BMI, apolipoprotein B/apolipoprotein A-I ratio, and insulin resistance in patients with prolactinomas: a pilot study in a Chinese cohort
BMI, apolipoprotein B/apolipoprotein A-I ratio, and insulin resistance in patients with prolactinomas: a pilot study in a Chinese cohort
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泌乳素瘤患者的 BMI、载脂蛋白 B/载脂蛋白 A-I 比值和胰岛素抵抗：中国队列的初步研究
DOI：
10.1007/s13277-013-0660-z
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发表时间：
2013-04-01
期刊：
影响因子：
--
通讯作者：
Wang, Hai-Jun
中科院分区：
文献类型：
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作者：
Jiang, Xiao-Bing;He, Dong-Sheng;Wang, Hai-Jun
催乳素瘤患者存在代谢紊乱和胰岛素抵抗 (IR) 的情况。关于泌乳素瘤患者的载脂蛋白 (apo) B/apoA-I 比率及其与 IR 的关系，目前尚无多少数据。本研究旨在评估中国泌乳素瘤亚组的 apoB/apoA-I 比值水平及其与 IR 的关系。 23 名催乳素瘤患者和 20 名健康对照者参加了这项研究。收集临床人体测量参数和实验室评估。使用稳态模型评估[胰岛素抵抗的稳态模型评估（HOMA-IR）]估计胰岛素敏感性。泌乳素瘤患者的腰围和体重指数 (BMI) 显着高于对照组 (p < 0.05)。与此同时，与健康受试者相比，男性患者全身肥胖和腹部肥胖的患病率似乎更为明显（分别为 57.14% vs. 0% 和 71.43% vs. 16.7%）。此外，泌乳素瘤患者的空腹血糖、胰岛素、HOMA-IR、甘油三酯和apoB/apoA-I比值也显着较高，但apoA-I水平较低（p < 0.05）。单变量回归分析显示，催乳素、腰围、BMI 和性腺功能减退症与 IR 显着相关（p < 0.05）。然而，在多变量 Logistic 分析中，只有 BMI [比值比 (OR) = 1.937，95% 置信区间 (CI) 1.112-3.375，p = 0.02] 和催乳素（OR = 5.173，95% CI 1.073-24.94，p = 0.041）被证明是 IR 存在的独立预测因子。这项研究证实了催乳素瘤患者代谢特征的改变，包括体重增加、IR、血脂紊乱和载脂蛋白。催乳素和 BMI 与 IR 独立相关。 apoB/apoA-I 比率对 IR 的影响有必要在进一步的研究中确定。
Deranged metabolic profiles and insulin resistance (IR) have been documented in patients with prolactinomas. Few data are yet available on the apolipoprotein (apo) B/apoA-I ratio and its relationship with IR in patients with prolactinomas. This study was aimed to evaluate the level of apoB/apoA-I ratio and its association with IR in a Chinese subgroup with prolactinomas. Twenty-three prolactinoma patients and 20 healthy controls were enrolled in this study. The clinical anthropometric parameters and laboratory evaluation were collected. Insulin sensitivity was estimated using homeostatic model assessment [homeostasis model assessment of insulin resistance (HOMA-IR)]. Waist circumference and body weight index (BMI) were significantly higher in patients with prolactinomas than those in the controls (p < 0.05). Meanwhile, the prevalence of general and abdominal obesity seemed more pronounced in male patients compared to that in healthy subjects (57.14 vs. 0 % and 71.43 vs. 16.7 %, respectively). Furthermore, fasting glucose, insulin, HOMA-IR, triglyceride, and apoB/apoA-I ratio were also significantly higher in prolactinoma patients, but with lower level of apoA-I (p < 0.05). Univariate regression analysis revealed that prolactin, waist circumference, BMI, and presence of hypogonadism were significantly associated with IR (p < 0.05). However, only BMI [odds ratio (OR) = 1.937, 95 % confidence interval (CI) 1.112-3.375, p = 0.02] and prolactin (OR = 5.173, 95 % CI 1.073-24.94, p = 0.041) were shown to be independent predictors for the presence of IR in multivariate logistic analysis. This study confirmed the altered metabolic profile, including body weight gain, IR, disordered lipids, and apolipoproteins in prolactinoma patients. Prolactin and BMI were independently associated with IR. The effect of apoB/apoA-I ratio on IR is warranted to be determined in further studies.