUSION Plasma levels of PA,OA,GLU and ASN are related to the pathogenesis of T2D and insulin resistance.T2D prediction models with the addition of PA,OA,GLU and ASN can better predict the risk of developing T2D.

关 键 词：代谢物 氨基酸 脂肪酸 2型糖尿病 胰岛素抵抗 

分 类 号：R917[医药卫生—药物分析学] R587.1[医药卫生—药学]