摘要
目的 探讨血清白脂素(Asprosin)水平在 2 型糖尿病合并骨质疏松(type 2 diabetic osteoporosis,T2DOP)患者中的变化情况,及其与Toll样受体 4/c-Jun氨基末端蛋白激酶/白细胞介素 1β(TLR4/JNK/IL-1β)炎症信号通路的关系.方法 选取2020 年 1 月至 2023 年 1 月在黄冈市中心医院就诊的 123 例 2 型糖尿病(type 2 diabetes mellitus,T2DM)患者,根据骨密度(bone mineral density,BMD)计算出的T值分为 3 组.采用酶联免疫吸附试验(ELISA)检测 3 组患者血清Asprosin、骨钙素(OC)、骨源性碱性磷酸酶(BALP)、Ⅰ型原胶原N-端前肽(P1NP)、TLR4、p-JNK/JNK和IL-1β的表达水平;利用Pearson相关系数分析Asprosin与TLR4、p-JNK/JNK、IL-1β及BMD、OC、BALP的相关性;利用多因素Logistic回归分析Asprosin对T2DOP的风险性;并采用受试者工作特征(ROC)曲线判断Asprosin对T2DOP的诊断价值.结果 3 组患者血清Asprosin水平差异明显(P＜0.05).血清 Asprosin 水平与 TLR4、p-JNK/JNK、IL-1β 呈正相关(P＜0.05),与 BMD、OC、BALP 呈显著负相关(P＜0.001).多因素Logistic回归分析显示,血清Asprosin水平升高是诱发T2DOP的危险因素(P＜0.05).ROC曲线分析显示,血清Asprosin截断值 230.5 ng/mL对预测T2DOP具有良好的灵敏度(80.43%)和特异性(85.00%),曲线下面积(AUC)为0.844(95%CI:0.818～0.959,P＜0.001).结论 血清Asprosin水平在T2DOP 患者中显著升高,且与BMD、OC和BALP 呈负相关,是T2DOP的危险因素,对预测T2DOP具有良好的诊断价值,并可能通过激活TLR4/JNK/IL-1β信号通路,促进T2DOP的发生发展.
Abstract
Objective To investigate the changes of asprosin level in patients with type 2 diabetes mellitus complicated with osteoporosis(T2DOP)and its relationship with toll-like receptor 4/c-Jun N-terminal protein kainse/interleukin1β(TLR4/JNK/IL-1β)inflammatory signaling pathway.Methods A total of 123 T2DM patients admitted to Huanggang Central Hospital from January 2020 to January 2023 were selected and divided into three groups according to the T value calculated based on bone mineral density(BMD).Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of serum asprosin,osteocalcin(OC),bone-derived alkaline phosphatase(BALP),type Ⅰ procollagen N-terminal propeptide(P1NP),TLR4,p-JNK/JNK,and IL-1β in the three groups.Pearson correlation coefficient was used to analyze the correlation between asprosin and TLR4,p-JNK/JNK,IL-1β,BMD,OC,and BALP.Multivariate logistic regression was used to analyze the risk of asprosin for T2DOP.Receiver operating characteristic(ROC)curve was used to determine the diagnostic value of asprosin for T2DOP.Results There were significant differences in serum asprosin levels among the three groups(P＜0.05).Serum asprosin level was positively correlated with TLR4,p-JNK/JNK,and IL-1β(P＜0.05),but negatively correlated with BMD,OC,and BALP(P＜0.001).Multivariate logistic regression analysis showed that increased serum asprosin level was a risk factor for inducing T2DOP(P＜0.05).ROC curve analysis showed that serum asprosin cut-off value of 230.5 ng/mL had good sensitivity(80.43%)and specificity(85.00%)for T2DOP prediction.Area under the curve,AUC,was 0.844(95%CI:0.818-0.959,P＜0.001).Conclusion Serum asprosin level is significantly increased in T2DOP patients,and is negatively correlated with BMD,OC,and BALP.Asprosin level is a risk factor for T2DOP.It has good diagnostic value in predicting T2DOP.It may promote the occurrence and development of T2DOP by activating the TLR4/JNK/IL-1β signaling pathway.
NETL
NSTL
维普
万方数据