论文部分内容阅读
背景累积的数据表明,胆酸(BAs)在调节代谢平衡中可能有新的作用。已证明,在小鼠模型,胆酸治疗可改善糖耐量,增加能量消耗。因此,针对空腹血浆BAs浓度和人体代谢参数之间的关系,我们进行了这项试验。方法本试验纳入了14名健康受试者,20名2型糖尿病(T2D)患者,和22名非糖尿病腹部肥胖患者。检测的项目包括:空腹血糖、胰岛素和血脂水平。本试验针对一亚组(包括9名健康受试者,16名T2D患者)进行了胰岛素敏感性评估,采用的是高胰岛素-正常葡萄糖钳夹试验,在该过程中葡萄糖输注率(GIR)固定。能量消耗通过间接计算得出。血浆胆酸(CA)、鹅去氧胆酸(CDCA)和脱氧胆酸(DCA)的浓度,采用的是气相色谱-质谱法。结果 HOMA-IR,和血浆鹅去氧胆酸(P=0.001)、胆酸(P=0.09)和脱氧胆酸(P<0.0001)浓度呈正相关。葡萄糖输注率,和血浆鹅去氧胆酸(P=0.03)和胆酸(P=0.001)浓度呈负相关。经调整年龄、性别、BMI、糖化血红蛋白(HbA1C)和血浆脂质水平后,HOMA-IR,和血浆鹅去氧胆酸(P=0.01)、胆酸(P=0.01)和脱氧胆酸(P=0.007)浓度的正相关性仍存在。相比之下,经多变量分析后,血浆胆酸水平,和HbA1C、能量消耗和血浆血脂水平的相关性消失。结论在受试者范围内,胰岛素敏感性,和血浆鹅去氧胆酸、胆酸和脱氧胆酸浓度呈负相关。
Background The accumulated data show that bile acids (BAs) may have a new role in the regulation of metabolic balance. It has been demonstrated that in the mouse model, bile acid therapy improves glucose tolerance and increases energy expenditure. Therefore, we conducted this experiment on the relationship between fasting plasma BAs concentration and human metabolic parameters. Methods This study enrolled 14 healthy subjects, 20 patients with type 2 diabetes (T2D), and 22 non-diabetic patients with abdominal obesity. Test items include: fasting blood glucose, insulin and lipid levels. This trial evaluated insulin sensitivity in a subset of nine healthy subjects, 16 T2D patients, using a hyperinsulinemic-normal glucose clamp test in which glucose infusion rate (GIR) fixed. Energy consumption is calculated indirectly. Plasma concentrations of cholic acid (CA), chenodeoxycholic acid (CDCA) and deoxycholic acid (DCA) were determined by gas chromatography-mass spectrometry. Results HOMA-IR was positively correlated with plasma chenodeoxycholic acid (P = 0.001), cholic acid (P = 0.09) and deoxycholic acid (P <0.0001) Glucose infusion rates were negatively correlated with plasma chenodeoxycholic acid (P = 0.03) and cholic acid (P = 0.001). HOMA-IR and plasma chenodeoxycholic acid (P = 0.01), cholic acid (P = 0.01) and deoxycholic acid (P) were significantly lower after adjusting for age, sex, BMI, HbA1C and plasma lipid levels = 0.007) concentration still exists. In contrast, after multivariate analysis, plasma cholic acid levels disappeared in correlation with HbA1C, energy expenditure, and plasma lipid levels. Conclusions Insulin sensitivity was negatively correlated with plasma concentrations of chenodeoxycholic acid, cholic acid and deoxycholic acid in subjects.