糖代谢异常肥胖患者脑肠肽水平的改变及临床意义

Changes and clinical significance of plasma brain-gut peptide in obese patients with glycometabolism abnormality

目的观察糖代谢异常肥胖患者外周血脑肠肽：肥胖抑制素（Obestatin）和胃饥饿素（Ghrelin）水平的变化及临床意义。方法选择22名健康人为对照组，48例糖代谢异常肥胖患者分为2组各24例：肥胖-糖耐量受损（IGT）组和肥胖-2型糖尿病（T2DM）组。采用酶联免疫吸附法测定空腹血Obestatin、Ghrelin和高敏c反应蛋白（hs—CRP）水平。采用放射免疫法测定空腹胰岛素（FPI）水平。结果肥胖-IGT绢和肥胖-T2DM组Obestatin和Gh-relin水平均显著低于健康对照组[Obestatin：（2．48±1．14）μg/L和（1．83±0．76）μg／L比（3．11±0．69）μg/L；Ghrelin：（2．86±0．76）μg／L和（2．33±0．61）μg／L比（3．65±0．80）μg／L，均为P〈0．05]，且肥胖-T2DM组Obestatin和Ghrelin水平显著低于肥胖-IGT组（均为P〈0．05）。随HOMA模型计算胰岛素抵抗指数（HOMA—IR）的增加，Obestatin和Ghrelin水平在健康对照组、肥胖-IGT组和肥胖-T2DM组均呈下降趋势，差异有统计学意义（P〈0．05）。相关分析显示，Obestatin和Ghrelin均与体质指数（BMI）、HOMA—IR、FPI、空腹血糖（FPG）和hs—CRP呈负相关。结论血Obestatin和Ghrelin水平的降低与肥胖、胰岛素抵抗程度密切相关。

Objective To investigate the levels of circulating brain-gut peptide in obese patients with glycometabolism abnormality. Methods A total of 22 healthy people were selected as normal control group, and 48 obese patients with glycometabolism abnormality were divided into two groups： impaired glucose tolerance （IGT） group and type 2 diabetes mellitus （T2DM） group. The concentrations of plasma ghrelin, obestatin and high-sensitivity C-reactive protein （hs-CRP） were measured by enzyme-linked immunosorbent assay （ELISA）, and fasting plasma insulin （FPI） concentration was measured by radioimmunoassay （RIA）. Results The levels of obestatin and ghrelin were decreased significantly in obese IGT group and obese T2DM group than in normal control group [ obestatin： （2. 48±1.14）μg/L and （ 1.83±0. 76）μg/L vs. （3.11±0. 69）μg/L ; ghrelin ： （ 2. 86±0.76 ）μg/L and （ 2. 33±0. 61 ）μg/L vs. （3.65±0. 80）μg/L, all P 〈0. 05 ]. Obestatin and ghrelin were higher in obese IGT group than in obese T2DM group （P 〈0. 05） . The levels of obestatin and ghrelin in normal group, obese IGT group and obese T2DM group showed significant decrease with the increase of HOMA-IR （ P 〈 0. 05 ）. The level of obestatin or ghrelin had significantly negative correlation with body mass index （BMI）, HOMA-IR, FPI, fasting plasma glucose （FPG） and hs-CRP. Conclusions The decreases of circulating obestatin and ghrelin are associated with obesity and insulin resistance.