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不同糖代谢及不同体质量指数人群空腹血浆内毒素水平的变化及其相关因素研究

Change and Correlated Factors of Fasting Level of the Plasma Endotoxin in Subjects with Different Glucose Tolerances and Body Mass Indices

  • 摘要: 目的 探讨不同糖代谢及不同体质量指数(BMI)人群空腹血浆内毒素(endotoxin,ET)水平的变化及相关因素。 方法 采用鲎试剂终点显色法测定初诊的2型糖尿病(T2DM)、糖调节受损(IGR)和正常糖耐量(NGT)人群空腹ET水平。常规方法测量身高、体质量、腰围、臀围、血压,计算BMI、腰臀比(WHR)。将每组分为肥胖(BMI ≥ 25 kg/m2)和非肥胖(BMI<25 kg/m2)亚组。检测空腹及餐后2 h血糖(FBG、2 hPG)和空腹及餐后胰岛素(FINS、PINS)、糖化血红蛋白(HbA1c)、血脂、游离脂肪酸及肝功能,计算胰岛素抵抗指数(HOMA-IR),并进行血浆ET与上述因素的相关分析。 结果 ①T2DM组(n=37) ET高于NGT组(n=37)7.1(3.7~11.8) EU/mL vs.4.5(2.2~6.3) EU/mL,P<0.05;IGR组(n=23) ET5.0(2.4~10.3) EU/mL介于T2DM组和NGT组之间,分别与T2DM及NGT组比较,差异均无统计学意义(P>0.05);②T2DM肥胖亚组血浆ET水平较T2DM非肥胖亚组有升高但差异无统计学意义7.3(3.8~13.3) EU/mL vs.7.0(3.6~10.4) EU/mL,P>0.05,IGR及NGT肥胖亚组血浆ET高于同组非肥胖亚组6.8(2.9~13.2) EU/mL vs.2.7(1.6~5.5) EU/mL及6.2(3.4~12.7) EU/mL vs.2.8(1.8~4.9) EU/mL,P均<0.05;③多元线性逐步回归分析表明:ET不是影响FBG、2 hPG的因素;BMI、FBG是影响血浆ET的重要因素,2 hPG、WHR不是影响ET的因素。 结论 随着糖代谢异常及肥胖程度的加重,血浆ET水平逐渐升高;ET不是影响FBG、2 hPG的因素;BMI、FBG是影响血浆ET的重要因素。

     

    Abstract: Objective To investigate the change of the levels of fasting plasma endotoxin (ET) and assess its correlated factors in individuals with different glucose tolerances and body mass indices. Methods The levels of fasting plasma ET were assayed by the endpoint chromogenic limulus amebocyte lysate method in subjects with type 2 diabetes (T2DM), impaired glucose regulation (IGR) and normal glucose tolerance (NGT). The height, body mass, waist, hips, systolic blood pressure and diastolic blood pressure were measured with the conventional methods; body mass index (BMI) and waist hip ratio (WHR) were calculated. All groups were divided into obesity (BMI ≥ 25 kg/m2) and non-obesity (BMI<25 kg/m2) subgroups. The levels of fasting blood glucose (FBG), 2 hours plasma glucose (2 hPG), fasting insulin (FINS), postprandial insulin (PINS), hemoglobin A1c (HbA1c), blood lipids, free fatty acids (FFA), serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were also analyzed, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The relationship of the levels of plasma ET with age, BMI, WHR, blood pressure, FBG, 2 hPG, FINS, PINS, HOMA-IR, HbA1c, blood lipids, FFA, AST and ALT were also analyzed. Results ①The levels of plasma ET in T2DM group (n=37) was significantly higher than that in NGT group (n=37)7.1 (3.7-11.8) EU/mL vs. 4.5 (2.2-6.3) EU/mL, P<0.05. The levels of plasma ET in IGR group (n=23)5.0 (2.4-10.3) EU/mL was lower than that in T2DM group and higher than NGT group but the differences were not significant (P>0.05). ② The levels of plasma ET in the obesity T2DM subgroup was higher than that in the non-obesity T2DM subgroup but the differences were not significant7.3 (3.8-13.3) EU/mL vs. 7.0 (3.6-10.4) EU/mL, P>0.05.There was a remarkable difference in the levels of plasma ET between obesity and non-obesity subgroup of IGR6.8(2.9-13.2) EU/mL vs. 2.7 (1.6-5.5) EU/mL, P<0.05, similarly between obesity and non-obesity subgroup of NGT6.2 (3.4-12.7) EU/mL vs. 2.8 (1.8-4.9) EU/mL, P<0.05.③ Multiple linear regression analysis demonstrated that ET wasn't the important factor influencing FBG and 2 hPG.But BMI and FBG were the important factors influencing ET. 2 hPG and WHR weren't the important factors influencing ET. Conclusion With the increase in glucose metabolic abnormalities and BMI, the levels of plasma ET are gradually increased. ET isn't the important factor influencing FBG and 2 hPG. BMI and FBG are the important factors in influencing ET.

     

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