血清成纤维细胞生长因子21在不同空腹血糖人群中的变化及与糖脂代谢的相关性

Changes of serum fibroblast growth factor 21 in people with different fasting plasma glucose and its correlation with glycolipid metabolism

目的观察空腹血糖（FPG）递增人群血清成纤维细胞生长因子21 （FGF-21）水平变化，并探讨其与糖脂代谢指标的相关性。 方法选择2014年1月至12月于我院就诊的54例2型糖尿病（T2DM）患者为研究对象（A组），按照年龄、性别匹配原则，另选同期健康体检人群中空腹血糖受损（B组）及正常者（C组）各50名作为对照组，收集三组人群体质指数（BMI）、腰臀比等指标，测定血液生化、胰岛功能、FGF-21水平等。采用Pearson相关分析与多元线性逐步回归分析，探索FGF-21与糖脂代谢指标的相关性。 结果A、B、C组血清FGF-21浓度分别为（3.0±0.6）、（2.9±0.5）、（1.9±0.4）μg/L，差异有统计学意义（F=3.352，P〈0.05）；Pearson相关分析提示FGF-21与FPG、糖化血红蛋白、空腹胰岛素、稳态模型胰岛素抵抗指数（HOMA-IR）、低密度脂蛋白胆固醇正相关（r=0.193~0.676，均P〈0.05），与稳态模型β细胞功能指数（HOMA-β）负相关（r=-0.548，P〈0.05）。多元线性逐步回归分析模型提示，FGF-21水平与FPG、HOMA-IR、HOMA-β、总胆固醇（TC）密切相关（标准回归方程为：YFGF-21=0.204× FPG＋0.285×HOMA-IR-0.231×HOMA-β＋0.098×TC，均P〈0.05）。 结论血清FGF-21与糖脂代谢指标密切相关，随着血糖升高、胰岛素抵抗和脂质代谢紊乱的加重而出现FGF-21水平上升。

ObjectiveTo observe the variation of serum fibroblast growth factor 21 （FGF-21） in people with different fasting plasma glucose （FPG） and to investigate the correlation between FGF-21 and glucose and lipid metabolism. MethodsA total of 54 type 2 diabetes mellitus （T2DM） patients from January to December 2014 were enrolled as study subjects （group A）. Two control groups were selected as impaired fasting plasma glucose （IFG） （group B, n=50） and normal fasting plasma glucose （group C, n=50） from those who were conducting regular health check during the same time period. All of the subjects in each group were matched based on age and gender. Body mass index （BMI）, waist/hip ratio （WHR）, islet function and FGF-21, and plasma bio-chemical measurements were collected. Pearson correlation analysis and multiple linear stepwise regression analysis were introduced to explore the correlation between FGF-21 and glucose and lipid metabolic indexes. ResultsThe serum FGF-21 concentrations in group A, B and C were （3.0±0.6）, （2.9±0.5）, （1.9±0.4） μg/L, respectively, and the differences were statistically significant （F= 3.352, P〈0.05）. Pearson correlation analysis showed that FGF-21 was positively correlated with FPG, glycated hemoglobin （HbAlc）, fasting plasma insulin, homeostasis model of assessment （HOMA） for insulin resistence index （HOMA-IR） and low-density lipoprotein cholesterol （LDL-C） （r=0.193-0.676, all P〈0.05）, and negatively correlated with HOMA-β （r=-0.548, P〈0.05）. Multivariate linear stepwise regression model suggested that FGF-21 closely correlated with FPG, HOMA-IR, HOMA-β, total cholesterol （with standard regression equation as： YFGF-21=0.204 × FPG ＋ 0.285 × HOMA-IR- 0.231 × HOMA-β ＋ 0.098 × TC, all P〈0.05）. ConclusionSerum FGF-21 is closely correlated with glucose and lipid metabolic parameters, which increases with the escalation of blood glucose, insulin resistance and lipid metabolism disorder.