摘要
目的观察T2DM患者血清锌α2糖蛋白(ZAG)、25羟维生素D[25(OH)D]与腹腔内脏脂肪面积(VFA)的关系并分析其相关性。方法选取2017年4月至2018年3月于遵义医学院附属医院内分泌科住院的新诊断T2DM患者80例,分为单纯T2DM组(T2DM组)40例及T2DM合并腹型肥胖(AO)组(T2DM+AO组)40例;另选取同期健康体检人群75名,分为正常对照(NC)组35名及单纯AO组40名。收集各组临床资料,检测血清25(OH)D、ZAG水平等生化指标;腹部定量螺旋电子计算机断层扫描测定内脏脂肪分布情况。Spearman相关分析ZAG与各指标的相关性;多元逐步回归分析T2DM+AO组血清ZAG的影响因素。结果NC、AO、T2DM、T2DM+AO组25(OH)D、ZAG依次降低[(37.42±4.44)vs(26.76±3.71)vs(20.67±2.78)vs(13.76±3.56)mg/L,(65.20±18.03)vs(58.78±12.89)vs(48.28±13.09)vs(39.20±15.10)mg/L,P<0.05]。T2DM+AO、AO组VFA、VFA/皮下脂肪面积(SFA)高于T2DM、NC组(P<0.05)。Spearman相关分析显示,T2DM+AO组血清ZAG与HDL-C、25(OH)D呈正相关(r=0.489、0.443,P<0.05),与WHR、HbA1c、HOMA-IR、TG、VFA呈负相关(r=-0.321、-0.332、-0.879、-0.286、-0.869,P<0.05)。多元逐步回归分析显示,HDL-C、HOMA-IR、BMI、25(OH)D、VFA是血清ZAG的影响因素。结论T2DM合并AO患者血清ZAG减少,易引起维生素D缺乏,推测ZAG及25(OH)D可能与T2DM合并AO的发生发展相关。
Objective To investigate the relationship between serum zinc alpha 2 glycoprotein(ZAG)and 25 hydroxyvitamin D[25(OH)D]and visceral fat area(VFA)in patients with type 2 diabetes mellitus.Methods A total of 80 hospitalized patients with newly diagnosed T2 DM were enrolled from the Endocrinology Department in Zunyi Medical College Affiliated Hospital.All the patients were divided into two groups:simple T2 DM group(T2 DM,n=40);T2 DM with abdominal obesity group(T2 DM+AO,n=40).Besides,75 age-matched patients were selected as the control group,and divided into two subgroups:normal control group(NC,n=35)and simple abdominal obesity group(AO,n=40).The clinical data were collected,and the serum 25(OH)D and ZAG levels were tested in all the subjects.Quantitative CT was used to measure the distribution of body fat.Partial correlation analysis was used to analyze the association between ZAG and other index.Multiple stepwise regression analysis was used to analyze the influencing factors for serum ZAG in T2 DM+AO group.Results The levels of 25(OH)D[(13.76±3.56)vs(20.67±2.78)vs(26.76±3.71)vs(37.42±4.44)mg/L]and ZAG[(39.20±15.10)vs(48.28±13.09)vs(58.78±12.89)vs(65.20±18.03)mg/L]were lowest in T2 DM+AO group,and increased significantly in T2 DM,then in AO group and reached the highest level in NC group(P<0.05).VFA and VFA/SFA were significantly higher in T2 DM+AO and AO group than in T2 DM and NC group(P<0.05).Spearman analysis showed that serum ZAG was positively correlated with HDL-C and 25(OH)D(r=0.489,0.443,P<0.05)and negatively correlated with WHR,Hb A1 c,HOMA-IR,TG and VFA(r=-0.321,-0.332,-0.879,-0.286,-0.869,P<0.05)in T2 DM+AO group.The stepwise multiple regression analysis showed that HDL-C,HOMA-IR,BMI,25(OH)D and VFA were independent influencing factors for serum ZAG.Conclusion The serum ZAG decreased in patients with T2 DM and AO,which may induce vitamin D deficiency.ZAG and 25(OH)D may be associated with the development of T2 DM with AO.
作者
李琪
王勇朋
阳琰
罗丽娅
朱玉玉
王哲
樊思桐
LI Qi;WANG Yongpeng;YANG Yan(Department of Endocrinology,Affiliated Hospital of Zunyi Medical College,Zunyi 563099,China)
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2020年第6期428-432,共5页
Chinese Journal of Diabetes
基金
国家自然科学基金(81460168)
遵义市联合基金[遵市科合社字(2018)63]
遵义医学院学术新苗培养及创新探索专项后补助基金(黔科合平台人才[2017]5733-043)。
