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【JCEM】在病态肥胖升高了的胎球蛋白-A在快速减
在病态肥胖升高了的胎球蛋白-A在快速减肥后会降低
Context: Morbid obesity (MO) is a risk factor for cardiovascular morbidity, mortality, and diabetes, which can be effectively reduced by bariatric surgery. The liver-secreted protein Fetuin-A is elevated in insulin resistance, is an independent predictor of type 2 diabetes and is associated with atherosclerosis.
背景：病态肥胖（MO）是心血管疾病发病率、死亡率和糖尿病的一个危险因素，病态肥胖可以通过减肥手术有效减重。肝脏分泌的胎球蛋白-A在胰岛素抵抗时会升高，是2型糖尿病的一个独立预测因子，与动脉粥样硬化相关。
Objective: We studied Fetuin-A concentrations in patients with MO before and after weight loss induced by gastric bypass.
Design: We conducted a cross-sectional study and a 16-month longitudinal study. Setting: This study was performed in secondary care. Patients, Subjects, and Intervention: We included 75 MO patients [65 women, body mass index (BMI) 45.6 +/- 8.1 kg/m(2)] and 38 healthy controls (21 women, BMI 26.0 +/- 5.5 kg/m(2)) in a cross-sectional study and investigated them before and about 16 months after gastric bypass surgery. Main Outcome Measures: Apart from measurements of blood pressure and routine laboratory parameters, a 75-g oral glucose tolerance test was performed. Insulin resistance was calculated by using homeostatic model assessment (HOMA).
目的：我们研究了病态肥胖患者胃旁路手术减肥前后胎球蛋白-A的浓度。我们进行了横断面研究及16个月的纵向研究。
设计：这项研究是在二级保健中心进行的。
患者、参与者和干预：在一个横断面研究中，我们纳入75例病态肥胖的病人[65位女性，体重指数（BMI）45.6±8.1 kg/m(2)]和38名健康对照（21位女性，BMI 26.0±5.5 kg/m(2)），并在胃旁路手术前和手术后16月进行了观察。
主要观察指标：除进行测量血压和常规实验室参数外，也进行了75g糖耐量试验。用稳态模型评估（HOMA）计算胰岛素抵抗。
Results: Fetuin-A levels were significantly higher in MO (877 +/- 318 mug/ml) than in controls (295 +/- 61 mug/ml; P < 0.001). After surgery-induced weight loss (BMI 31.6 +/- 6.8 vs. 45.6 +/- 8.1 kg/m(2); P < 0.001), HOMA (2.0 +/- 1.2 vs. 6.6 +/- 6.3; P < 0.001) and Fetuin-A (710 +/- 350 vs. 877 +/- 318 mug/ml; P < 0.001) decreased. Delta (Delta) Fetuin-A concentrations correlated with Deltafasting insulin (r = 0.710; P = 0.001), Delta2-h insulin (r = 0.693; P = 0.005), and HOMA-insulin resistance (r = 0.684; P = 0.001).
结果：胎球蛋白-A水平在病态肥胖的患者(877 +/- 318 mug/ml)与对照组(295 +/- 61 mug/ml; P < 0.001)相比明显升高。在手术减重后（BMI 31.6 +/- 6.8 vs. 45.6 +/- 8.1 kg/m(2); P < 0.001），HOMA(2.0+/-1.2 vs. 6.6+/-6.3; P < 0.001)和胎球蛋白-A(710+/-350 vs. 877+/-318 mug/ml; P<0.001)明显下降。Delta (Δ)胎球蛋白-A浓度与Δ空腹胰岛素(r = 0.710; P = 0.001)，Δ2-h胰岛素(r = 0.693; P = 0.005)和HOMA胰岛素抵抗(r = 0.684; P = 0.001)相关。
Conclusions: Fetuin-A is markedly increased in patients with MO. The reduction of Fetuin-A after weight loss could play an important role in the beneficial effects of gastric bypass surgery.
结论：胎球蛋白-A在病态肥胖患者明显升高。减重后胎球蛋白-A的降低在胃旁路手术的有益效应中发挥重要作用。
J Clin Endocrinol Metab. 2010 Nov;95(11):4877-81 欢迎来动态版！
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