脂肪因子Chemerin与肥胖及2型糖尿病的关系

目的 测定正常人群、肥胖及新诊断的2型糖尿病患者血清Chemerin水平,探讨脂肪因子Chemerin与体脂参数、糖脂代谢、胰岛素抵抗的关系.方法 收集正常糖调节(NGR)和新诊断2型糖尿病患者(T2DM)各76例,按体重指数≥25 kg/m2分为正常糖调节正常体重组(NGR-NW)、正常糖调节超重/肥胖组(NGR-OW/OB)、2型糖尿病正常体重组(T2DM-NW)、2型糖尿病超重/肥胖组(T2DM-OW/OB)4个亚组.检测所有研究对象血清Chemerin水平、空腹胰岛素(FINS)、空腹C肽和糖脂代谢参数等,并计算体重指数、腰臀比和胰岛素抵抗指数(HOMA-IR).结果 女性血清Chemerin水平高于男性[(109±28)μg/L比(98±23)μg/L,P<0.05].超重/肥胖者Chemerin水平明显高于正常体重者[(113±27)μg/L比(94±25)μg/L,P<0.01],T2DM与NGR组血清Chemerin水平差异无统计学意义[(105±29)μg/L比(102±27)μg/L,P=0.786].在校正性别和年龄后,血清Chemerin水平与体重指数(r=0.336,P=0.000),腰围(r=0.460,P=0.000),腰臀比(r=0.325,P=0.000),空腹C肽(r=0.377,P=0.000),FINS(r=0.333,P=0.000),HOMA-IR(r=0.182,P=0.027)和甘油三酯(r=0.280,P=0.001)呈正相关;与高密度脂蛋白胆固醇(r=-0.251,P<0.01)呈负相关.多元逐步回归分析显示,空腹C肽、甘油三酯是血清Chemerin水平的独立相关因素(β=0.328、0.280,均P<0.05).结论 女性血清Chemerin水平高于男性,超重/肥胖者血清Chemerin水平显著升高,与胰岛素水平、体脂分布、脂代谢相关,提示Chemerin可能参与肥胖及代谢综合征的病理生理过程.

Relationship of serum Chemerin to obesity and type 2 diabetes mellitus

Objective To detect the serum Chemerin levels in patients with obesity and newly diagnosed type 2 diabetes mellitus (T2DM) and explore the relationship of serum Chemerin to body fat parameters, glucose and lipid metabohsm, and insulin resistance index (IR). Methods 76 newly diagnosed T2DM patients and 76 subjects with normal glucose regulation (NGR), with the body mass index (BMI) <25 kg/m2 (NW) or ≥25 kg/m2 (OW/OB), 38 in each subgroups each, underwent body measurement including body weight, height, waist circumference, and hip circumference, and waist hip ratio (WHR) and calculation of body mass index (BMI) were calculated. Peripheral blood samples were collected from them to detect the blood lipids, glucose, hemoglobin A1C, fasting insulin (FINS), and fasting C peptide. Homeostasis model assessment insulin resistance index (HOMA-IR) was calculated. ELISA was used to detect the Chemerin level, body mass index (BMI) and waist hip ratio (WHR) were evaluated and insulin sensitivity was assessed by HOMA-IR. Results The serum Chemerin level of the females was ( 109 ± 28) μg/L, significantly higher than that of the males [ (98 ± 23 ) μ/L, P < 0. 05 ]. After adjustment of gender and age, the serum Chemerin level of the OW/OB group, including NGR-OW/ OB and T2DM-OW/OB subgroups, was (113 ± 27) μg/L, significantly higher than that of the NW group [ (94±25) μg/ L, P <0. 01 ], that of the NGR-OW/OB subgroup being the highest. Partial correlation analyses showed that the serum Chemerin was positively correlated with waist circumference, WHR, fasting serum C peptide, HOMA-IR, TG, ALT, γ-GT, and uric acid (r =0.460-0. 182, all P<0.05) and negatively correlated with high density lipoprotein-cholesterol ( r = - 0. 251, P < 0. 01 ). Stepwise regression analysis showed that fasting serum C peptide and TG were the independent variables of Chemerin (β = 0. 328, 0. 280,P < 0. 05 ). Conclusion Serum Chemerin levels are much higher in females and obese subjects are much higher than in men and subjects with normal weight. Serum Chemerin is correlated with insulin level, body fat disposition and lipid metabolism which suggesting that it may play a role in the pathophysiology of obesity and metabolic syndrome.