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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(Hb A1c)、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/m L]明显低于正常体质量组[444.95(372.69~668.16)ng/m L,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。
OBJECTIVE: To observe the serum level of netrin-1 in overweight / obese patients and explore its relationship with obesity, glucose and lipid metabolism and insulin resistance. Methods: A total of 150 subjects were divided into two groups according to the oral glucose tolerance test (OGTT) of 75 g in 76 patients in the normal body weight group and 74 in the overweight / obesity group with a body mass index (BMI) of 25 kg / m2 Two groups of patients were divided into normal glucose tolerance (NGT) and newly diagnosed type 2 diabetes (T2DM) subgroups. Waist circumference, waist-to-hip ratio, Hb A1c, blood glucose, insulin, blood lipids and netrin-1 levels were measured in each group. Results: The level of netrin-1 in overweight / obesity group was significantly lower than that of normal body weight group [367.87 (268.42 ~ 545.09) ng / m L [444.95 (372.69 ~ 668.16) ng / m L, P <0.01]. The levels of netrin-1 in NGT subgroup and T2DM subgroup were lower than those in NGT subgroup and T2DM subgroup in overweight / obesity group (P <0.01). As serum netrin-1 levels increased, BMI and waist circumference decreased. Correlation analysis showed that serum netrin-1 level was positively correlated with age (P <0.05), negatively correlated with BMI and waist circumference (P <0.01). Multivariate stepwise regression analysis showed that age and BMI were independent influencing factors of serum netrin-1 level. Conclusion: The level of serum netrin-1 is closely related to the level of BMI, which may be involved in the occurrence and development of obesity.