Relationship between Serum Indirect Bilirubin Level and Insulin Sensitivity: Results from Two Independent Cohorts of Obese Patients with Impaired Glucose Regulation and Type 2 Diabetes Mellitus in China
Relationship between Serum Indirect Bilirubin Level and Insulin Sensitivity: Results from Two Independent Cohorts of Obese Patients with Impaired Glucose Regulation and Type 2 Diabetes Mellitus in China
复制标题
血清间接胆红素水平与胰岛素敏感性之间的关系：中国血糖调节受损和 2 型糖尿病肥胖患者的两个独立队列的结果
DOI：
10.1155/2020/5681296
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发表时间：
2020
影响因子：
2.8
通讯作者：
Zhou Hongwen
中科院分区：
文献类型：
--
作者：
Zhang Fan;Guan Wei;Fu Zhenzhen;Zhou Li;Guo Wen;Ma Yizhe;Gong Yingyun;Jiang Wanzi;Liang Hui;Zhou Hongwen
背景血清胆红素是一种内源性抗氧化剂，对肥胖相关的代谢性疾病具有保护作用。目的探讨肥胖合并糖调节受损（IGR/T2 DM）患者血清总胆红素（TBIL）、直接胆红素（DBIL）和间接胆红素（IBIL）水平的特点及其与胰岛素敏感性的关系。患者和方法。队列1包括肥胖患者（n = 71），分为IGR/T2 DM组（n = 38，肥胖伴IGR/T2 DM）和对照组（n = 33，肥胖不伴IGR/T2 DM）。采用高胰岛素-正葡萄糖钳夹技术（HEC），以葡萄糖代谢率（GDR，M值）评价胰岛素敏感性。队列2包括接受代谢手术的IGR/T2 DM肥胖患者（n = 109），作为队列1的补充。采用Matsuda指数和稳态模型胰岛素敏感性评价法（HOMA-IS）评价胰岛素敏感性。结果队列1中，IGR/T2 DM组TBIL、DBIL、IBIL在生理范围内均高于对照组，IBIL与M值呈正相关多因素Logistic回归分析显示IBIL可能是IGR/T2 DM患者胰岛素抵抗的独立保护因素（比值比（OR）= 0.602; 95%置信区间（CI）：0.413-0.878; p=0.008）。在队列2中，代谢手术后1个月，血清胆红素水平（TBIL、DBIL和IBIL）升高，IBIL的百分比变化与Matsuda指数的变化呈正相关（r = 0.195，p=0.045）。结论不同类型胆红素与胰岛素敏感性的关系各不相同。血清间接胆红素可能是增强胰岛素敏感性的保护因素。
Background Serum bilirubin is an endogenous antioxidant that has protective effects against obesity-related metabolic diseases. Objectives This study aimed to evaluate the characteristics of total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) and their relationships with insulin sensitivity in obese patients with impaired glucose regulation and type 2 diabetes mellitus (IGR/T2DM) in China. Patients and Methods. Cohort 1 comprised obese patients (n = 71) was divided into the IGR/T2DM group (n = 38, obesity with IGR/T2DM) and control group (n = 33, obesity without IGR/T2DM). Insulin sensitivity was evaluated using the hyperinsulinemic-euglycemic clamp technique (HEC) with glucose disposal rate (GDR, M value). Cohort 2 comprised obese patients with IGR/T2DM who underwent metabolic surgery (n = 109) as complementary to cohort 1. Insulin sensitivity was evaluated with the Matsuda Index and homeostatic model assessment of insulin sensitivity (HOMA-IS). Results In cohort 1, TBIL, DBIL, and IBIL were higher within the physiological range in the IGR/T2DM group compared with the control group; IBIL was positively correlated with M value (r = 0.342, p=0.044) in the IGR/T2DM group, and multivariate logistic regression showed that IBIL might be independent protective factors against insulin resistance (odds ratio (OR) = 0.602; 95% confidence interval (CI): 0.413–0.878; p=0.008). In cohort 2, at 1 month after metabolic surgery, serum bilirubin levels (TBIL, DBIL, and IBIL) increased, and the percentage change in IBIL was positively correlated with the change of the Matsuda Index (r = 0.195, p=0.045). Conclusions The relationships between different types of bilirubin and insulin sensitivity varied. Serum indirect bilirubin might be a protective factor that enhances insulin sensitivity.