摘要
目的探讨新发肥胖2型糖尿病患者治疗前后成纤维细胞生长因子19(FGF19)与血清色素上皮衍生因子(PEDF)水平的变化及临床意义。方法将170例新发2型糖尿病患者按照体重指数(BMI)分为正常体重组85例(DM组)和肥胖组85例(ODM组),选取同期60例健康人群作为对照组(NC组)。糖尿病患者均接受个体化降糖治疗。测定3组治疗前后各项生化指标,采用酶联免疫法测定血清FGF19与PEDF水平。结果NC组、DM组、ODM组治疗前血清FGF19水平依次降低[(161.3±25.6)vs(128.3±31.2)vs(92.2±27.4)pg/ml,P<0.05],PEDF水平依次升高[(31.7±10.9)vs(48.3±11.7)vs(63.7±12.9)μg/ml,P<0.05]。治疗后6个月与DM组比较,ODM组FGF19水平仍偏低,PEDF水平偏高(均P<0.05)。相关分析显示,治疗前FGF19与BMI、腰围、空腹血糖(FBG)、糖化血红蛋白(HbA1C)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、C反应蛋白(CRP)、胰岛素抵抗指数(HOMA-IR)均呈负相关(均P<0.05),PEDF与BMI、腰围、FBG、PBG、HbA1C、TC、CRP均呈正相关(均P<0.05)。治疗后FGF19差值与BMI、腰围、FBG、HbA1C、CRP、HOMA-IR差值均呈负相关(均P<0.05),PEDF差值与BMI、FBG、PBG、HbA1C、CRP差值均呈正相关(均P<0.05)。多元逐步回归分析显示,治疗后BMI、腰围变化是FGF19影响因素;CRP、FBG水平变化是PEDF影响因素(P<0.05)。结论FGF19水平变化与肥胖相关,而PEDF与血糖及炎性指标相关,PEDF可能是2型糖尿病发病预测因子。
Objective To investigate serum fibroblast growth factor 19(FGF-19)and pigment epithelium-derived factor(PEDF)in patients with type 2 diabetes mellitus(T2DM).Methods One hundred seven patients with newly diagnosed T2DM were enrolled in the study,including 85 cases with normal BMI(DM group)and 85 obese patients obesity(ODM group);65 healthy subjects were enrolled as control group(NC).All T2DM patients received individual treatment.Clinical data and biochemical makers of healthy subjects and patients before and after treatment were collected.ELISA was used to detect the serum FGF19 and PEDF.Results The level of serumFGF19 decreased in order of ODM,DM and NC groups(161.3±25.6 pg/ml,128.3±31.2 pg/ml and 92.2±27.4pg/ml,P<0.05),while PEDF increased in order of three groups(31.7±10.9μg/ml,48.3±11.7μg/ml and 63.7±12.9μg/ml,P<0.05).Six month after treatment,the serum FGF19 level in DM group was still lower than that in ODM group(P<0.05),while PEDF was higher(P<0.05).Before treatment in T2DM patients serum FGF19 level was negatively correlated with BMI,WC,FBG,HbA1C,TC,LDL-C,CRP and HOMA-IR;while PEDF was positively correlated with BMI,WC,FBG,PBG,HbA1C,TC and CRP(P<0.05).After the changes of serum FGF19 level were negatively correlated with BMI,WC,FBG,HbA1C,CRP and HOMA-IR and the changes of PEDF level were positively correlated with BMI,WC,FBG,PBG,HbA1C,TC and CRP(P<0.05).Multiple stepwise regression analysis showed that after treatment,the changes of BMI and WC were independent risk factors of FGF19;the changes of CRP and FBG levels were independent risk factors of PEDF(P<0.05).Conclusion The changes FGF19 level is mainly related to obesity,while PEDF is mainly related to blood glucose and inflammatory indicators.PEDF may be used as the indicator of type 2 diabetes.
作者
肖艳新
赵新翠
贾丽艳
王翯
王君
XIAO Yanxin;ZHAO Xincui;JIA Liyan(Department of Endocrinology,Baoding First Municipal Central Hospital,Baoding 071000,China)
出处
《浙江医学》
CAS
2020年第9期905-909,共5页
Zhejiang Medical Journal
基金
河北省卫生厅科研基金项目。
