CAJ | 학술논문

目的分析糖代谢状况不一致的单卵双生子之间血清胆红素水平的差异，探索新的糖代谢异常的标志物。方法自2014年1月至9月，由社会募集双生子55对，选择18~70岁、经口服葡萄糖耐量试验（OGTT）后确诊糖代谢情况不一致的单卵双生子，将其分为糖代谢异常组[包括糖尿病和糖耐量减低（IGT）]和血糖正常组。检测血液生化指标，以Spearman相关分析血清胆红素与血糖等参数之间的相关性。结果（1）入选9对双生子，均为女性，年龄50~62岁。其中，4对为1人患糖尿病（DM）、另1人糖耐量正常（NGT1）；5对为1人患IGT、另1人糖耐量正常（NGT2）。（2）糖代谢异常组血清直接胆红素水平（3.1±0.8）μmol/L明显低于血糖正常组（4.5±1.2）μmol/L（t=-5.26，P<0.05），而腰臀比（0.89±0.05）、甘油三酯水平（2.3±1.4）mmol/L明显高于血糖正常组[（0.85±0.07）、（1.0±0.6）mmol/L （t=2.38、3.14，均P<0.05）]。（3）Spearman相关性分析显示，糖代谢异常组血清直接胆红素水平与OGTT 2 h血糖呈负相关（r=－0.625，P<0.05）。（4）Logistic回归分析显示直接胆红素水平与糖代谢异常相关（OR＝0.246，95％CI：0.660～0.922，P<0.05），但校正甘油三酯、腰臀比后，未能发现直接胆红素与糖代谢异常有关（OR＝0.366，95％CI：0.050～2.665，P>0.05）。结论在同卵双生子中，血清胆红素水平较低者可能是糖代谢异常的高危人群。
목적분석당대사상황불일치적단란쌍생자지간혈청담홍소수평적차이，탐색신적당대사이상적표지물。방법자2014년1월지9월，유사회모집쌍생자55대，선택18~70세、경구복포도당내량시험（OGTT）후학진당대사정황불일치적단란쌍생자，장기분위당대사이상조[포괄당뇨병화당내량감저（IGT）]화혈당정상조。검측혈액생화지표，이Spearman상관분석혈청담홍소여혈당등삼수지간적상관성。결과（1）입선9대쌍생자，균위녀성，년령50~62세。기중，4대위1인환당뇨병（DM）、령1인당내량정상（NGT1）；5대위1인환IGT、령1인당내량정상（NGT2）。（2）당대사이상조혈청직접담홍소수평（3.1±0.8）μmol/L명현저우혈당정상조（4.5±1.2）μmol/L（t=-5.26，P<0.05），이요둔비（0.89±0.05）、감유삼지수평（2.3±1.4）mmol/L명현고우혈당정상조[（0.85±0.07）、（1.0±0.6）mmol/L （t=2.38、3.14，균P<0.05）]。（3）Spearman상관성분석현시，당대사이상조혈청직접담홍소수평여OGTT 2 h혈당정부상관（r=－0.625，P<0.05）。（4）Logistic회귀분석현시직접담홍소수평여당대사이상상관（OR＝0.246，95％CI：0.660～0.922，P<0.05），단교정감유삼지、요둔비후，미능발현직접담홍소여당대사이상유관（OR＝0.366，95％CI：0.050～2.665，P>0.05）。결론재동란쌍생자중，혈청담홍소수평교저자가능시당대사이상적고위인군。
Objective To analyze the different levels of serum bilirubin in different glucose metabolism status between monozygotic twins and to explore the new markers of abnormal glucose metabolism. Methods Fifty-five pairs of twins from January to September 2014 were registered in the cohort study, aged 18-70 yrs. Oral glucose tolerance test (OGTT) was performed and glucose level was recorded 2 hours (2 hPG) after taking 75 g glucose. The individuals with diabetes and impaired glucose tolerance (IGT) were pooled to be abnormal glucose metabolism group (DM+IGT) while normal glucose subjects were pooled as NGT group. Serum biochemistry index was analyzed. Spearman correlation analysis was used to analyze the relationship of serum direct bilirubin and blood glucose in the subjects with abnormal glucose metabolism. Results (1)Enrolled nine pairs of twins were all females, aged 50-62 yrs. Nine pairs of twins whose abnormal glucose tolerance was different were analyzed in the study. Among nine pairs of twins, 4 pairs were characterized as one with type 2 diabetes mellitus (T2DM) and the other with normal glucose tolerance (NGT1); 5 pairs were characterized as one with impaired glucose tolerance (IGT) and the other with normal glucose tolerance (NGT2).(2)Compared with NGT group, DM/IGT group had higher waist-to-hip ratio(0.89 ± 0.05 vs 0.85 ± 0.07,t=2.38,P<0.05), higher triglyceride level((2.3 ± 1.4)vs (1.0±0.6)mmol/L,t=3,14,P<0.05), but lower serum level of direct bilirubin((3.1±0.8)vs(4.5±1.2)μmol/L, t=-5.26,P<0.05). (3)Spearman correlation analysis showed direct bilirubin level was negatively correlated with 2 hPG in DM/IGT group(r=-0.625, P<0.05). (4) Logistic regression analysis further confirmed the negative correlation between direct bilirubin and 2 hPG (OR=0.246,95%CI 0.66-0.922,P<0.05). After adjusting for triglyceride and waist-to-hip ratio, direct bilirubin was no related with abnormal glucose metabolism (OR=0.366,95%CI 0.050-2.665,P>0.05). Conclusion One with lower serum bilirubin level may be at higher risk of abnormal glucose metabolism in monozygotic twins.