Correlation between CTRP3 and serum uric acid levels in patients with newly diagnosed type 2 diabetes
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摘要:
目的 探讨血清补体C1q/肿瘤坏死因子相关蛋白3(complement C1q/tumor necrosis factor-related protein-3, CTRP3)与新诊断2型糖尿病(type 2 diabetes mellitus, T2DM)患者血尿酸水平的相关性。 方法 选取中国人民解放军中部战区总医院新诊断T2DM患者152例, 根据内脏脂肪面积(visceral fat area, VFA)分为非腹型肥胖组[AO (-)组]79例和腹型肥胖组[AO (+)组]73例。采用Spearman相关分析对CTRP3与血尿酸之间的相关性进行研究, 采用多元逐步回归分析模型分析CTRP3对血尿酸的独立影响作用。 结果 与AO(-)组比较, AO(+)组的血尿酸更高(P=0.029), CTRP3水平更低(P < 0.001)。Spearman相关分析显示:整体人群及AO(+)组中, CTRP3与血尿酸呈负相关(r=-0.180, r=-0.518, 均有P < 0.05);然而, AO(-)组CTRP3与血尿酸等参数均无相关性(均有P > 0.05)。多元逐步回归分析显示, AO(+)组中, CTRP3水平独立影响血尿酸水平(β=-0.290, P=0.005), 但AO(-)组未观察到这种关联。 结论 血清CTRP3与新诊断T2DM患者血尿酸水平独立负相关, 该相关性具有肥胖依赖性的特点。 -
关键词:
- 补体C1q/肿瘤坏死因子相关蛋白3 /
- 血尿酸 /
- 2型糖尿病 /
- 腹型肥胖 /
- 胰岛素抵抗
Abstract:Objective To investigate the correlation between serum complement C1 q/tumor necrosis factor-related protein-3(CTRP3) and serum uric acid levels in patients with newly diagnosed type 2 diabetes mellitus(T2 DM). Methods A total of 152 patients with newly diagnosed T2 DM from Central Theater Command General Hospital were enrolled. Based on the visceral fat area(VFA), the subjects were divided into non-abdominal obesity group [AO(-) group](n=79) and abdominal obesity group [AO(+) group](n=73). Spearman correlation analysis was used to analyze the correlation between serum CTRP3 and uric acid as well as other parameters.Multiple stepwise regression analysis model was used to analyze the independent effect of CTRP3 on serum uric acid levels in patients with newly diagnosed T2 DM. Results When compared with AO(-) group, patients in AO(+) group had higher levels of serum uric acid(P=0.029) and lower CTRP3(P < 0.001). Spearman correlation analysis showed that CTRP3 was negatively correlated with serum uric acid in the whole subjects and AO(+) group(r=-0.180, r=-0.518, all P < 0.05). However, there was no correlation between CTRP3 and uric acid as well as other parameters in AO(-) group(allP > 0.05). Multiple stepwise regression analysis demonstrated that CTRP3 was an independent contributor to serum uric acid levels in AO(+) group(β=-0.290, P=0.005), while not in AO(-) group. Conclusions Serum CTRP3 was an independent influencing factor and negatively correlated with serum uric acid levels in patients with newly diagnosed T2 DM, in an obesity-dependent manner. -
表 1 两组临床资料及血指标的比较[(x±s)或M(P25, P75)]
Table 1. Comparison of clinical and blood parameters between the two groups[(x±s) or M(P25, P75)]
变量 肥胖分组 t/χ2值 P值 AO(-)组 AO(+)组 年龄(岁) 51±12 54±9 -1.710 0.09 性别[n(%)] 0.041 0.84 男 42(53.16) 40(54.79) 女 37(46.84) 33(45.21) 吸烟[n(%)] 21.882 ﹤0.001 是 12(15.19) 37(50.68) 否 67(84.81) 36(49.32) 饮酒[n(%)] 12.561 < 0.001 是 9(11.39) 26(35.62) 否 70(88.61) 47(64.38) SBP(mmHg) 122±14 122±17 -0.329 0.743 DBP(mmHg) 76±10 77±12 -0.643 0.521 体重(kg) 62.1±8.2 74.0±9.0 -8.564 ﹤0.001 BMI(kg/m2) 22.9±2.5 25.9±2.3 -7.635 ﹤0.001 WC(cm) 79.3±6.0 91.0±5.2 -12.825 ﹤0.001 WHR 0.84±0.04 0.95±0.03 -18.089 ﹤0.001 VFA(cm2) 73.4±21.0 131.3±19.6 -17.551 ﹤0.001 体脂量(kg) 16.5±4.5 19.8±4.1 -4.686 ﹤0.001 体脂率(%) 26.5±6.4 26.6±4.2 -0.159 0.874 TC(mmol/L) 4.65±1.04 5.06±0.93 -2.591 0.011 TG(mmol/L) 1.62(0.98, 2.46) 1.84(1.29, 3.05) -2.461 0.015 LDL-C(mmol/L) 2.22±0.70 2.57±0.70 -3.020 0.003 HDL-C(mmol/L) 1.23±0.29 1.04±0.23 4.398 ﹤0.001 FBG(mmol/L) 8.1±2.5 8.5±2.6 -0.987 0.325 FINS(mU/L) 49.6±21.1 60.0±49.0 -1.487 0.14 HOMA-IR 16.6±7.7 21.3±13.5 -2.325 0.022 HbA1c(%) 9.2±2.1 9.2±2.5 0.178 0.859 CRP(mg/L) 1.27(0.75, 2.27) 1.48(0.77, 3.00) -0.738 0.462 SCr(μmol/L) 58±15 68±16 -4.047 ﹤0.001 血尿酸(μmol/L) 299±111 337±92 -2.208 0.029 CTRP3(ng/mL) 6.27(4.18, 11.41) 4.63(2.46, 7.78) 3.684 ﹤0.001 表 2 新诊断T2DM患者血尿酸的独立影响因素分析
Table 2. Analysis of independent influencing factors of blood uric acid served as a dependent variable in newly diagnosed T2DM patients
变量 β值 Sx值 标准β值 t值 P值 AO(-) 常数项 64.163 47.082 - 1.363 0.177 SCr 3.137 0.737 0.420 4.256 < 0.001 TG 27.680 7.095 0.385 3.901 < 0.001 AO(+) 常数项 -86.678 90.621 - -0.956 0.342 CTRP3 -2.453 0.849 -0.290 -2.890 0.005 DBP 2.239 0.806 0.287 2.778 0.007 VFA 1.297 0.473 0.275 2.740 0.008 SCr 1.489 0.601 0.256 2.478 0.016 -
[1] Li C, Hsieh MC. Metabolic syndrome, diabetes, and hyperuricemia[J]. Curr Opin Rheumatol, 2013, 25(2): 210-216. DOI: 10.1097/BOR.0b013e32835d951e. [2] 高尿酸血症相关疾病诊疗多学科共识专家组.中国高尿酸血症相关疾病诊疗多学科专家共识[J].中华内科杂志, 2017, 56(3): 235-248. DOI: 10.3760/cma.j.issn.0578-1426.2017.03.021.Multidisciplinary consensus expert group for the diagnosis and treatment of hyperuricemia related diseases. Chinese multi-disciplinary consensus on the diagnosis and treatment of hyperuricemia and its related diseases[J]. Chin J Inter Med, 2017, 56(3): 235-248. DOI: 10.3760/cma.j.issn.0578-1426.2017.03.021. [3] 刘琰, 宋菲, 伍思佳, 等.内蒙古乌海市成人超重肥胖和甜饮料摄入对血尿酸的影响[J].中华疾病控制杂志, 2017, 21(3): 228-232. DOI: 10.16462/j.cnki.zhjbkz.2017.03.004.Liu Y, Song F, Wu SJ, et al. The effects of overweight, obesity and sugar-sweetened beverage consumption on serum uric acid in adult residents of Wuhai, Inner Mongolian[J]. Chin J Dis Control Prev, 2017, 21(3): 228-232. DOI: 10.16462/j.cnki.zhjbkz.2017.03.004. [4] Ali N, Perveen R, Rahman S, et al. Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: a study on Bangladeshi adults[J]. PLoS One, 2018, 13(11): e0206850. DOI: 10.1371/journal.pone.0206850. [5] Wang J, Chen RP, Lei L, et al. Prevalence and determinants of hyperuricemia in type 2 diabetes mellitus patients with central obesity in Guangdong province in China[J]. Asia Pac J Clin Nutr, 2013, 22(4): 590-598. DOI: 10.6133/apjcn.2013.22.4.16. [6] 张城林, 吴立玲, 李丽.补体C1q/肿瘤坏死因子相关蛋白3的研究进展[J].生理学报, 2017, 69(5): 666-676. DOI: 10.13294/j.aps.2017.0032.Zhang CL, Wu LL, Li L. Research progress of complement-C1q/tumor necrosis factor-related protein 3[J]. Acta physiol Sin, 2017, 69(5): 666-676. DOI: 10.13294/j.aps.2017.0032. [7] Moradi N, Fadaei R, Khamseh ME, et al. Serum levels of CTRP3 in diabetic nephropathy and its relationship with insulin resistance and kidney function[J]. PLoS One, 2019, 14(4): e0215617. DOI: 10.1371/journal.pone.0215617. [8] Wolf RM, Steele KE, Peterson LA, et al. Lower circulating C1q/TNF-related protein-3(CTRP3)levels are associated with obesity: a cross-sectional study[J]. PLoS One, 2015, 10(7): e0133955. DOI: 10.1371/journal.pone.0133955. [9] Qu H, Deng M, Wang H, et al. Plasma CTRP-3 concentrations in Chinese patients with obesity and type II diabetes negatively correlate with insulin resistance[J]. J Clin Lipidol, 2015, 9(3): 289-294. DOI: 10.1016/j.jacl.2015.03.006. [10] Maltais-Payette I, Boulet MM, Prehn C, et al. Circulating glutamate concentration as a biomarker of visceral obesity and associated metabolic alterations[J]. Nutr Metab(Lond), 2018, 15: 78. DOI: 10.1186/s12986-018-0316-5. [11] Yamada A, Sato KK, Kinuhata S, et al. Both visceral fat and liver fat are independently associated with hyperuricemia: the ohtori study[J]. Arthritis Care Res(Hoboken), 2016, 68(4): 553-561. DOI: 10.1002/acr.22729. [12] Schmid A, Kopp A, Hanses F, et al. The novel adipokine C1q/TNF-related protein-3 is expressed in human adipocytes and regulated by metabolic and infection-related parameters[J]. Exp Clin Endocrinol Diabetes, 2012, 120(10): 611-617. DOI: 10.1055/s-0032-1323803. [13] Hasegawa N, Fujie S, Horii N, et al. Aerobic exercise training-induced changes in serum C1q/TNF-related protein levels are associated with reduced arterial stiffness in middle-aged and older adults[J]. Am J Physiol Regul Integr Comp Physiol, 2018, 314(1): 94-101. DOI: 10.1152/ajpregu.00212.2017. [14] Tsushima Y, Nishizawa H, Tochino Y, et al. Uric acid secretion from adipose tissue and its increase in obesity[J]. J Biol Chem, 2013, 288(38): 27138-27149. DOI: 10.1074/jbc.M113.485094. [15] 程杨阳, 张军霞. Clq-肿瘤坏死因子相关蛋白3与胰岛素抵抗相关性疾病的研究进展[J].中国糖尿病杂志, 2018, 26(2): 170-172. DOI: 10.3969/j.issn.1006-6187.2018.02.017.Chen YY, Zhang JX. Research progressin Clq/TNF-related protein-3 and insulin resistance-related diseases[J]. Chin J Diabetes, 2018, 26(2): 170-172. DOI: 10.3969/j.issn.1006-6187.2018.02.017. [16] Zhang J, Zhang B, Cheng Y. Low serum CTRP3 levels are associated with nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus[J]. Cytokine, 2018, 106: 131-135. DOI: 10.1016/j.cyto.2017.10.023. [17] Li X, Jiang L, Yang M, et al. CTRP3 improves the insulin sensitivity of 3T3-L1 adipocytes by inhibiting inflammation and ameliorating insulin signalling transduction[J]. Endokrynol Pol, 2014, 65(4): 252-258. DOI: 10.5603/EP.2014.0034. [18] Peterson JM, Wei Z. C1q/TNF-related protein-3(CTRP3), a novel adipokine that regulates hepatic glucose output[J]. J Biol Chem, 2010, 285(51): 39691-39701. DOI: 10.1074/jbc.M110.180695. [19] Toyoki D, Shibata S, Kuribayashi-Okuma E, et al. Insulin stimulates uric acid reabsorption via regulating urate transporter 1 and ATP-binding cassette subfamily G member 2[J]. Am J Physiol Renal Physiol, 2017, 313(3): 826-834. DOI: 10.1152/ajprenal.00012.2017.