CAJ | 학술논문

目的探讨不同糖耐量状态下分泌型卷曲相关蛋白4(SFRP4)与胰岛β细胞第一时相分泌功能的关系。方法新诊断2型糖尿病患者56例(T2DM 组)；糖耐量受损52例(IGT 组)；正常对照者42名(NGT 组)。行静脉葡萄糖耐量试验,ELISA 法测定空腹血清 SFRP4及白细胞介素(IL)-1β水平。计算急性胰岛素分泌反应( AIR)、第一时相(0~10 min)胰岛素分泌曲线下面积( AUC)、葡萄糖处置指数(GDI)、稳态模型评估的胰岛β细胞功能指数(HOMA-β)及胰岛素抵抗指数(HOMA-IR)。探讨 SFRP4与AIR、AUC、GDI、HOMA-IR、HOMA-β的关系。结果(1)T2DM 组和 IGT 组血清 SFRP4水平显著高于 NGT组[(184.38±61.34和141.64±40.46对95.46±20.13)ng/ ml, P<0.01]；T2DM 组和 IGT 组 AIR、AUC、GDI显著低于 NGT 组(P<0.01),且在 T2DM 组最低；(2)SFRP4与 HOMA-β、AIR、AUC、GDI 呈显著负相关(P<0.01),与空腹血糖、餐后2 h 血糖、HbA1C、IL-1β、超敏 C 反应蛋白呈正相关(P<0.01)；(3)多元逐步回归分析显示,AUC、HOMA-IR、血清 IL-1β水平是 SFRP4的独立影响因素。结论血清 SFRP4水平与糖代谢状态密切相关,且与胰岛β细胞第一时相分泌功能及慢性低度炎症反应有关,SFRP4可能参与2型糖尿病的发生发展。
목적탐토불동당내량상태하분비형권곡상관단백4(SFRP4)여이도β세포제일시상분비공능적관계。방법신진단2형당뇨병환자56례(T2DM 조)；당내량수손52례(IGT 조)；정상대조자42명(NGT 조)。행정맥포도당내량시험,ELISA 법측정공복혈청 SFRP4급백세포개소(IL)-1β수평。계산급성이도소분비반응( AIR)、제일시상(0~10 min)이도소분비곡선하면적( AUC)、포도당처치지수(GDI)、은태모형평고적이도β세포공능지수(HOMA-β)급이도소저항지수(HOMA-IR)。탐토 SFRP4여AIR、AUC、GDI、HOMA-IR、HOMA-β적관계。결과(1)T2DM 조화 IGT 조혈청 SFRP4수평현저고우 NGT조[(184.38±61.34화141.64±40.46대95.46±20.13)ng/ ml, P<0.01]；T2DM 조화 IGT 조 AIR、AUC、GDI현저저우 NGT 조(P<0.01),차재 T2DM 조최저；(2)SFRP4여 HOMA-β、AIR、AUC、GDI 정현저부상관(P<0.01),여공복혈당、찬후2 h 혈당、HbA1C、IL-1β、초민 C 반응단백정정상관(P<0.01)；(3)다원축보회귀분석현시,AUC、HOMA-IR、혈청 IL-1β수평시 SFRP4적독립영향인소。결론혈청 SFRP4수평여당대사상태밀절상관,차여이도β세포제일시상분비공능급만성저도염증반응유관,SFRP4가능삼여2형당뇨병적발생발전。
Objective To investigate the relationship between serum secreted frizzled-related protein 4 (SFRP4) and the first-phase of glucose-stimulated insulin secretion from pancreatic β cell under different glucose tolerance statuses. Methods Fifty-six patients with newly diagnosed type 2 diabetes mellitus ( T2DM group), 52 patients with impaired glucose tolerance (IGT group), and 42 subjects with normal glucose tolerance (NGT group) underwent intravenous glucose tolerance test. Fasting serum SFRP4 and interleukin ( IL)-1β were assayed by ELISA. Acute insulin response ( AIR), the area under the curve of the first-phase (0-10 min) insulin secretion (AUC), glucose disposition index(GDI), homeostasis model assessment for β cell function index(HOMA-β), and insulin resistance index(HOMA-IR) were calculated. Results (1) The levels of SFRP4 and IL-1β in T2DM group and IGT group were significantly higher than that in NGT group [(184. 38 ± 61. 34 or 141. 64 ± 40. 46 or 95. 46 ± 20. 13)ng/ ml, P<0. 01]. AIR, AUC, and GDI in T2DM group and IGT group were significantly lower than those in NGT group(P<0. 01), and these results were more significantly reduced in T2DM group compared with those in IGT group. (2) SFRP4 was negatively correlated with AIR, AUC, GDI, HOMA-β (P<0. 01), and positively correlated with fasting plasma glucose, 2 h plasma glucose after glucose loading, HbA1C , IL-1β, and high sensitive C-reactive protein(P<0. 01). (3) Multiple stepwise regression analysis showed that AUC, HOMA-IR, and serum IL-1β level were independently associated with SFRP4. Conclusion The concentration of serum SFRP4 is closely correlated with the glycolipid metabolic disorder, the first-phase of glucose-stimulated insulin secretion, and chronic low-grade inflammation. SFRP4 may be involved in the mechanism of β cell dysfunction in type 2 diabetes mellitus.