新诊断2型糖尿病患者血清spexin水平与内脏脂肪面积及代谢指标的相关性分析

Correlation of serum spexin level with visceral fat area and metabolic markers in newly diagnosed type 2 diabetic patients

目的研究新诊断2型糖尿病(T2DM)患者血清spexin水平与腹部内脏脂肪面积(visceral fat area, VFA)的关系,探寻其与各代谢指标的相关性。方法新诊断T2DM患者分为T2DM内脏型肥胖组(T2DM-ob组)和T2DM非内脏型肥胖组(T2DM-nonob组),正常血糖且非内脏型肥胖者为正常对照组(NC组),测量BMI、腰围、臀围、腰臀比(WHR)、收缩压(SBP)和舒张压(DBP),欧姆龙DUALSCANHDS-2000测量VFA与皮下脂肪面积(subcutaneous fat area, SFA)及内脏脂肪与皮下脂肪比率(visceral fat to subcutaneous fat ratio, VSR)。行口服葡萄糖耐量试验,测定空腹血糖(FPG)、餐后2h血糖(PPG2h)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)及餐后2h胰岛素(PINS2h),计算HOMA-IR,用ELISA测定血清spexin水平。结果 T2DM-ob组BMI、腰围、臀围、总胆固醇(TC)、HOMA-IR、VFA、SFA、VSR均较T2DM-nonob组升高,血清spexin水平较T2DM-nonob组和NC组均明显降低(P<0.05),VFA与BMI、腰围、WHR、FPG、PPG2h、HbA1c、丙氨酸转氨酶(ALT)、HOMA-IR显著正相关,与高密度脂蛋白胆固醇(HDL-C)呈显著负相关(P<0.05)。spexin水平与VFA、VSR、BMI、WHR、FPG、PPG2h、HbA1c、HOMA-IR呈显著负相关,与HDL-C呈显著正相关,多元回归分析发现HbAlc、VSR为spexin的独立影响因素(P<0.05)。结论新诊断T2DM患者血清spexin水平与VFA密切相关,spexin及VFA与血糖、血脂及胰岛素抵抗显著相关,spexin可能在T2DM患者的内脏脂肪代谢中有重要作用。

Objective To study the relationship between serum spexin level with abdominal visceral fat area(VFA) and metabolic indicators in patients with newly diagnosed type 2 diabetes mellitus(T2 DM). Methods Eighty-eight newly diagnosed T2 DM patients were divided into visceral obesity group(T2 DM-ob group, n=52) and non-visceral obesity group(T2 DM-nonob group, n=38);and 41 subjects with normal blood glucose and non-visceral obesity served as control group(NC group). Body mass index(BMI), waist circumference(WC), hip circumference(HC), waist hip ratio(WHR), systolic blood pressure(SBP) and diastolic blood pressure(DBP) were measured. The visceral fat was measured by fat area analyzer Omron DUALSCANHDS-2000 and the VFA and subcutaneous fat area(SFA) and ratio of visceral fat to subcutaneous fat(VSR) were calculated. Oral glucose tolerance test was performed to determine fasting plasma glucose(FPG), postprandial 2 h plasma glucose(PPG2 h), glycosylated hemoglobin(HbA1 c), fasting insulin(FINS) and postprandial 2 h insulin(PINS2 h) were measured, and HOMA-IR was calculated. The serum spexin was measured by ELISA, and the correlation of spexin level with visceral fat and various metabolic markers was analyzed using SPSS software. Results BMI, waist circumference, hip circumference, total cholesterol(TC), HOMA-IR, VFA, SFA and VSR in T2 DM-ob group were significantly higher than those in T2 DM-nonob group, while serum spexin level was lower than that in T2 DM-nonob group and NC group(P<0.05). VFA was positively correlated with BMI, waist circumference, WHR, FPG, PPG2 h, HbA1 c, alanine aminotransferase(ALT), HOMA-IR, and negatively correlated with high-density lipoprotein cholesterol(HDL-C, P<0.05). Spexin level was negatively correlated with VFA, VSR, BMI, WHR, FPG, PPG2 h, HbA1 c and HOMA-IR, and positively correlated with HDL-C. Multiple regression analysis showed that HbAlc and VSR were independent influencing factors of spexin(P<0.05). Conclusion Serum spexin level and VFA are closely correlated with blood sugar, lipid and insulin resistance in patients with newly diagnosed type 2 diabetes mellitus. Spexin may play an important role in visceral fat metabolism in T2 DM patients.