摘要
目的研究血清网膜素1(omentin-1)和趋化素(chemerin)与慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)气道炎症和胰岛素抵抗(insulin resistance,IR)的相关性。方法选取2016-09/2018-09月作者医院门诊就诊的128例COPD患者为COPD组,选取同期作者医院100例健康体检者为对照组,对比两组患者的血清omentin-1和chemerin水平,根据两组稳态模型评估的胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR),将COPD组分为IR-COPD组、非IR-COPD组,将对照组分为单纯IR组、正常对照组,对比分析各亚组的血清omentin-1、chemerin水平、诱导痰炎症因子水平,并作相关性分析。结果COPD组血清omentin-1明显低于对照组,血清chemerin明显高于对照组(P<0.05)。血清omentin-1水平:IR-COPD组<非IR-COPD组<单纯IR组<正常对照组;血清chemerin水平:IR-COPD组>非IR-COPD组>单纯IR组>正常对照组。IR-COPD组的糖代谢参数、HOMA-IR的自然对数值(InHOMA-IR)、诱导痰炎性因子水平明显高于其余3个亚组(P<0.05)。IR-COPD组的肺功能参数明显低于其余3个亚组,非IR-COPD组的肺功能参数明显低于单纯IR组和正常对照组(P<0.05)。血清omentin-1水平与体质量指数(body mass index,BMI)、空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting insulin,FINS)、InHOMA-IR水平负相关(P<0.05);血清chemerin水平与BMI、FBG、FINS、InHOMA-IR、诱导痰炎性因子呈正相关(P<0.05),与肺功能参数呈负相关(P<0.05)。BMI、FBG、FINS、InHOMA-IR为血清omentin-1独立相关因素(P<0.05),血清chemerin独立相关因素为BMI、FBG、FINS、InHOMA-IR、用力呼气容积(forced expiratory volume in one second,FEV1)/用力肺活量(forced vital capacity,FVC)、FEV1占预计值百分比、诱导痰肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、白细胞介素6(interleukin-6,IL-6)(P<0.05)。结论血清omentin-1和chemerin均可反映COPD患者的糖代谢、IR程度,血清chemerin还可反映COPD患者的气道炎症状态。
Objective To study the relationship between serum omentin-1,chemerin and airway inflammation and insulin resistance(IR)in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 128 COPD patients treated in the outpatient department of author’s hospital from September 2016 to September 2018 were selected as COPD group and 100 healthy persons who underwent physical examination in author’s hospital in the same period were selected as the control group.The levels of serum omentin-1 and chemerin were compared between the two groups.According to the homeostasis model assessment of insulin resistance(HOMA-IR)evaluated by the steady-state model of the two groups,the COPD group was divided into IR-COPD group and non-IR COPD group,and the control group was divided into simple IR group and normal control group.The levels of serum omentin-1,chemerin and inflammatory factors in induced sputum were compared,and the correlation was analyzed among the subgroups.Results Compared with the control group,the serum omentin-1 was significantly lower,and the serum chemerin was higher in COPD group(P<0.05).The levels of serum omentin-1:IR-COPD group<non-IR COPD group<simple IR group<normal control group,the levels of serum chemerin:IR-COPD group>non-IR COPD group>simple IR group>normal control group.The parameters of glucose metabolism,the natural logarithm of HOMA-IR(InHOMA-IR)and the level of inflammatory factors in induced sputum in IR-COPD group were significantly higher than those in the other three subgroups(P<0.05).The pulmonary function parameters in IR-COPD group were significantly lower than those in the three subgroups,and the pulmonary function parameters in non-IR COPD group were significantly lower than those in simple IR group and normal control group(P<0.05).The level of serum omentin-1 was negatively correlated with body mass index(BMI),fasting blood glucose(FBG),fasting insulin(FINS)and InHOMA-IR(P<0.05),while the level of serum chemerin was positively correlated with BMI,FBG,FINS,InHOMA-IR,and inflammatory factors in induced sputum(P<0.05),the level of serum chemerin was negatively correlated with pulmonary function parameters.BMI,FBG,FINS,InHOMA-IR were the independent related factors of serum omentin-1.The independent correlation factors of serum chemerin were BMI,FBG,FINS,InHOMA-IR,the forced expiratory volume in one second(FEV1)/(forced vital capacity,FVC),the percentage of FEV1 in predicted value,tumor necrosis factorα(TNF-α)and interleukin 6(IL-6)in induced sputum(P<0.05).Conclusion Serum omentin-1 can reflect the degree of glucose metabolism and IR in patients with COPD.Serum chemerin can reflect glucose metabolism,IR and airway inflammation in patients with COPD.
作者
王娟娟
贺碧英
王丽丽
王菊
WANG Juanjuan;HE Biying;WANG Lili;WANG Ju(Department of Respiratory Medicine,Xiangyang Central Hospital,Xiangyang Hubei 441021,China)
出处
《华南国防医学杂志》
CAS
2020年第7期467-471,476,共6页
Military Medical Journal of South China
基金
湖北省自然科学基金(2018CFB635)
关键词
网膜素1
趋化素
慢性阻塞性肺疾病
气道炎症
胰岛素抵抗
Omentin-1
Chemerin
Chronic obstructive pulmonary disease
Airway inflammation
Insulin resistance
