肥胖患者维生素D与Wnt1诱导信号通路蛋白-1及肿瘤坏死因子-α的关系

Relationship between vitamin D and Wnt1-induced signaling pathway protein-1 and tumor necrosis factor-αin obese patients

目的探讨肥胖患者维生素D[25(OH)D]与Wnt1诱导信号通路蛋白-1(WISP1)、肿瘤坏死因子-α(TNF-α)的关系。方法采用前瞻性研究方法,选取2017年6月至2019年9月海南医学院第一附属医院收治的80例肥胖患者作为肥胖组,并选取同期于体检中心进行正常体检的86例非肥胖人群作为对照组,比较两组研究对象的维生素D水平分层(正常、减少、缺乏)情况,以及血清WISP1与TNF-α水平,并比较肥胖组维生素D正常、下降、缺乏患者的体重指数(BMI)、腰围、血清WISP1、TNF-α水平,采用Pearson检验分析肥胖组患者的血清25(OH)D水平与BMI、腰围、WISP1、TNF-α的相关性。结果肥胖组与对照组研究对象的维生素D水平正常率、下降率、缺乏率(15.00%、47.50%、37.50%vs.53.49%、27.91%、18.60%)比较,差异具有统计学意义(P<0.05);肥胖组患者的血清WISP1、TNF-α水平分别为(1123.64±282.34)pg/ml、(86.92±22.95)pg/ml,高于对照组的(719.64±120.36)pg/ml、(60.78±14.03)pg/ml,差异具有统计学意义(P<0.05);维生素D缺乏患者的BMI、腰围分别为(30.79±0.61)kg/m^2、(92.66±3.19)cm,高于维生素D正常患者的(28.86±0.22)kg/m^2、(85.03±1.15)cm、下降患者的(29.47±0.20)kg/m^2、(90.14±1.78)cm,维生素D下降患者的BMI、腰围分别为(29.47±0.20)kg/m^2、(90.14±1.78)cm,高于维生素D正常者的(28.86±0.22)kg/m^2、(85.03±1.15)cm,差异均具有统计学意义(P<0.05);肥胖组患者的血清25(OH)D水平与BMI呈负相关(r=-0.737,P<0.001),与腰围呈负相关(r=-0.752,P<0.001);维生素D缺乏患者WISP1、TNF-α水平分别为(1622.07±585.99)pg/ml、(99.47±25.71)pg/ml,高于维生素D正常患者的(549.91±82.23)pg/ml、(61.05±14.14)pg/ml、下降患者的(911.32±105.8)pg/ml、(85.19±23.56)pg/ml,差异均具有统计学意义(P<0.05);维生素D下降患者的WISP1、TNF-α水平分别为(911.32±105.8)pg/ml、(85.19±23.56)pg/ml,高于维生素D正常者的(549.91±82.23)pg/ml、(61.05±14.14)pg/ml,差异均具有统计学意义(P<0.05);肥胖组患者的血清25(OH)D水平与WISP1呈负相关(r=-0.669,P<0.001),与TNF-α呈负相关(r=-0.651,P<0.001);肥胖组患者的血清WISP1与BMI呈正相关(r=0.445,P<0.001),与腰围呈正相关(r=0.488,P<0.001);肥胖组患者的血清TNF-α水平与BMI呈正相关(r=0.395,P<0.001),与腰围呈正相关(r=0.447,P<0.001)。结论维生素D在肥胖患者中呈低表达,与BMI、腰围、TNF-α、WISP1呈负相关,补充维生素D可能通过下调WISP1、TNF-α,改善肥胖患者的BMI及腰围。

Objective To investigate the relationship between vitamin D[25(OH)D],Wnt1 induced signaling pathway protein-1(WISP1)and tumor necrosis factor-α(TNF-α)in obese patients.Methods A prospective research was performed,80 obese patients admitted to the First Affiliated Hospital of Hainan Medical College from June 2017 to September 2019 were selected as the obese group,and 86 non-obese people who had undergone normal physical examination at the physical examination center during the same period were selected as the control group.The stratification of vitamin D levels(normal,reduced,and deficient)and serum WISP1 and TNF-αlevels between the two groups of subjects were compared.The body mass index(BMI),waist circumference,serum WISP1,TNF-αlevels in obese group patients with different Vitamin D levels were also compared respectively.The correlation between serum 25(OH)D and BMI,waist circumference,WISP1,TNF-αin obesity group was analyzed by Pearson.Results The normal rate,decline rate,and deficiency rate(15.00%,47.50%,37.50%vs.53.49%,27.91%,18.60%)of vitamin D levels in the obese group and the control subjects were compared,and the differences were statistically significant(P<0.05).The serum levels of WISP1 and TNF-αin the obese group were(1123.64±282.34)pg/ml and(86.92±22.95)pg/ml,which were higher than those in control group,(719.64±120.36)pg/ml and(60.78±14.03)pg/ml,the differences were statistically significant(P<0.05).BMI and waist circumference of patients with vitamin D deficiency were(30.79±0.61)kg/m^2,(92.66±3.19)cm,which were higher than(28.86±0.22)kg/m^2,(85.03±1.15)cm in patients with normal vitamin D,and(29.47±0.20)kg/m^2,(90.14±1.78)cm in descending patients.The BMI and waist circumference of patients with decreased vitamin D were(29.47±0.20)kg/m^2,(90.14±1.78)cm,which were higher than those with normal vitamin D(28.86±0.22)kg/m^2,(85.03±1.15)cm,the differences were statistically significant(P<0.05).The serum 25(OH)D level in the obese group was negatively correlated with BMI(r=-0.737,P<0.001)and negatively correlated with waist circumference(r=-0.752,P<0.001).The levels of WISP1 and TNF-αin patients with vitamin D deficiency were(1622.07±585.99)pg/ml and(99.47±25.71)pg/ml,which were higher than(549.91±82.23)pg/ml,(61.05±14.14)pg/ml in patients with normal vitamin D,(911.32±105.8)pg/ml,and(85.19±23.56)pg/ml in descending patients,the differences were statistically significant(P<0.05).The levels of WISP1 and TNF-αin patients with decreased vitamin D were(911.32±105.8)pg/ml and(85.19±23.56)pg/ml,which were higher than those with normal vitamin D(549.91±82.23)pg/ml and(61.05±14.14)pg/ml,the differences were statistically significant(P<0.05).Serum 25(OH)D levels in obese patients were negatively correlated with WISP1(r=-0.669,P<0.001)and negatively correlated with TNF-α(r=-0.651,P<0.001).There was a positive correlation between serum WISP1 and BMI in the obese group(r=0.445,P<0.001)and a positive correlation with waist circumference(r=0.488,P<0.001).Serum TNF-αlevels were positively correlated with BMI in the obese group(r=0.395,P<0.001)and positively correlated with waist circumference(r=0.447,P<0.001).Conclusion Vitamin D has a low expression in obese patients,and was negatively correlated with BMI,waist circumference,TNF-α,and WISP1,Vitamin D supplementation may help improve the BMI and waist circumference of obese patients by down-regulating the WISP1 and TNF-α.