Abnormal Change of Serum Irisin Level in Overweight or Obese Patients with Type 2 Diabetes Mellitus

doi:10.12114/j.issn.1007-9572.2022.0491

Chinese General Practice ›› 2022, Vol. 25 ›› Issue (32): 4041-4045.DOI: 10.12114/j.issn.1007-9572.2022.0491

Special Issue: 内分泌代谢性疾病最新文章合辑；肥胖/减重最新文章合辑

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Abnormal Change of Serum Irisin Level in Overweight or Obese Patients with Type 2 Diabetes Mellitus

1. Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
2. School of Public Health, Anhui Medical University, Hefei 230032, China

Received:2022-05-16 Revised:2022-08-05 Published:2022-11-15 Online:2022-08-18
Contact: ZHANG Qiu
About author:
ZHANG N, JIANG T, ZHANG Y, et al. Abnormal change of serum irisin level in overweight or obese patients with type 2 diabetes mellitus [J]. Chinese General Practice, 2022, 25 (32) : 4041-4045.

2型糖尿病合并超重肥胖患者血清Irisin水平变化研究

1．230022　安徽省合肥市，安徽医科大学第一附属医院内分泌科
2．230032　安徽省合肥市，安徽医科大学公共卫生学院

通讯作者: 章秋
作者简介:
张楠，姜天，张一，等. 2型糖尿病合并超重肥胖患者血清Irisin水平变化研究[J].中国全科医学，2022，25（32）：4041-4045. [www.chinagp.net] 作者贡献：张楠进行资料收集、统计和结果分析，撰写论文；姜天参与研究的实施和可行性分析；张一参与统计分析和格式修订；章秋负责文章的质量控制和审校。
基金资助:
2020年度安徽医科大学校科研基金项目--利拉鲁肽通过诱导骨骼肌表达Irisin促进肥胖T2DM大鼠白色脂肪组织棕色化及初步机制探讨(2020xkj168); 安医大一附院2018年度国家自然科学基金青年科学基金培育计划项目--2型糖尿病患者皮肤晚期糖基化终末产物水平与糖尿病视网膜病变的关系(2018kj20)

Abstract

Abstract:

Background

Obesity may cause insulin resistance (IR), then leads to type 2 diabetes mellitus (T2DM), seriously affecting human health. Irisin is a newly discovered myokine produced by adipose and skeletal muscle tissues, which plays an important role in metabolic regulation. It is worth investigating what changes will occur in serum irisin levels in T2DM patients with overweight or obesity.

Objective

To examine the abnormality in serum irisin levels in overweight or obese patients with T2DM, and to explore the influencing factors.

Methods

A total of 119 patients with T2DM who were hospitalized in Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University from December 2019 to June 2021 were selected, including 78 with overweight or obesity and 41 with normal weight assessed by body mass index (BMI). They were compared to 52 healthy people with normal body weight in terms of general demographics, laboratory test indices and serum irisin level. Spearman rank correlation analysis was used to explore the correlation of serum irisin level with demographic and laboratory test indices. Multiple linear regression analysis was used to explore factors associated with the abnormality in serum irisin in overweight or obese T2DM patients.

Results

Normal-weight diabetics, overweight or obese diabetics and healthy controls had significant differences in levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA_1c), fasting blood glucose (FBG), fasting insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR) (P<0.05). The serum irisin level in normal-weight diabetics was lower than that in healthy controls (P<0.05). Overweight or obese diabetics had lower serum irisin level than healthy controls or normal-weight diabetics (P<0.05). Spearman rank correlation analysis showed that serum irisin level was positively correlated with HDL-C (r_s=0.304, P<0.05), and negatively correlated with SBP, DBP, BMI, TG, HbA_1c, FBG, FINS, and HOMA-IR (r_s=-0.271, -0.420, -0.372, -0.164, -0.418, -0.348, -0.293, -0.348, P<0.05). Multiple linear regression analysis showed that DBP 〔b=-0.049, P=0.011〕, HbA_1c〔b=-0.156, P=0.009〕, and FINS〔b=-0.21, P=0.038〕 were associated with the abnormality in serum irisin in overweight or obese T2DM patients.

Conclusion

T2DM patients, especially those who were overweight or obese, were found with lower serum irisin level, which was associated with BMI, blood pressure, blood lipids, blood glucose and IR.

Key words: Diabetes mellitus, type 2, Obesity, Overweight, Irisin, Insulin resistance, Root cause analysis

摘要：

背景

肥胖会导致胰岛素抵抗（IR）的发生进而引发2型糖尿病（T2DM），严重影响人类健康。鸢尾素（irisin）是一种新发现的肌肉和脂肪因子，在代谢调控中具有重要作用，T2DM合并超重肥胖患者的血清irisin水平会出现何种变化值得研究。

目的

观察T2DM超重肥胖患者血清irisin水平情况，并探讨血清irisin水平变化的影响因素。

方法

选取2019年12月至2021年6月于安徽医科大学第一附属医院内分泌科住院治疗的T2DM患者119例，根据体质指数（BMI）分为糖尿病超重肥胖组（n=78）和糖尿病体质量正常组（n=41）。另选取同期于本院体检且BMI正常的健康者为对照组（n=52）。比较三组受试者一般资料、实验室检查指标及血清irisin水平，采用Spearman秩相关分析探究血清irisin水平与一般资料及实验室检查指标的相关性，采用多元线性回归分析探究血清irisin水平的影响因素。

结果

三组收缩压（SBP）、舒张压（DBP）、BMI、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、糖化血红蛋白（HbA_1c）、空腹血糖（FBG）、空腹胰岛素（FINS）、稳态胰岛素抵抗指数（HOMA-IR）比较，差异均有统计学意义（P<0.05）。糖尿病体质量正常组血清irisin水平低于对照组，糖尿病超重肥胖组血清irisin水平低于对照组、糖尿病体质量正常组（P<0.05）。Spearman秩相关分析结果显示，血清irisin水平与HDL-C呈正相关（r_s=0.304，P<0.05），与SBP、DBP、BMI、TG、HbA_1c、FBG、FINS、HOMA-IR呈负相关（r_s值分别为-0.271、-0.420、-0.372、-0.164、-0.418、-0.348、-0.293、-0.348，P<0.05）。多元线性回归分析结果显示，DBP〔b=-0.049，P=0.011〕、HbA_1c〔b=-0.156，P=0.009〕、FINS〔b=-0.21，P=0.038〕是血清irisin水平的影响因素。

结论

T2DM患者血清irisin水平较健康者明显降低，尤其是合并超重肥胖患者，且血清irisin水平与血压、BMI、血脂、血糖及IR等因素存在一定关系。

关键词: 糖尿病, 2型, 肥胖, 超重, 鸢尾素, 胰岛素抵抗, 影响因素分析

ZHANG Nan,JIANG Tian,ZHANG Yi, et al. Abnormal Change of Serum Irisin Level in Overweight or Obese Patients with Type 2 Diabetes Mellitus[J]. Chinese General Practice, 2022, 25(32): 4041-4045. DOI: 10.12114/j.issn.1007-9572.2022.0491.
张楠,姜天,张一等. 2型糖尿病合并超重肥胖患者血清Irisin水平变化研究[J]. 中国全科医学, 2022, 25(32): 4041-4045. DOI: 10.12114/j.issn.1007-9572.2022.0491.

Figures/Tables 3

References 31

[1]	KURIOKA S，MURAKAMI Y，NISHIKI M，et al. Relationship between visceral fat accumulation and anti-lipolytic action of insulin in patients with type 2 diabetes mellitus[J]. Endocr J，2002，49（4）：459-464. DOI：10.1507/endocrj.49.459.
[2]	Riobó Serván P. Obesity and diabetes[J]. Nutr Hosp，2013，28（Suppl 5）：138-143. DOI：10.3305/nh.2013.28.sup5.6929.
[3]	MORENO-NAVARRETE J M，ORTEGA F，SERRANO M，et al. Irisin is expressed and produced by human muscle and adipose tissue in association with obesity and insulin resistance[J]. J Clin Endocrinol Metab，2013，98（4）：E769-778. DOI：10.1210/jc.2012-2749.
[4]	钱荣立. 关于糖尿病的新诊断标准与分型[J]. 中国糖尿病杂志，2000，8（1）：90-91，78.
[5]	中国肥胖问题工作组. 中国成人超重和肥胖症预防与控制指南（节录）[J]. 营养学报，2004，26（1）：1-4.
[6]	LUO Y Y，QIAO X Y，XU L Z，et al. Irisin：circulating levels in serum and its relation to gonadal axis[J]. Endocrine，2022，75（3）：663-671. DOI：10.1007/s12020-022-02981-5.
[7]	CHOI Y K，KIM M K，BAE K H，et al. Serum irisin levels in new-onset type 2 diabetes[J]. Diabetes Res Clin Pract，2013，100（1）：96-101. DOI：10.1016/j.diabres.2013.01.007.
[8]	LIU J J，WONG M D，TOY W C，et al. Lower circulating irisin is associated with type 2 diabetes mellitus[J]. J Diabetes Complications，2013，27（4）：365-369. DOI：10.1016/j.jdiacomp.2013.03.002.
[9]	HU J，KE Y N，WU F P，et al. Circulating Iris inLevels in patients with nonalcoholic fatty liver disease：a systematic review and meta-analysis[J]. Gastroenterol Res Pract，2020，2020：8818191. DOI：10.1155/2020/8818191.
[10]	POLYZOS S A，ANASTASILAKIS A D，EFSTATHIADOU Z A，et al. Irisin in metabolic diseases[J]. Endocrine，2018，59（2）：260-274. DOI：10.1007/s12020-017-1476-1.
[11]	MOOTHA V K，LINDGREN C M，ERIKSSON K F，et al. PGC-1alpha-responsive genes involved in oxidative phosphorylation are coordinately downregulated in human diabetes[J]. Nat Genet，2003，34（3）：267-273. DOI：10.1038/ng1180.
[12]	BOSTRÖM P，WU J，JEDRYCHOWSKI M P，et al. A PGC1-α-dependent myokine that drives brown-fat-like development of white fat and thermogenesis[J]. Nature，2012，481（7382）：463-468. DOI：10.1038/nature10777.
[13]	VILLARROYA F. Irisin，turning up the heat[J]. Cell Metab，2012，15（3）：277-278. DOI：10.1016/j.cmet.2012.02.010.
[14]	VAN MARKEN LICHTENBELT W D，VANHOMMERIG J W，SMULDERS N M，et al. Cold-activated brown adipose tissue in healthy men[J]. N Engl J Med，2009，360（15）：1500-1508. DOI：10.1056/NEJMoa0808718.
[15]	ZHANG Y，LI R，MENG Y，et al. Irisin stimulates browning of white adipocytes through mitogen-activated protein kinase p38 MAP kinase and ERK MAP kinase signaling[J]. Diabetes，2014，63（2）：514-525. DOI：10.2337/db13-1106.
[16]	HOFMANN T，ELBELT U，STENGEL A. Irisin as a muscle-derived hormone stimulating thermogenesis—a critical update[J]. Peptides，2014，54：89-100. DOI：10.1016/j.peptides.2014.01.016.
[17]	MACIORKOWSKA M，MUSIAIOWSKA D，MAIYSZKO J. Adropin and irisin in arterial hypertension，diabetes mellitus and chronic kidney disease[J]. Adv Clin Exp Med，2019，28（11）：1571-1575. DOI：10.17219/acem/104551.
[18]	HO M Y，WANG C Y. Role of Iris inin myocardial infarction，heart failure，and cardiac hypertrophy[J]. Cells，2021，10（8）：2103. DOI：10.3390/cells10082103.
[19]	SOUSA R，IMPROTA-CARIA A C，SOUZA B. Exercise-linked irisin：consequences on mental and cardiovascular health in type 2 diabetes[J]. Int J Mol Sci，2021，22（4）：2199. DOI：10.3390/ijms22042199.
[20]	TIMMONS J A，BAAR K，DAVIDSEN P K，et al. Is irisin a human exercise gene? [J]. Nature，2012，488（7413）：E9-10；discussionE10-1. DOI：10.1038/nature11364.
[21]	KURDIOVA T，BALAZ M，VICIAN M，et al. Effects of obesity，diabetes and exercise on Fndc5 gene expression and irisin release in human skeletal muscle and adipose tissue：in vivo and in vitro studies[J]. J Physiol，2014，592（5）：1091-1107. DOI：10.1113/jphysiol.2013.264655.
[22]	HUH J Y，PANAGIOTOU G，MOUGIOS V，et al. FNDC5 and irisin in humans：I. Predictors of circulating concentrations in serum and plasma and II. mRNA expression and circulating concentrations in response to weight loss and exercise[J]. Metabolism，2012，61（12）：1725-1738. DOI：10.1016/j.metabol.2012.09.002.
[23]	GAO S S，LI F M，LI H M，et al. Effects and molecular mechanism of GST-Iris inon lipolysis and autocrine function in 3T3-L1 adipocytes[J]. PLoS One，2016，11（1）：e0147480. DOI：10.1371/journal.pone.0147480.
[24]	GOUNI-BERTHOLD I，BERTHOLD H K，HUH J Y，et al. Effects of lipid-lowering drugs on irisin in human subjects in vivo and in human skeletal muscle cells ex vivo[J]. PLoS One，2013，8（9）：e72858. DOI：10.1371/journal.pone.0072858.
[25]	PERAKAKIS N，TRIANTAFYLLOU G A，FERNANDEZ-REAL J M，et al. Physiology and role of irisin in glucose homeostasis[J]. Nat Rev Endocrinol，2017，13（6）：324-337. DOI：10.1038/nrendo.2016.221.
[26]	张楠，姜天，孙莉，等. 2型糖尿病肥胖或超重患者血清成纤维细胞生长因子21水平及其临床价值研究[J]. 中国全科医学，2018，21（5）：521-525. DOI：10.3969/j.issn.1007-9572.2017.00.259.
[27]	ZHANG N，LIU C，ZHANG Y，et al. Liraglutide regulates lipid metabolism via FGF21- LKB1- AMPK-ACC1 pathway in white adipose tissues and macrophage of type 2 diabetic mice[J]. Biochem Biophys Res Commun，2021，548：120-126. DOI：10.1016/j.bbrc.2021.02.065.
[28]	EL-LEBEDY D H，IBRAHIM A A，ASHMAWY I O. Novel adipokines vaspin and irisin as risk biomarkers for cardiovascular diseases in type 2 diabetes mellitus[J]. Diabetes Metab Syndr，2018，12（5）：643-648. DOI：10.1016/j.dsx.2018.04.025.
[29]	CHEN N，LI Q X，LIU J，et al. Irisin，an exercise-induced myokine as a metabolic regulator：an updated narrative review[J]. Diabetes Metab Res Rev，2016，32（1）：51-59. DOI：10.1002/dmrr.2660.
[30]	HUH J Y，DINCER F，MESFUM E，et al. Irisin stimulates muscle growth-related genes and regulates adipocyte differentiation and metabolism in humans[J]. Int J Obes （Lond），2014，38（12）：1538-1544. DOI：10.1038/ijo.2014.42.
[31]	NORMAN D，DROTT C J，CARLSSON P O，et al. Irisin-A pancreatic islet hormone[J]. Biomedicines，2022，10（2）：258. DOI：10.3390/biomedicines10020258.

组别	例数	性别（男/女）	年龄（岁）	SBP（mm Hg）	DBP（mm Hg）	BMI〔M（P₂₅，P₇₅），kg/m²〕	TC（mmol/L）	TG〔M（P₂₅，P₇₅），mmol/L〕
对照组	52	29/23	47.6±10.4	121±13	74±9	22.2（21.1，23.2）	4.70±0.86	1.10（0.83，1.45）
糖尿病体质量正常组	41	26/15	48.1±13.7	125±15	82±9^a	22.3（2.2，23.2）	4.74±1.10	1.80（0.92，2.63）^a
糖尿病超重肥胖组	78	58/20	43.3±11.8	136±15^ab	88±9^ab	26.9（25.5，28.6）^ab	4.70±0.90	1.94（1.45，3.02）^ab
检验统计量值		4.982^c	3.020	18.333	43.422	121.981^d	0.030	37.065^d
P值		0.083	0.051	<0.001	<0.001	<0.001	0.970	<0.001
组别	HDL-C〔M（P₂₅，P₇₅），mmol/L〕	LDL-C〔M（P₂₅，P₇₅），mmol/L〕	HbA_1c（%）	FBG〔M（P₂₅，P₇₅），mmol/L〕	FINS〔M（P₂₅，P₇₅），mU/L〕	HOMA-IR〔M（P₂₅，P₇₅）〕
对照组	1.49（1.20，1.79）	2.73±0.78	5.27±0.32	5.3（5.0，5.6）	7.70（6.54，9.00）	1.77（1.55，2.16）
糖尿病体质量正常组	0.98（0.86，1.12）^a	2.96±1.02	11.22±2.13^a	7.5（6.4，9.1）^a	7.99（6.03，9.03）	2.54（2.00，3.64）^a
糖尿病超重肥胖组	0.91（0.77，1.06）^a	2.80±0.90	10.48±1.82^a	8.7（7.5，10.4）^a	13.89（10.03，18.84）^ab	5.26（3.95，8.00）^ab
检验统计量值	67.763^d	0.775	208.017	94.793^d	71.028^d	96.364^d
P值	<0.001	0.462	<0.001	<0.001	<0.001	<0.001

组别	例数	性别（男/女）	年龄（岁）	SBP（mm Hg）	DBP（mm Hg）	BMI〔M（P₂₅，P₇₅），kg/m²〕	TC（mmol/L）	TG〔M（P₂₅，P₇₅），mmol/L〕
对照组	52	29/23	47.6±10.4	121±13	74±9	22.2（21.1，23.2）	4.70±0.86	1.10（0.83，1.45）
糖尿病体质量正常组	41	26/15	48.1±13.7	125±15	82±9^a	22.3（2.2，23.2）	4.74±1.10	1.80（0.92，2.63）^a
糖尿病超重肥胖组	78	58/20	43.3±11.8	136±15^ab	88±9^ab	26.9（25.5，28.6）^ab	4.70±0.90	1.94（1.45，3.02）^ab
检验统计量值		4.982^c	3.020	18.333	43.422	121.981^d	0.030	37.065^d
P值		0.083	0.051	<0.001	<0.001	<0.001	0.970	<0.001
组别	HDL-C〔M（P₂₅，P₇₅），mmol/L〕	LDL-C〔M（P₂₅，P₇₅），mmol/L〕	HbA_1c（%）	FBG〔M（P₂₅，P₇₅），mmol/L〕	FINS〔M（P₂₅，P₇₅），mU/L〕	HOMA-IR〔M（P₂₅，P₇₅）〕
对照组	1.49（1.20，1.79）	2.73±0.78	5.27±0.32	5.3（5.0，5.6）	7.70（6.54，9.00）	1.77（1.55，2.16）
糖尿病体质量正常组	0.98（0.86，1.12）^a	2.96±1.02	11.22±2.13^a	7.5（6.4，9.1）^a	7.99（6.03，9.03）	2.54（2.00，3.64）^a
糖尿病超重肥胖组	0.91（0.77，1.06）^a	2.80±0.90	10.48±1.82^a	8.7（7.5，10.4）^a	13.89（10.03，18.84）^ab	5.26（3.95，8.00）^ab
检验统计量值	67.763^d	0.775	208.017	94.793^d	71.028^d	96.364^d
P值	<0.001	0.462	<0.001	<0.001	<0.001	<0.001

组别	例数	irisin
对照组	52	5.72（4.49，7.13）
糖尿病体质量正常组	41	4.46（3.91，4.76）^a
糖尿病超重肥胖组	78	2.92（1.70，4.47）^ab
H值		60.012
P值		<0.001

组别	例数	irisin
对照组	52	5.72（4.49，7.13）
糖尿病体质量正常组	41	4.46（3.91，4.76）^a
糖尿病超重肥胖组	78	2.92（1.70，4.47）^ab
H值		60.012
P值		<0.001

Abnormal Change of Serum Irisin Level in Overweight or Obese Patients with Type 2 Diabetes Mellitus

2型糖尿病合并超重肥胖患者血清Irisin水平变化研究

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项目	r_s值	P值	项目	r_s值	P值
年龄	0.126	0.101	HDL-C	0.304	<0.001
SBP	-0.271	<0.001	LDL-C	-0.005	0.947
DBP	-0.42	<0.001	HbA_1c	-0.418	<0.001
BMI	-0.372	<0.001	FBG	-0.348	<0.001
TC	0.002	0.975	FINS	-0.293	<0.001
TG	-0.164	0.032	HOMA-IR	-0.348	<0.001

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