Abstract: Background　The associations of adipokines with body fat distribution and glycolipid metabolism have become hot topics of research. But the associations of Asprosin and Spexin with obesity in type 2 diabetics have been rarely reported. Objective　To explore the correlation of serum Asprosin and Spexin levels with visceral obesity in type 2 diabetics. Methods　We recruited 381 type 2 diabetics from National Metabolic Management Center，Endocrinology Department，the First Affiliated Hospital of Baotou Medical College，Inner Mongolia University of Science and Technology between January 2019 and June 2020. We compared general demographics，body fat indices，and serum asprosin and spexin levels between patients with（n=226） and without（n=155） visceral obesity 〔defined as visceral fat area（VFA）≥100 cm2〕. We examined the association of serum asprosin and spexin with other indicators. We used binary Logistic regression analysis to identify factors associated with visceral obesity in type 2 diabetes. Results　Compared to patients without visceral obesity，those with visceral obesity had higher mean values of diastolic blood pressure，height，fasting C-peptide（FCP），2-hour postprandial C-peptide （2 hCP），serum triglyceride，uric acid and Asprosin，and homeostasis model assessment-insulin resistance（HOMA-IR），greater mean values of weight，BMI，waist circumference （WC），hip circumference （HC），waist-to-hip ratio （WHR），VFA，subcutaneous fat area （SFA），visceral-to-subcutaneous fat ratio （VSR），and lower male ratio as well as lower mean serum spexin（P<0.05）. Asprosin was positively associated with height，weight，BMI，WC，HC，WHR，FCP，2 hCP，triglyceride，HOMA-IR，VFA，SFA，VSR，but negatively with Spexin （P<0.05）. Spexin was negatively correlated with weight，BMI，WC，HC，WHR，FCP，2 hCP，serum creatinine and uric acid，HOMA-IR，VFA，SFA，and VSR，but positively with HbA1c （P<0.05）. Binary Logistic regression analysis showed that gender 〔OR=2.967，95%CI（1.830，4.810）〕，BMI〔OR=1.729，95%CI（0.801，3.732）〕，WHR〔OR=0.000，95%CI（0.000，0.105）〕，SFA〔OR=0.985，95%CI（0.977，0.992）〕，asprosin〔OR=0.539，95%CI（0.426，0.681）〕，and Spexin〔OR=1.001，95%CI（1.000，1.001）〕were associated with visceral obesity in type 2 diabetics. Conclusion　Both serum Asprosin and Spexin levels are closely correlated with visceral obesity in type 2 diabetics，which might be new potential targets for the treatment of type 2 diabetes and the prevention of its related complications.

Key words: Diabetes mellitus, type 2, Obesity, abdominal, Asprosin, Spexin, Intra-abdominal fat, Insulin resistance, Correlation study

摘要： 背景　脂肪因子与体脂分布及糖脂代谢的相关性研究已成为国内外研究热点，而脂肪因子Asprosin、Spexin在2型糖尿病（T2DM）及肥胖中的研究鲜有报道。目的　探究血清Asprosin、Spexin水平与T2DM并发内脏型肥胖（VO）的相关性。方法　选取2019年1月至2020年6月于内蒙古科技大学包头医学院第一附属医院内分泌科国家标准化代谢性疾病管理中心就诊的381例T2DM患者为研究对象。依据是否发生VO将患者分为T2DM并发VO组（T2DM-VO组，n=226）、T2DM未并发VO组（T2DM-nonVO组，n=155）。本研究中VO的诊断标准为内脏脂肪面积（VFA）≥100 cm2。比较两组患者一般资料、生化指标、体脂相关指标及血清Asprosin、Spexin水平，并分析血清Asprosin、Spexin水平与各指标间的相关性。采用二元Logistic回归分析探究T2DM并发VO的影响因素。结果　T2DM-VO组患者舒张压（DBP）、身高、空腹C肽（FCP）水平、餐后2 hC肽（2 hCP）水平、三酰甘油（TG）水平、血尿酸（UA）水平、稳态模型评估胰岛素抵抗指数（HOMA-IR）、Asprosin水平高于T2DM-nonVO组，体质量、体质指数（BMI）、腰围（WC）、臀围（HC）、腰臀比（WHR）、VFA、皮下脂肪面积（SFA）、内脏脂肪面积比皮下脂肪面积（VSR）大于T2DM-nonVO组，男性所占比例、Spexin水平低于T2DM-nonVO组（P<0.05）。Asprosin与身高、体质量、BMI、WC、HC、WHR、FCP、2 hCP、TG、HOMA-IR、VFA、SFA、VSR呈正相关，与Spexin呈负相关（P<0.05）；Spexin与体质量、BMI、WC、HC、WHR、FCP、2 hCP、Cr、UA、HOMA-IR、VFA、SFA、VSR呈负相关，与HbA1c呈正相关（P<0.05）。二元Logistic回归分析结果显示，性别〔OR=2.967，95%CI（1.830，4.810）〕、BMI〔OR=1.729，95%CI（0.801，3.732）〕、WHR〔OR=0.000，95%CI（0.000，0.105）〕、SFA〔OR=0.985，95%CI（0.977，0.992）〕、Asprosin〔OR=0.539，95%CI（0.426，0.681）〕、Spexin〔OR=1.001，95%CI（1.000，1.001）〕是T2DM并发VO的影响因素（P<0.05）。结论　血清Asprosin、Spexin水平与T2DM并发VO密切相关，为治疗T2DM、预防T2DM并发症提供了新的、可能的治疗靶点。

关键词: 糖尿病，2型, 肥胖，腹部, Asprosin, Spexin, 腹内脂肪, 胰岛素抵抗, 相关性研究