超重/肥胖患者血清netrin-1水平及其影响因素分析

［摘要］目的: 观察超重/肥胖患者血清神经导向因子netrin-1水平，探讨其与肥胖、糖脂代谢及胰岛素抵抗的关系。方法: 以体质量指数（BMI）25 kg/m2为切点将150例研究对象分为正常体质量组76例和超重/肥胖组74例，再根据75 g口服葡萄糖耐量试验（OGTT）结果将两组患者分为正常糖耐量（NGT）和新诊断2型糖尿病（T2DM）亚组。检测各组腰围、腰臀比、糖化血红蛋白（HbA1c）、血糖、胰岛素、血脂及netrin-1水平。结果： 超重/肥胖组血清netrin 1水平［367.87 (268.42~545.09) ng/mL］明显低于正常体质量组［444.95 (372.69~668.16) ng/mL，P<0.01\]。超重/肥胖组的NGT亚组和T2DM亚组netrin 1水平分别低于正常体质量组的NGT亚组和T2DM亚组（P<0.01）。随着血清netrin-1水平增加，BMI及腰围水平下降。相关性分析显示，血清netrin 1水平与年龄呈正相关（P<0.05），与BMI及腰围呈负相关（P<0.01）。多元逐步回归分析提示，年龄及BMI是血清netrin-1水平的独立影响因素。结论： 血清netrin 1水平与BMI水平密切相关，其水平下降可能参与了肥胖的发生发展。

Changes of serum netrin-1 levels and related factors in patients with overweight/obesity

Abstract]Objective: To investigate the change of serum netrin-1 level in overweight/obesity patients and investigate the relationships of serum netrin 1 level with obesity, glycolipid metabolism and insulin resistance. Methods: A total of 150 Chinese subjects were enrolled in the study, including seventy six subjects with normal weight (NW) and seventy four patients with overweight/obesity (OW/OB). NW and OW/OB groups were further divided into normal glucose tolerance (NGT) and patients with newly-diagnosed T2DM subgroups separately. OW/OB was defined as BMI≥25 kg/m2 according to the WHO Western Pacific Region diagnostic set forth in 2000. 75 g oral glucose tolerance test (OGTT) was performed in all subjects. Waist circumference (WC), waist to hip ratio (WHR), HbA1c, blood glucose, blood insulin, blood lipids and netrin-1 level were also determined. Results: The serum netrin 1 level was significantly lower in OW/OB group than that in NW group \367.87 (268.42 to 545.09) ng/mL vs 444.95 (372.69 to 668.16) ng/mL，P<0.01\]. Subjects in the upper and middle serum netrin-1 levels had lower levels of BMI and WC, when compared to subjects in the lower serum netrin 1 levels. Pearson correlation analysis showed that serum netrin-1 level was negatively correlated with BMI and WC (P<0.01), and positively correlated with age (P<0.05). Multiple linear regression analysis showed that age and BMI were independently related to serum netrin 1 level(P<0.05 or P<0.01). Conclusion: Circulating levels of netrin 1 were decreased in subjects with overweight/obesity. Serum netrin-1 level was significantly negatively correlated with BMI. It suggested that the netrin 1 might play an important role in the pathogenesis of obesity.