2型糖尿病腹型肥胖患者血清镍纹样蛋白水平与糖脂代谢和炎症状态相关性的研究  

Correlation of serum Metrnl levels with glycolipid metabolism and inflammatory status in patients with type 2 diabetes mellitus combined with abdominal obesity

作　　者：温子英 刘静[2] 余静 仇菊梅 杨帆[1] 杨瑞霞 张琦[2] WEN Zsving;LIU Jing;YU Jing(The First Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]甘肃省人民医院老年医学科

出　　处：《中国糖尿病杂志》2024年第10期721-725,共5页Chinese Journal of Diabetes

基　　金：国家自然科学基金(81960173、82160166);甘肃省重点研发计划(22YF7FA096);甘肃省人民医院院内科研基金(22GSSYA-1);兰州市人才创新创业项目(2021-RC-136);兰州市卫生健康科技发展项目(2021005);甜蜜医生培育项目(2021SD01)。

摘　　要：目的 探讨腹型肥胖的T2DM患者血清镍纹样蛋白(Metrnl)水平与糖脂代谢和炎症状态的相关性.方法 选取 2022 年 5~9 月于甘肃省人民医院老年医学科住院治疗的T2DM患者124 例,根据是否合并腹型肥胖分为T2DM合并腹型肥胖组(T2DM+AO,n=81)及单纯T2DM组(n=43);另选取同期 140 名体检健康者,分为腹型肥胖组(AO,n=69)及正常对照组(NC,n=71).ELISA 法检测血清Metrnl、IL-4、IL-13 水平,比较各组血清 Metrnl 与 WC、BMI、内脏脂肪面积(VFA)、FPG、HbA1c、TC、TG、LDL-C、HDL-C等代谢指标和IL-4、IL-13 等炎症指标的差异,探讨Metrnl与T2DM合并腹型肥胖的关系.结果 与NC组比较,AO、T2DM及T2DM+AO组血清Metrnl 降低(P<0.05).Spearman相关分析显示,血清Metrnl 与HDL-C呈正相关(P<0.05),与WC、BMI、VFA、FPG、HbA1c、TG、IL-4、IL-13 呈负相关(P<0.01).多元线性回归分析显示,年龄、WC、BMI、IL-4 是血清Metrnl的影响因素.Logistic回归分析显示,WC、VFA、FPG、Metrnl是T2DM合并腹型肥胖的影响因素.受试者工作特征曲线分析显示,Metrnl预测T2DM合并腹型肥胖的曲线下面积为0.929,敏感度为82.5%,特异度为93.8%.结论 T2DM合并腹型肥胖患者血清Metrnl显著降低,与糖脂代谢及炎症状态密切相关.血清Metrnl可能是T2DM合并腹型肥胖的新型生物学标志物.Objective To investigate the correlation between serum nickel-like protein(Metrnl)level and glycolipid metabolism and inflammatory state in patients with T2DM complicated with abdominal obesity.Methods One hundred and twenty-four T2DM patients and 140 non-diabetic controls who were hospitalized in Gansu Provincial People's Hospital from May to September 2022 were selected and divided into T2DM combined abdominal obesity group(T2DM+AO,n=81),T2DM group(n=43),abdominal obesity group(AO,n=69)and normal control group(NC,n=71)according to whether they suffered from T2DM and abdominal obesity.ELISA method was used to determine the levels of serum Metrnl,IL-4 and IL-13.The correlation between serum Metrnl and the indicators of glucose and lipid metabolism,WC,BMI,VFA,FPG,HbA1c,TC,TG,LDL-C,HDL-C and the indicators of inflammatory state,IL-4 and IL-13 were analyzed.Results Compared with NC group,serum Metrnl levels in T2DM group,AO and T2DM+AO group were decreased(P<0.05).Serum Metrnl was negatively correlated with WC,BMI,VFA,FPG,HbA1c,TG,IL-4,IL-13(P<0.01),and positively correlated with HDL-C(P<0.05).Age,WC,BMI and IL-4 were the influencing factors of Metrnl.WC,VFA,FPG and Metrnl were the influencing factors of T2DM combined with abdominal obesity.The ROC curve showed that serum Metrnl had a sensitivity of 82.5%and a specificity of 93.8%for the diagnosis of T2DM with abdominal obesity.Conclusions Serum Metrnl in T2DM patients with abdominal obesity is significantly reduced,and is closely related to glucose and lipid metabolism and inflammatory status.Serum Metrnl may be a novel biomarker factor for T2DM complicated with abdominal obesity.

关 键 词：糖尿病 2型 腹型肥胖 镍纹样蛋白 糖脂代谢 炎症状态 

分 类 号：R587.1[医药卫生—内分泌] R589.2[医药卫生—内科学]