肥胖青少年患者血清肝型脂肪酸结合蛋白水平及其相关因素分析

Serum liver-type fatty acid binding protein level and related factors in obese young adults

目的:测定上海地区肥胖青少年在不同糖代谢情况下血清肝型脂肪酸结合蛋白(L-FABP)水平,探讨L-FABP与糖代谢、脂代谢、胰岛β细胞功能等的相关性。方法:共有267例受试者纳入本研究,包括糖耐量正常(NGT)组107例,糖调节受损(IGR)组118例和2型糖尿病(T2DM)组42例,采用酶联免疫吸附法检测血清L-FABP,并以△I30/△G30(糖耐量试验开始30 min胰岛素与血糖变化的比值)和急性胰岛素分泌反应(AIRg)评估胰岛β细胞功能。结果:校正年龄、性别和体质量指数(BMI)后,IGR和T2DM组的L-FABP浓度均明显高于NGT组(P<0.001),而在IGR与T2DM组间差异无统计学意义;简单相关分析显示,L-FABP与三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)和糖负荷后2 h血糖(2 hPG)相关,校正年龄和BMI后,上述相关性依然存在;多元逐步回归发现,2 hPG是血清L-FABP的独立相关因素;在267例受试者中未见L-FABP与△I30/△G30的相关性,在162例(NGT组65例、IGR组73例和T2DM组24例)行多样本静脉葡萄糖耐量试验的受试对象中,未见L-FABP与AIRg的相关性。结论:血清L-FABP在肥胖伴糖代谢异常的青少年人群中升高,且与糖、脂代谢相关,但与胰岛β细胞功能无关。

Objective To asses the serum liver-type fatty acid binding protein （L-FABP or FABP1） level in Shanghai obese young adults under different glucose metabolism and study the relationship between serum L-FABP level and glucose metabolism, lipid metabolism and pancreatic β-cell function. Methods A total of 267 subjects were enrolled in this study including subjects with normal glucose tolerance （NGT, n=107）, impaired glucose regulation （IGR, n=118） and type-2 diabetes mellitus （T2DM, n=42）. Serum L-FABP level was detected by enzyme-linked immunosorbent assay （ELISA）. Meanwhile, pancreatic β-cell function was assessed by △I30/△G30 and by acute insulin response to glucose （AIRg）. Results After adjustment for age, gender and body mass index （BMI）, the serum L-FABP level in IGR and T2DM was significantly higher than that in NGT （P〈0.001）, but there was no statistical difference in serum L-FABP level between IGR and T2DM. Correlation analysis showed that serum L-FABP level was significantly correlated to triglyeeride （TG）, high-density lipoprotein-eholesterol （HDL-C）, fasting blood glucose （FBG） and 2-hour plasma glucose （2 hPG） （P〈0.05） before and after adjustment for age and BMI. Multiple step-wise regression analysis showed that 2 hPG was an independent factor related to serum L-FABP level. In 267 subjects, correlation analysis did not show any correlation between serum L- FABP level and △I30/△G30. In 162 subjects （65 NGT, 73 IGR and 24 T2DM）, serum L-FABP level was shown to be not related to AIRg. Conclusions Serum L-FABP level increased significantly in obese subjects with abnormal glucose homeostasis. Serum L-FABP level was correlated with glucose and lipid metabolism, but not with pancreatic △-cell function.