伴腹型肥胖2型糖尿病患者胰岛素抵抗指数与脂肪细胞脂肪酸结合蛋白、血尿酸水平密切相关
Correlation between insulin function and adipocyte fatty acid-binding protein and serum uric acid level in type 2 diabetes mellitus patients with adipocyte obesity

刘利慧.伴腹型肥胖2型糖尿病患者胰岛素抵抗指数与脂肪细胞脂肪酸结合蛋白、血尿酸水平密切相关[J].内科急危重症杂志,2021,27(4):

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DOI：10.11768/nkjwzzzz20210413

中文关键词: 新诊断2型糖尿病伴腹型肥胖胰岛素抵抗脂肪细胞脂肪酸结合蛋白血尿酸相关性

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作者	单位	E-mail
刘利慧	中国人民解放军第九六〇医院淄博院区	496222079@qq.com

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中文摘要:

目的：探讨新诊断伴腹型肥胖的2型糖尿病患者胰岛素抵抗与脂肪细胞脂肪酸结合蛋白( A-FABP)、血尿酸水平(sUA)的相关性。方法：选取2018年10月-2019年11月在中国人民解放军第九六〇医院淄博院区住院的新诊断2型糖尿病患者218例，根据患者腰围分为腹型肥胖组（男性≥90cm;女性≥85cm，98例)和非腹型肥胖组(120例)。比较2组患者的基础资料、实验室指标、胰岛素抵抗指数(HOMA-IR)及胰岛素分泌指数(HOMA-β)的差异。采用Pearson 检验分析HOMA-IR与A-FABP、sUA、HOMA-β的相关性。Logistic回归分析用于新诊断2型糖尿病伴腹型肥胖患者的危险因素分析，决策树模型用于确定连续变量Logistic分析时的分层分界点。结果：腹型肥胖组体质指数(BMI)、腰围、腰臀比、舒张压及收缩压显著高于非腹型肥胖组(P均<0.05)；极低密度脂蛋白胆固醇(VLDL-C)、低密度脂蛋白胆固醇 (LDL-C)、甘油三酯(TG)、总胆固醇(TC)、天门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、空腹血清胰岛素(FINS) 、A-FABP、sUA、HOMA-IR及HOMA-β显著升高 (P均<0.05)，高密度脂蛋白胆〖JP2〗固醇(HDL-C)显著降低(P<0.05)。HOMA-IR与A-FABP、sUA和HOMA-β呈显著性正相关(P均<0.01)。TG≥1.7mmol/L、A-FABP≥12.5μg/L、sUA≥280.0μmol/L、HOMA-IR≥4.1对新诊断2型糖尿病伴腹型肥胖预测价值更大(P均<0.05)。结论：新诊断2型糖尿病伴腹型肥胖患者HOMA-IR与A-FABP和sUA水平呈正相关性。

英文摘要:

Objective: To investigate the correlation between insulin function and adipocyte fatty acid-binding protein (A-FABP) and serum uric acid (sUA) in newly diagnosed type 2 diabetes patients with abdominal obesity. Methods: A total of 218 newly diagnosed patients with type 2 diabetes mellitus who were hospitalized in the Department of Endocrinology of our hospital from October 2018 to November 2019 were selected, and the patients were divided into abdominal obesity group (98 cases) and non-abdominal obesity group (120 cases) according to waist circumference. The differences in basic data, laboratory indexes, insulin resistance index (HOMA-IR) and insulin secretion index (HOMA-β) between the two groups were compared. The correlation between HOMA-IR and A-FABP, sUA and HOMA-β was analyzed by Pearson test. Logistic regression analysis was used to analyze the risk factors of newly diagnosed type 2 diabetes mellitus with abdominal obesity, and the decision tree model was used to determine the stratification cut-off point of continuous variable Logistic analysis. Results: Body mass index (BMI), waist circumference, waist-hip ratio, diastolic blood pressure and systolic blood pressure in the abdominal obesity group were significantly higher than those in the non-abdominal obesity group (P<0.05). Very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C), triacylglycerol (TG), total cholesterol (TC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting serum insulin (FINS), A-FABP, sUA, HOMA-IR and HOMA-β were significantly increased (P<0.05), and high density lipoprotein cholesterol (HDL-C) decreased significantly (P<0.05). HOMA-IR was significantly positively correlated with A-FABP, sUA, and HOMA-β (all P<0.01). TG≥ 1.7mmol/L, A-FABP≥ 12.5μg/L, sUA≥ 280.0μmol/L and HOMA-IR≥ 4.1 had greater predictive value for newly diagnosed type 2 diabetes mellitus with abdominal obesity (P<0.05). Conclusion: Insulin resistance was positively correlated with A-FABP and sUA levels in newly diagnosed type 2 diabetes patients with abdominal obesity.