血清黑色素浓缩激素与2型糖尿病和超重/肥胖的相关性研究

Association between serum melanin-concentrating hormone and type 2 diabetes mellitus and overweight/obesity

目的:探讨血清黑色素浓缩激素(MCH)与2型糖尿病(T2DM)和超重/肥胖的相关性。方法:为横断面研究。选取2021年6月至2022年4月遵义医科大学附属医院内分泌与代谢病科门诊及住院的T2DM患者及同期于该院体检中心进行健康体检者作为研究对象。测量研究对象身高、体重并计算体重指数(BMI),检测其MCH、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA 1c)、甘油三酯(TG)、瘦素,并计算稳态模型评估胰岛素抵抗指数(HOMA-IR)。根据研究对象BMI及糖代谢状态将其分为正常对照组(BMI<25 kg/m^(2),糖代谢状态正常)、超重/肥胖组(BMI≥25 kg/m^(2),糖代谢状态正常)、T2DM体重正常组(BMI<25 kg/m^(2))、T2DM合并超重/肥胖组(BMI≥25 kg/m^(2))。组间比较采用单因素方差分析、Kruskal-Wallis H检验或 χ^(2)检验。采用Spearman相关性分析法分析MCH与各变量间的相关性,采用多分类logistic回归分析法探究MCH与超重/肥胖和T2DM之间的关系。 结果:共纳入T2DM患者236例、健康体检者244例。其中,正常对照组160名,超重/肥胖组84例,T2DM体重正常组93例,T2DM合并超重/肥胖组143例。T2DM体重正常组MCH最高,为(14.18±2.28)ng/ml;正常对照组最低,为(9.37±2.18)ng/ml( P<0.001);与正常对照组相比,超重/肥胖组、T2DM体重正常组和T2DM合并超重/肥胖组MCH均更高( P均<0.05);但T2DM体重正常组和T2DM合并超重/肥胖组间MCH差异无统计学意义( P>0.05)。Spearman相关性分析结果显示,血清MCH与HOMA-IR( r=0.285)、FPG( r=0.551)、HbA 1c( r=0.569)、TG( r=0.317)、瘦素( r=0.511)均呈正相关(均 P<0.001)。多分类logistic回归分析结果显示,校正多个混杂因素后,与正常对照组相比,MCH高者患超重/肥胖、T2DM体重正常、T2DM合并超重/肥胖风险仍然更高,OR值(95%CI)分别为1.336(1.031~1.733)、2.095(1.594~2.752)、1.858(1.402~2.463)。 结论:血清MCH与T2DM和超重/肥胖密切相关。

ObjectiveTo investigate the association between serum melanin-concentrating hormone(MCH)and type 2 diabetes mellitus(T2DM)and overweight/obesity.MethodsA cross-sectional study was conducted.Outpatients and inpatients with T2DM in the Department of Endocrinology and metabolic Disease of the Affiliated Hospital of Zunyi Medical University from June 2021 to April 2022,and those who underwent health examinations in the physical examination center of the hospital during the same period were selected as the research subjects.The height and weight of the study subjects were measured,and the body mass index(BMI)was calculated,and their MCH,fasting plasma glucose(FPG),fasting insulin(FINS),glycated hemoglobin A 1c(HbA 1c),triglyceride(TG),leptin were measured,and the homeostasis model assessment of insulin resistance(HOMA-IR)was calculated.According to the BMI of the study participants and their glycometabolic status,they were divided into normal control group(BMI<25 kg/m^(2),normal glucose metabolism),overweight/obese group(BMI≥25 kg/m^(2),normal glucose metabolism),and normal weight T2DM group(BMI<25 kg/m^(2))and T2DM combined with overweight/obese group(BMI≥25 kg/m^(2)).One-way analysis of variance,Kruskal-Wallis H-test,or chi-square test were used for comparisons between groups.Spearman correlation analysis was used to analyze the correlation between MCH and other variables,and multivariate logistic regression analysis was used to explore the relationship between MCH and overweight/obesity and T2DM.ResultsA total of 236 patients with T2DM and 244 patients with physical examination were included.There were 160 cases in the normal control group,84 cases in the overweight/obese group,93 cases in the normal weight T2DM group,and 143 cases in the T2DM combined with overweight/obese group.The level of MCH was the highest in the normal weight T2DM group(14.18±2.28)ng/ml,and the lowest in the normal control group was(9.37±2.18)ng/ml(P<0.001).Compared with the normal control group,the MCH of overweight/obese group,normal weight T2DM group and T2DM combined with overweight/obese group were all higher(P<0.05).However,there was no significant difference in MCH between normal weight group T2DM group and T2DM combined with overweight/obese group(P>0.05).The results of Spearman correlation analysis showed that serum MCH levels were positively correlated with HOMA-IR(r=0.285),FPG(r=0.551),HbA 1c(r=0.569),TG(r=0.317)and leptin(r=0.511)(all P<0.001).The results of multivariate logistic regression analysis showed that MCH the risk of overweight/obesity,normal weight T2DM,T2DM combined overweight/obesity remained higher in those with high MCH compared with the normal control group after adjusting for multiple confounding factors,with OR values(95%CI)of 1.336(1.031-1.733),2.095(1.594-2.752),and 1.858(1.402-2.463),respectively.ConclusionSerum MCH is closely related to T2DM and overweight/obesity.