Betatrophin与1型和2型糖尿病患者胰岛β细胞功能及其他代谢指标的相关性

The correlation between Betatrophin and islet beta cell function and other metabolic indexes in type one and type two diabetes meliitus

目的观察Betatrophin在1型和2型糖尿病患者体内的变化，分析Betatrophin水平与各代谢相关指标的相关性。方法收集1型糖尿病患者30例、2型糖尿病患者44例和健康人群（对照组）80例。测量人体指标，检测相关代谢的血生化指标，采用酶联免疫吸附试验检测Betatrophin水平。采用单因素方差分析比较多组之间的差异，直线相关分析研究Betatrophin与体测及生化指标的相关性。采用多元线性回归分析Betatrophin的影响因素。结果1型糖尿病患者Betatrophin水平[（3．57±0．48）ns／ml比（2．26±0．54）ng／ml，P〈0．05]、空腹血糖[（12．3±2．4）mmol／L比（4．8±2．6）mmol／L，P〈0．05]、餐后2h血糖[（23．1±3．2）mmol／L比（7．2±3．1）mmol／L，P〈0．05]、糖化血红蛋白（HbAlc）[（9．9±3．5）％比（5．3±2．4）％，P〈0．05]较对照组明显升高，空腹c肽[（0．12±0．08）ng／ml比（0．47±0．16）ng／ml，P〈0．05）]、餐后2hC肽水平[（0．14±0．09）ns／ml比（1．06±0．49）ng／ml，P〈0．05]及HOMA—B指数（26．20±12．70比82．93±48．12，P〈0．05）下降。Betatrophin水平与年龄（r=0．417，P〈0．05）、HbAlc（r=0．475，P〈0．05）、空腹血糖（r=0．386，P〈0．05）、餐后2h血糖（r=0．367，P〈0．05）、HOMA—B（r=-0．400，P〈0．05）相关。其主要影响因素为HOMA-母、空腹血糖、年龄和HbAlc。2型糖尿病患者和对照组相比，具有较高的Betatrophin水平[（4．874-0．65）ng／ml比（2．26±0．54）ng／ml，P〈0．05]、三酰甘油[（2．20±1．60）mmol／L比（1．36±0．76）mmol／L，P〈0．05]、空腹血糖[（8．9±2．8）mmol／L比（4．8±2．6）mmo]／L，P〈0．05]、餐后2h血糖[（17．7±4．2）mmol／L比（7．2±3．1）mmol／L，P〈0．05]、空腹胰岛素[（15．30±8．60）p,U／ml比（5．02±2．34）wU／ml，P〈0．05]、空腹c肽[（1．93±1．60）rig／ml比（0．47±0．16）ng／ng，P〈0．05]、餐后2hC肽[（5．20±2．70）ng／ml比（1．06±0．49）ng／ml，P〈0．05]、HbAlc[（7．9-4．2．2）％比（5．3±2．4）％，P〈0．05]、HOMA-IR指数（4．70±2．30比1．59±0．94，P〈0．05）以及较低的HOMA—B指数（57．50±22．30比82．93±48．12，P〈0．05）。Betatrophin与年龄（r=0．442，P〈0．05）、空腹血糖（r=0．362，P〈0．05）、空腹胰岛素（r=0．312，P〈0．05）、HbAlc（r=0．486，P〈0．05）、三酰甘油（r=0．270，P〈0．05）、低密度脂蛋白胆固醇（r=0．294，P〈0．05）、HOMA—IR（r=0．436，P〈0．05）呈正相关，与高密度脂蛋白胆固醇（r=-0．257，P〈0．05）、HOMA-B（r=-0．365，P〈0．05）呈负相关。2型糖尿病患者Betatrophin主要影响因素为BMI、HOMA．IR、HOMA．B、空腹血糖和年龄。且其Betatrophin浓度高于1型糖尿病患者[（4．87±0．65）n∥ml比（3．57±0．48）ng／ml，P〈0．05]。结论Betatrophin与糖尿病患者糖代谢及B细胞功能相关，且与2型糖尿病患者脂代谢紊乱关系密切，推测Betatrophin可能参与了糖尿病的发生。

Objective To observe the change of circulating Betatrophin in patients with type 1 or type 2 diabetes mellitus （T1DM, T2DM） and analyze the correlation between serum Betatrophin levels and metabo- lism-related indexes. Methods A total of 154 people （80 healthy controls, 30 TIDM, 44 T2DM were en- rolled in the study. Anthropometrics and blood Biochemical indexes of metabolism were measured, and serum betatrophin was measured with enzyme-linked immunosorbent assay kit. Comparison among the three groups was tested with univariate analysis of variance, correlation between Betatrophin and anthropometrics and biochemical indicators with linear correlation analysis, and factors influencing betatrophin with multivariate linear regres- sion. Results Serum Betatrohpinlevel [ （3.57±0.48） ng/mlvs. （2.26±0.54） ng/ml, P〈0.05], fast- ing blood glucose [ （ 12. 3 ±2. 4） mmolf L vs. （4. 8 ±2. 6） mmol/L, P 〈0. 05], 2-hour postprandial blood glucose [ （23. 1 ± 3.2） mmol/L vs. （7. 2 ± 3.1 ） mmol/L, P 〈 0.05 ], glycosylated hemoglobin （ HbA1 c） [ （ 9.9 ± 3. 5 ） % vs. （5.3 ± 2.4 ） %, P 〈 0. 05 ] were significantly increased in patients with T1DM compared with healthy controls; while fasting C peptide [ （0. 12 ±0. 08） ng/ml vs. （0. 47 ±0. 16） ng/ml, P 〈0. 05], 2-hour postprandial C peptide [ （0. 14 ± 0. 09 ） ng/ml vs. （ 1.06 ± 0. 49 ） ng/ml, P 〈 0. 05 ], HOMA-[3 （26. 20 ± 12. 70 vs. 82. 93 ± 48.12, P 〈 0.05 ） were significantly reduced in patients with T1DM compared with healthy controls. In T1DM patients, serum Betatrophin concentration was correlated with age （r = 0. 417, P 〈 0. 05 ）, HbA1 c （ r = 0. 475, P 〈 0. 05 ）, fasting blood glucose （ r = 0. 386, P 〈 0. 05 ）, 2-hour postprandi- al blood glucose （r = 0. 367, P 〈 0. 05 ）, and HOMA-13 （ r = - 0. 400, P 〈 0. 05 ）. HOMA-β, fasting blood glucose, age and HbAlc were the main influencing factors of serum Betatrophin level. Serum Betatrophin level [ （4. 87 ±0. 65） ng/ml vs. （2. 26 ±0. 54） ng/ml, P 〈0. 05], triglycerides [ （2. 20 ± 1.60） mmol/L vs. （1.36±0.76） mmol/L, P〈0.05], fasting blood glucose [ （8.9±2.8） mmol/Lvs. （4.8±2.6） mmol/L, P〈0.05], 2-hour postprandial blood glueose [ （17.7 ±4.2） mmol/L vs. （7.2 ±3.1） mmol/L, P 〈 0. 05 ], fasting insulin [ （ 15.30 ± 8. 60） ±U/ml vs. （5.02 ± 2. 34） IxU/ml, P 〈 0. 05 ], fasting C peptide [ （ 1.93 ± 1.60） ng/ml vs. （0. 47 ± 0. 16） ng/ml, P 〈 0. 05 ], 2-hour postprandial C peptide [ （ 5.20 ± 2.70） ng/mlvs. （1.06±0.49） ng/ml, P〈0.05], HbAlc [ （7.9±2.2）% vs. （5.3±2.4）%, P〈 0. 05], HOMA-IR （4.70 ± 2. 30 vs. 1.59 ± 0. 94, P 〈 0. 05 ） were higher in T2DM patients compared with healthy controls, and HOMA-[$ （57.50 ± 22. 30 vs. 82. 93 ± 48.12, P 〈 0. 05 ） was contrary. In patients with T2DM, serum Betatrophin concentration was positively correlated with age （ r = 0. 442, P 〈 0. 05 ）, fasting blood glucose （r=0.362, P 〈0.05）, fasting insulin （r =0.312, P 〈0.05）, HbAlc （r =0.486, P 〈 0. 05 ）, triglycerides （ r = 0. 270, P 〈 0. 05 ）, low-density lipoprotein cholesterol （ r = 0. 294, P 〈 0. 05 ）, HOMA-IR （r = 0. 436, P 〈 0. 05 ）, and negatively related with high-density lipoprotein cholesterol （ r = - 0. 257, P 〈 0.05） and HOMA-β（r = - 0. 365, P 〈 0. 05）. Body mass index, HOMA-IR, HOMA-β, fasting insulin and age were the main influencing factors of Betatrophin in patients with T2DM. Serum Betatrophin concentration was higher in T＇2DM patients than in T1DM patients [ （4. 87 ± 0. 65） ng/ml vs. （3.57 ± 0.48） ng/ml, P 〈 0. 05 ]. Conclusion Betatrophin may be associated with the carbohydrate metabolism and function of islet beta cells in diabetic patients, and with serum lipid metabolic disorder in T2DM patients. It may be involved in the development of diabetes.