超重/肥胖合并2型糖尿病患者血清ANGPTL4、HSP70、IL-34水平与胰岛素抵抗的相关性

Correlation of serum ANGPTL4,HSP70 and IL-34 levels and insulin resistance in overweight and obese patients with type 2 diabetes mellitus

目的 探讨超重/肥胖合并2型糖尿病(T2DM)患者血清血管生成素样蛋白4(ANGPTL4)、热休克蛋白(HSP)70、白细胞介素-34(IL-34)水平与胰岛素抵抗的相关性。方法 选取2020年5月—2022年5月保定市第一中心医院T2DM患者182例(T2DM组)。参考相关诊断标准,将T2DM患者分为超重/肥胖T2DM组(90例)和体重正常T2DM组(92例)。另选取同期健康体检者90名作为正常对照组,其中超重/肥胖者40名(超重/肥胖对照组)、体重正常者50名(体重正常对照组)。检测所有研究对象血清ANGPTL4、HSP70、IL-34、胰岛素和血糖水平,计算稳态模型胰岛素抵抗指数(HOMA-IR)。T2DM患者治疗3个月后,再次检测其血清ANGPTL4、HSP70、IL-34水平和HOMA-IR。采用Pearson相关分析评估血清ANGPTL4、HSP70、IL-34与HOMA-IR的相关性。结果 与正常对照组和体重正常T2DM组比较,超重/肥胖T2DM组血清ANGPTL4和HSP70显著降低(P<0.05),血清IL-34和HOMA-IR显著升高(P<0.05)。与正常对照组比较,体重正常T2DM组血清ANGPTL4和HSP70显著降低(P<0.05),血清IL-34和HOMA-IR显著升高(P<0.05)。Pearson相关分析结果显示,血清ANGPTL4、HSP70与HOMA-IR呈负相关(r值分别为-0.733、-0.758,P<0.001),IL-34和HOMA-IR呈正相关(r=0.705,P<0.001)。治疗后,超重/肥胖T2DM组和体重正常T2DM组血清ANGPTL4和HSP70均明显升高,血清IL-34和HOMA-IR明显降低;且相对于超重/肥胖T2DM组,体重正常T2DM组血清ANGPTL4和HSP70升高更显著(P<0.05),血清IL-34和HOMA-IR降低更显著(P<0.05)。结论 超重/肥胖合并T2DM患者ANGPTL4、HSP70和IL-34与胰岛素抵抗显著相关,或可作为超重/肥胖合并T2DM的疗效监测指标。

Objective To investigate the correlation between serum angiopoietin-like protein 4(ANGPTL4),heat shock protein(HSP)70,interleukin-34(IL-34)levels and insulin resistance in overweight and obese patients with type 2 diabetes mellitus(T2DM).Methods From May 2020 to May 2022,182 patients with T2DM who were treated in Baoding First Central Hospital were enrolled as research group.According to the World Health Organization obesity diagnostic criterion,they were classified into overweight and obese group(90 cases)and normal weight group(92 cases).Totally,90 healthy subjects were enrolled as healthy control group,including 40 overweight and obese subjects(overweight and obese control group)and 50 normal weight subjects(normal weight control group).Serum ANGPTL4,HSP70,IL-34,insulin and blood glucose levels were determined,and homeostasis model assessment for insulin resistance(HOMA-IR)was calculated.Serum levels of ANGPTL4,HSP70,IL-34 and HOMA-IR in T2DM group were determined again after 3 months of treatment.Pearson correlation analysis was used to evaluate the correlation between serum ANGPTL4,HSP70,IL-34 and HOMAIR.Results Compared with healthy control group and normal weight T2DM group,serum ANGPTL4 and HSP70 levels in overweight and obese T2DM group were decreased(P<0.05),and serum IL-34 level and HOMA-IR were increased(P<0.05).Compared with healthy control group,the levels of serum ANGPTL4 and HSP70 in normal weight T2DM group were decreased(P<0.05),and the levels of serum IL-34 and HOMA-IR were increased(P<0.05).Serum ANGPTL4 and HSP70 were negatively correlated with HOMA-IR(r values were-0.733 and-0.758,P<0.001),and IL-34 was positively correlated with HOMA-IR(r=0.705,P<0.001).After treatment,serum ANGPTL4 and HSP70 levels were increased in overweight and obese T2DM group and normal weight T2DM group,while serum IL-34 level and HOMA-IR were decreased.Compared with overweight and obese T2DM group,serum ANGPTL4 and HSP70 in normal weight T2DM group were increased(P<0.05),and serum IL-34 level and HOMA-IR were decreased(P<0.05).Conclusions ANGPTL4,HSP70 and IL-34 are correlated with insulin resistance in overweight and obese patients with T2DM,which may be used as the indicators for monitoring the efficacy of overweight and obese patients with T2DM.