摘要
背景肥胖会导致胰岛素抵抗(IR)的发生进而引发2型糖尿病(T2DM),严重影响人类健康。鸢尾素(irisin)是一种新发现的肌肉和脂肪因子,在代谢调控中具有重要作用,T2DM合并超重肥胖患者的血清irisin水平会出现何种变化值得研究。目的观察T2DM超重肥胖患者血清irisin水平情况,并探讨血清irisin水平变化的影响因素。方法选取2019年12月至2021年6月于安徽医科大学第一附属医院内分泌科住院治疗的T2DM患者119例,根据体质指数(BMI)分为糖尿病超重肥胖组(n=78)和糖尿病体质量正常组(n=41)。另选取同期于本院体检且BMI正常的健康者为对照组(n=52)。比较三组受试者一般资料、实验室检查指标及血清irisin水平,采用Spearman秩相关分析探究血清irisin水平与一般资料及实验室检查指标的相关性,采用多元线性回归分析探究血清irisin水平的影响因素。结果三组收缩压(SBP)、舒张压(DBP)、BMI、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、空腹胰岛素(FINS)、稳态胰岛素抵抗指数(HOMA-IR)比较,差异均有统计学意义(P<0.05)。糖尿病体质量正常组血清irisin水平低于对照组,糖尿病超重肥胖组血清irisin水平低于对照组、糖尿病体质量正常组(P<0.05)。Spearman秩相关分析结果显示,血清irisin水平与HDL-C呈正相关(rs=0.304,P<0.05),与SBP、DBP、BMI、TG、HbA1c、FBG、FINS、HOMA-IR呈负相关(rs值分别为-0.271、-0.420、-0.372、-0.164、-0.418、-0.348、-0.293、-0.348,P<0.05)。多元线性回归分析结果显示,DBP〔b=-0.049,P=0.011〕、HbA1c〔b=-0.156,P=0.009〕、FINS〔b=-0.21,P=0.038〕是血清irisin水平的影响因素。结论T2DM患者血清irisin水平较健康者明显降低,尤其是合并超重肥胖患者,且血清irisin水平与血压、BMI、血脂、血糖及IR等因素存在一定关系。
Background Obesity may cause insulin resistance(IR),then leads to type 2 diabetes mellitus(T2DM),seriously affecting human health.Irisin is a newly discovered myokine produced by adipose and skeletal muscle tissues,which plays an important role in metabolic regulation.It is worth investigating what changes will occur in serum irisin levels in T2DM patients with overweight or obesity.Objective To examine the abnormality in serum irisin levels in overweight or obese patients with T2DM,and to explore the influencing factors.Methods A total of 119 patients with T2DM who were hospitalized in Department of Endocrinology,the First Affiliated Hospital of Anhui Medical University from December 2019 to June 2021 were selected,including 78 with overweight or obesity and 41 with normal weight assessed by body mass index(BMI).They were compared to 52 healthy people with normal body weight in terms of general demographics,laboratory test indices and serum irisin level.Spearman rank correlation analysis was used to explore the correlation of serum irisin level with demographic and laboratory test indices.Multiple linear regression analysis was used to explore factors associated with the abnormality in serum irisin in overweight or obese T2DM patients.Results Normal-weight diabetics,overweight or obese diabetics and healthy controls had significant differences in levels of systolic blood pressure(SBP),diastolic blood pressure(DBP),BMI,triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),fasting insulin(FINS)and homeostasis model assessment of insulin resistance(HOMA-IR)(P<0.05).The serum irisin level in normal-weight diabetics was lower than that in healthy controls(P<0.05).Overweight or obese diabetics had lower serum irisin level than healthy controls or normal-weight diabetics(P<0.05).Spearman rank correlation analysis showed that serum irisin level was positively correlated with HDL-C(rs=0.304,P<0.05),and negatively correlated with SBP,DBP,BMI,TG,HbA1c,FBG,FINS,and HOMA-IR(r_(s)=-0.271,-0.420,-0.372,-0.164,-0.418,-0.348,-0.293,-0.348,P<0.05).Multiple linear regression analysis showed that DBP〔b=-0.049,P=0.011〕,HbA1c〔b=-0.156,P=0.009〕,and FINS〔b=-0.21,P=0.038〕were associated with the abnormality in serum irisin in overweight or obese T2DM patients.Conclusion T2DM patients,especially those who were overweight or obese,were found with lower serum irisin level,which was associated with BMI,blood pressure,blood lipids,blood glucose and IR.
作者
张楠
姜天
张一
章秋
ZHANG Nan;JIANG Tian;ZHANG Yi;ZHANG Qiu(Department of Endocrinology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;School of Public Health,Anhui Medical University,Hefei 230032,China)
出处
《中国全科医学》
CAS
北大核心
2022年第32期4041-4045,共5页
Chinese General Practice
基金
2020年度安徽医科大学校科研基金项目(2020xkj168)——利拉鲁肽通过诱导骨骼肌表达Irisin促进肥胖T2DM大鼠白色脂肪组织棕色化及初步机制探讨
安医大一附院2018年度国家自然科学基金青年科学基金培育计划项目(2018kj20)——2型糖尿病患者皮肤晚期糖基化终末产物水平与糖尿病视网膜病变的关系。
关键词
糖尿病
2型
肥胖
超重
鸢尾素
胰岛素抵抗
影响因素分析
Diabetes mellitus,type 2
Obesity
Overweight
Irisin
Insulin resistance
Root cause analysis
