Correlation Between Serum Wisp1 And Visceral Fat Area And Glycolipid Metabolism In Newly Diagnosed Type 2 Diabetes Mellitus

Objective: To determine the level of Wnt1-induced signaling pathway protein 1(Wisp1)in serum of newly diagnosed patients with Type 2 diabetes mellitus,T2DM),and to investigate the association with Visceral adipose tissue(VAT)area amd glycolipid metabolism.Methods: According to the 1999 WHO diabetes diagnostic criteria,110 patients(66 males,44 females)with type 2 diabetes WHO were admitted to the outpatient and inpatient departments of endocrinology and metabolic diseases of our hospital from June 2020 to January 2021 were included in this study.A total of 68 healthy subjects(34 males and 34females)with matched age and sex ratio were selected as the normal control group.According to the diagnostic criteria of abdominal obesity proposed by the Japan Obesity Research Association in 2002,visceral obesity(Ob)was defined as the visceral fat area(VAT≥100cm~2measured by dual-energy X-ray absorptiometry(DEXA).Namely of type2 diabetes with visceral obesity(T2DM-Ob)group(n=63),type 2diabetes non abdominal obesity(T2DM-NonOb)group(n=47),normal glucose tolerance abdominal obesity(NGT-Ob)group(n=25),normal glucose tolerance non abdominal obesity(NGT-NonOb)group(n=43).All the subjects with uniform questionnaire form data measurement and questionnaire survey;basic data including height,weight,waist circumference(WC),hip circumference(HC),blood pressure,age,weight,and previous medical history were collected and descriptive analysis was conducted.Fasting venous blood was collected from all subjects in the morning for the detection of fasting blood glucose(FPG),fasting insulin(Fins),glycated hemoglobin(Hb Alc),Glutamic acid decarboxylase antibody(GADA)antibodytotal cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),blood urea nitrogen(BUN),blood uric acid(UA),C-reactive protein(CRP);body mass index(BMI),waist-hip ratio(WHR)and homeostasis model were calculated to evaluate insulin resistance index(HOMA-IR).Serum levels of WISP1 and Adiponectin(ADPN)were determined by enzymy-linked immunosorbent assay(ELISA).Blood line on all subjects after oral glucose tolerance experiment(OGTT),the detection of sugar load 2 hours blood glucose(2h-PG)and insulin after 2 hours(2h-Ins).The area of visceral fat was measured using DEXA.SPSS22.0 software was used for statistical analysis of the above experimental data.Results:1.Comparison of clinical characteristics and metabolic indexes among the four groups:(1)There were no statistically significant differences in age,sex,blood pressure,WHR,liver and kidney function(AST,ALT,BUN,Cr,UA)among all subjects(P > 0.05).(2)Compared with T2DM-NonOb group,WC,HC,BMI,VAT,TG,TC,LDL-C in T2DM-Ob group were significantly increased,while HDL-C was significantly decreased(P<0.05);Compared with NGT-NonOb group,the WC,HC,BMI,VAT,TG,TC and LDL-C of NGT-Ob group were significantly increased,while the HDL-C was significantly decreased(P<0.05).(3)Compared with NGT-Ob group,FPG,2H-PG,Fins,2H-Ins,HOMA-IR and Hb Alc were significantly increased in T2DM-Ob group(P<0.05);Compared with NGT-NonOb group,FPG,2H-PG,Fins,2H-Ins,HOMA-IR and Hb Alc of T2DM-NonOb group were also significantly increased(P<0.05).2.Comparison of Wisp1,ADPN and CRP levels among the four groups:(1)There was no significant difference in CRP levels among the T2DM-Ob group,T2DM-NonOb group,NGT-Ob group and NGT-NonOb group(P > 0.05).(2)Compared with T2DM-NonOb group,serum Wisp1 level was significantly increased and ADPN concentration was significantly decreased in T2DM-Ob group(P<0.01).The level of serum Wisp1 in T2DM-Ob group and T2DM-NonOb group were higher than that of NGT-NonOb group,but there were no statistical difference(P>0.05).Compared with NGT-Ob group,ADPN concentration in T2DM-Ob group was significantly decreased(15.90±3.5ng/mlvs17.91± 3.37 ng /ml(P<0.01)).3.Correlation between serum Wisp1 and various clinical and biochemical indexes:In all subjects,serum Wisp1 was positively correlated with TC,TG,LDL-C,VAT,BMI,WC,CRP,HOMA-IR,and negatively correlated with ADPN(P<0.01);In newly diagnosed T2 DM patients,serum Wisp1 was positively correlated with the levels of TC,TG,LDL-C,VAT,and BMI,and negatively correlated with ADPN(P<0.01).4.In newly diagnosed T2 DM patients,using serum Wisp1 as the dependent variable,and using BMI,VAT,CRP,TG,TC,LDL-C,Fins,HOMA-IR as independent variables,the multiple regression analysis showed that BMI,VAT,and ADPN were independent related factors for Wisp1(P<0.05).Logistic regression analysis showed that serum Wisp1 was an independent risk factor for visceral obesity(VAT≥100cm2)in newly diagnosed T2 DM patients(P<0.05).5.The optimal cutoff value of WISP1 for predicting visceral obesity in newly diagnosed T2 DM patients was 307.62pg/ml,and the area under the receiver operating curve(AUC)was 0.666(P=0.333),the sensitivity was 44.4% and the specificity was 83%.The best cut-off value of visceral obesity in ADPN newly diagnosed T2 DM patients was 16.68ng/ml,and the AUC was 0.831(P<0.001),the sensitivity was 69.8%,and the specificity was 87.2%.AUC of WISP1 combined with ADPN was 0.857(P<0.001),the sensitivity was 79.4% and the specificity was 78.7%.Conclusions:1.Serum WISP1 levels were significantly increased in newly diagnosed type 2 diabetes and visceral obesity patients.2.Wisp1 is closely related to blood lipid,BMI,VAT and ADPN,and is an independent risk factor for VAT.Serum Wisp1 may be involved in the occurrence and development of T2 DM and abdominal obesity.3.In newly diagnosed type 2 diabetes patients,ADPN combined with WISP1 is better in the diagnosis of visceral obesity than either alone.