目的:乙酰糖蛋白(GlycA)是全身性炎症和心血管疾病的生物标志物,然而,对其在1型糖尿病(T1D)中的作用知之甚少。我们检查了GlycA之间的关联,中心性肥胖,胰岛素抵抗,和T1D青年早期肾损伤。
方法:通过碘海醇和对氨基马尿酸盐清除率,肾小球滤过率(GFR)和肾血浆流量(RPF),尿白蛋白与肌酐比值(UACR),DXA的中心肥胖,在50名患有T1D的年轻人中评估了估计的胰岛素敏感性(16±3.0岁,50%女性,HbA1c8.7±1.3%,T1D持续时间5.7±2.6年)。通过靶向核磁共振波谱对GlycA的浓度进行定量。进行相关性和多元线性回归分析。
结果:GlycA在女孩中高于女孩男孩(1.05±0.26vs.0.84±0.15mmol/L,p=0.001)和超重/肥胖的参与者正常体重(1.12±0.23vs.0.87±0.20mmol/L,p=0.0004)。GlycA与估计的肾小球内压呈正相关(r=0.52,p=0.001),UACR(r=0.53,p<0.0001)和躯干质量(r=0.45,p=0.001),与估计的胰岛素敏感性成反比(r:-0.36,p=0.01)。调整年龄后,所有关系都保持显著,性别,和HbA1c。
结论:GlycA,炎症的生物标志物,在T1D中,女孩和超重或肥胖体质的女孩更高。此外,GlycA与早期肾功能不全的参数相关,中心性肥胖,和胰岛素抵抗。
OBJECTIVE: Glycoprotein acetyls (GlycA\'s) are biomarkers of systemic inflammation and cardiovascular disease, yet little is known about their role in type 1 diabetes (T1D). In this study we examined the associations among GlycA\'s, central adiposity, insulin resistance, and early kidney injury in youth with T1D.
METHODS: Glomerular filtration rate and renal plasma flow by iohexol and p-aminohippurate clearance, urine albumin-to-creatinine ratio (UACR), central adiposity by dual-energy x-ray absorptiometry, and estimated insulin sensitivity were assessed in 50 youth with T1D (16±3.0 years of age, 50% female, glycated hemoglobin 8.7%±1.3%, T1D duration 5.7±2.6 years). Concentrations of GlycA were quantified by targeted nuclear magnetic resonance spectroscopy. Correlation and multivariable linear regression analyses were performed.
RESULTS: GlycA\'s were higher in girls vs boys (1.05±0.26 vs 0.84±0.15 mmol/L, p=0.001) and in participants living with overweight/obesity vs normal weight (1.12±0.23 vs 0.87±0.20 mmol/L, p=0.0004). GlycA\'s correlated positively with estimated intraglomerular pressure (r=0.52, p=0.001), UACR (r=0.53, p<0.0001), and trunk mass (r=0.45, p=0.001), and inversely with estimated insulin sensitivity (r=-0.36, p=0.01). All relationships remained significant after adjustment for age, sex, and glycated hemoglobin.
CONCLUSIONS: As biomarkers of inflammation, GlycA\'s were higher in girls and those with overweight or obese body habitus in T1D. GlycA\'s associated with parameters of early kidney dysfunction, central adiposity, and insulin resistance.