| Background:Diabetes mellitus(DM)is a complicated disease which is affected and involved by many environmental factors and various genetic factors,among which T2 DM accounts for more than 90%.Low concentration of inflammatory state and insulin resistance(IR)are the main causes of T2 DM.Chronic complications of cardiovascular and cerebrovascular diseases,eyes,nerves,kidneys and other organs caused by T2 DM pose a serious threat to human health and become one of the chronic diseases affecting the health of global residents.However,the pathogenesis of T2 DM has not been fully clarified,and obesity is a risk factor for T2 DM.Studies have found that lipopolysaccharide-binding protein(LBP)is elevated in T2 DM patients and obese patients,which is correlated with IR.Therefore,further exploration of the association between serum LBP and T2 DM will provide a new idea for the treatment of T2 DM.It is well known that chronic inflammatory state and IR are two important links in the occurrence and development of T2 DM,and obesity is closely related to them.LBP plays an important role not only in a variety of acute inflammatory diseases,but also in chronic metabolic diseases such as T2 DM.On the one hand,LBP can be used as a more accurate inflammatory response indicator than C-reactive protein(CRP),Tumor necrosis factor-α(TNF-α),Interleukin-6(IL-6),and participate in the diagnosis of inflammatory response such as pneumonia;on the other hand,LBP,as a new adipocytokine,is involved in lipid transport.LBP may be involved in the occurrence of T2 DM both in terms of structure and function,but LBP has not been widely used in the clinical practice of T2 DM.This study mainly explores whether LBP has differential expression in serum of T2 DM patients and healthy people,as well as its correlation with IR and obesity,so as to provide theoretical support for the early screening,diagnosis and treatment of T2 DM.Objective: To explore the relationship between serum LBP level and IR in newly diagnosed patients with T2 DM,and to provide a new clinical idea for the screening,diagnosis and treatment,and disease assessment of T2 DM mainly with IR.Methods: In this study,a case-control study was used to collect 57 patients in the T2 DM group who met the inclusion criteria and exclusion criteria,15 patients in the control group,35 patients in the T2 DM group with abdominal obesity,and 22 patients with non-abdominal obesity.Recording the basic information such as the age,sex,abdominal girth,body mass index(BMI),collecting the Clinical biochemical index such as the fasting plasma glucose(FPG),glucose tolerance test(OGTT)2 hours blood glucose(2HPG),fasting insulin(FINS),fasting C peptide,glycosylated hemoglobin(Hb A1C),total cholesterol(CHOL),triglyceride(TG),low density lipoprotein(LDL),high-density lipoprotein(HDL),and calculating the insulin resistance index(HOME-IR),the steady-state model evaluation of islet beta cell function index(HOME-beta).Blood serum of all subjects were collected and LBP concentration in each group was determined by ELISA.SPSS 26.0 and Graph Pad Prism 9.0 statistical software were used to analyze and plot the data.Results:.1.In diabetic group,abdominal girth,BMI,FPG,2HPG,FINS,Hb A1 c,CHOL,Home-IR,LBP were higher than those in control group,while Home-β were lower than those in control group,the difference was statistically significant(P<0.05),and there was no statistical significance in age,sex,C-peptide,TG,LDL,HDL(P>0.05).2.In the diabetic group,abdominal girth,BMI,FPG,fasting C-peptide,Hb A1 c,Home-IR,LBP in the abdominal obesity group were higher than those in the non-abdominal obesity group,and the differences were statistically significant(P<0.05),there was no significant difference in 2h PG,FINS,CHOL,TG,LDL,HDL,Home-β(P>0.05).3.The serum LBP level of the subjects showed that the serum LBP expression level of the T2 DM group was higher than the healthy control group,and it was 1.21 times the normal,the mean difference was 10.85,the difference was statistically significant(P<0.05).In the T2 DM group,the serum LBP expression level in the abdominal obesity group was higher than the non-abdominal obesity group,and it was 1.14 times the non-abdominal obesity group,the mean difference was 8.09,the difference was statistically significant(P<0.05).4.Correlation analysis showed that serum LBP expression level was significantly positively correlated with abdominal girth,BMI,FINS,fasting C-peptide,TG,Home-IR,Home-β(r=0.438,0.477,0.77,0.741,0.269,0.59,0.363,P<0.05),was negatively correlated with HDL(r=-0.299,P<0.05),and had no correlation with age,FPG,2HPG,Hb A1 c,CHOL and LDL(P>0.05).5.Multiple linear regression analysis showed an independent correlation between FINS,C-peptide,Home-IR and LBP(P=0.018,0.013,0.000,P<0.05).Conclusion: The level of serum LBP increased in newly diagnosed T2 DM patients,especially in patients with abdominal obesity.LBP is an independent risk factor for IR.LBP may be used for the assessment of IR degree in T2 DM patients,but LBP cannot be used to reflect blood glucose status and recent blood glucose control status in T2 DM patients. |
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