代谢综合征患者糖脂代谢和血尿酸水平对血清甲胎蛋白浓度的影响

李若青; 毛梅; 崔元廷; 蒋宜; 谢勤丽; 杨巧; 周敏; 唐渝平

doi:10.16766/j.cnki.issn.1674-4152.001824

代谢综合征患者糖脂代谢和血尿酸水平对血清甲胎蛋白浓度的影响

doi: 10.16766/j.cnki.issn.1674-4152.001824

李若青¹,
毛梅²,
崔元廷³,
蒋宜¹,
谢勤丽¹,
杨巧¹,
周敏¹,
唐渝平^1, ,

1.
重庆大学附属中心医院重庆市急救医疗中心全科医学科, 重庆 400014
2.
陆军第九五八医院全科医学科, 重庆 400020
3.
陆军军医大学第一附属医院心血管内科, 重庆 400038

基金项目:

国家自然科学基金青年基金项目 81900761

重庆市科卫联合医学科研项目 2020FYYX077

详细信息

通讯作者:
唐渝平，E-mail：tangyuping103@126.com

中图分类号: R589 R446
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- 文章访问数: 150
- HTML全文浏览量: 146
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2020-08-12
- 网络出版日期: 2022-02-19

Effects of glycolipid metabolism and blood uric acid level on serum alpha-fetoprotein concentration in patients with metabolic syndrome

1.
Department of General Medicine, Central Hospital of Chongqing University Chongqing Emergency Medical Center, Chongqing 400014, China

摘要

摘要: 目的研究代谢综合征(MS)患者的代谢参数与血清甲胎蛋白(AFP)浓度之间的关系, 明确代谢参数对AFP的影响, 为MS患者肿瘤防治提供参考。方法收集2017年6月—2020年6月在重庆大学附属中心医院住院的415例MS患者和参与体检的227例非MS人群的一般资料, 测量腹围、收缩压、舒张压、AFP、空腹血糖(FBS)、糖化血红蛋白(HbA1c)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、尿素氮(BUN)、血肌酐(Cr)、血尿酸(UA)、β2-微球蛋白、胱抑素-C等指标浓度, 比较MS患者与非MS人群上述参数的差异, 比较MS患者不同AFP浓度时各参数的差异, 分析MS患者AFP与各参数的相关性。结果 MS组血清AFP浓度显著高于非MS组(P＜0.001);MS患者的FBS、HbA1c、TC、LDL、UA高时, 血清AFP浓度对应处于高浓度水平(均P＜0.001), 且分别呈显著正相关(均P＜0.001);FBS(β'=0.460, P＜0.001)、HbA1c(β'=0.212, P＜0.001)、UA(β'=0.348, P＜0.001)与血清AFP浓度具有独立相关性。结论 MS患者糖脂代谢和血尿酸水平可能影响血清AFP浓度, 糖代谢和血尿酸异常时这种影响更为显著。
- 代谢综合征 /
- 糖代谢 /
- 血脂 /
- 尿酸 /
- 甲胎蛋白
Abstract: Objective To study the relationship between metabolic parameters and serum alpha-fetoprotein (AFP) of patients with metabolic syndrome (MS) and to clarify the influence of metabolic parameters on AFP, in order to provide reference for MS patients in cancer prevention and treatment. Methods General information of 415 MS patients and 227 non-MS people who participated in physical examination at Central Hospital of Chongqing University from June 2017 to June 2020 were collected. Abdominal circumference, systolic blood pressure, diastolic blood pressure, AFP, fasting blood glucose (FBS), glycated hemoglobin (HbA1c), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), urea nitrogen (BUN), serum creatinine (Cr), blood uric acid (UA), β2-microglobulin and cystatin-C were measured. Differences in the above parameters between patients with MS and non-MS were compared. The parameters of different AFP concentrations in MS patients were compared and the relationship between AFP and parameters in patients with MS were analyzed. Results The serum AFP concentration in the MS group was significantly higher than that in the non-MS group (P < 0.001). When the FBS, HbA1c, TC, LDL, and UA of MS patients were high, the serum AFP concentration matched corresponds to the high concentration level (P < 0.001), showing a significant positive correlation (P < 0.001). FBS (β'=0.460, P < 0.001), HbA1c (β'=0.212, P < 0.001), UA (β'=0.348, P < 0.001) were independently correlated with serum AFP concentrations. Conclusion Glycolipid metabolism and blood uric acid levels in MS patients may affect serum AFP concentration, and this influence was more significant when glucose metabolism and blood uric acid were abnormal.
- Metabolic syndrome /
- Glycometabolism /
- Blood lipid /
- Uric acid /
- Alpha fetoprotein

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表 1 MS组与非MS对照组的一般资料、AFP及各代谢指标比较(x ±s)

组别	例数	性别(男/女，例)	年龄(岁)	腹围(cm)	收缩压(mm Hg)	舒张压(mm Hg)	FBS(mmol/L)	HbA1c(%)	ALT(U/L)	AST(U/L)	TC(mmol/L)
MS组	415	210/205	67±11	95±15	138±21	79±14	7.69±1.29	6.2±0.9	37±22	35±21	4.50±1.53
非MS对照组	227	109/118	68±12	79±12	117±18	76±15	6.37±1.18	5.5±0.7	22±16	26±18	4.18±1.62
统计值		0.392^a	-0.783^b	22.741^b	20.537^b	5.168^b	20.927^b	16.108^b	13.918^b	9.452^b	4.275^b
P值		0.531	0.434	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

组别	例数	TG(mmol/L)	HDL(mmol/L)	LDL(mmol/L)	BUN(mmol/L)	Cr(μmol/L)	UA(μmol/L)	β2-微球蛋白(mg/L)	胱抑素-C(mg/L)	AFP(IU/mL)
MS组	415	2.35±1.78	1.43±0.63	2.26±0.87	6.00±2.88	75.7±34.1	327.6±122.0	2.45±1.69	1.32±0.65	3.10±1.59
非MS对照组	227	1.49±2.25	1.68±0.71	2.09±0.73	4.66±2.95	69.8±31.5	286.1±137.5	2.08±1.39	1.07±0.53	2.21±1.28
统计值		9.776^b	-7.846^b	3.922^b	9.498^b	3.494^b	6.937^b	4.444^b	7.977^b	11.416^b
P值		＜0.001	＜0.001	＜0.001	＜0.001	0.001	＜0.001	＜0.001	＜0.001	＜0.001
注：^a为χ²值，^b为t值；1 mm Hg=0.133 kPa。

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表 2 MS患者不同血清AFP浓度组间各指标比较(x ±s)

组别	年龄(岁)	腹围(cm)	收缩压(mm Hg)	舒张压(mm Hg)	FBS(mmol/L)	HbA1c(%)	ALT(U/L)	AST(U/L)	TC(mmol/L)
Q1	66±13	94±13	137±20	75±15	6.71±0.73	5.6±0.7	35±24	33±20	4.02±1.49
Q2	67±10	96±16	135±17	79±10	7.19±0.89	5.8±0.4	37±23	39±24	4.33±1.48
Q3	68±10	95±14	136±21	81±12	7.83±1.26	6.4±0.6	39±22	34±19	4.58±1.62
Q4	69±12	95±15	142±22	82±16	8.99±1.28	7.0±0.8	38±22	38±21	5.06±1.36
F值	1.103	0.367	2.458	5.445	109.247	86.728	0.621	2.250	9.074
P值	0.347	0.777	0.062	0.001	＜0.001	＜0.001	0.602	0.082	＜0.001

组别	TG(mmol/L)	HDL(mmol/L)	LDL(mmol/L)	BUN(mmol/L)	Cr(μmol/L)	UA(μmol/L)	β2-微球蛋白(mg/L)	胱抑素-C(mg/L)
Q1	2.03±1.52	1.41±0.66	1.99±0.69	6.32±2.56	74.5±24.9	246.7±93.7	2.49±1.55	1.23±0.58
Q2	2.21±1.54	1.42±0.52	2.18±0.75	5.94±3.89	76.8±39.5	260.8±62.3	2.68±2.50	1.38±0.72
Q3	2.86±12.44	1.41±0.57	2.29±0.97	5.48±1.81	66.6±21.6	326.2±55.8	2.12±0.95	1.29±0.63
Q4	2.28±1.59	1.52±0.76	2.57±0.95	6.28±3.42	84.8±43.3	475.4±105.5	2.52±1.36	1.39±0.64
F值	4.291	0.759	8.535	1.920	5.184	169.246	2.029	1.500
P值	0.005	0.518	＜0.001	0.126	0.002	＜0.001	0.109	0.214

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表 3 AFP与各参数之间的Pearson相关性分析

统计量	年龄	腹围	收缩压	舒张压	FBS	HbA1c	ALT	AST
r值	-0.078	0.010	0.121	0.167	0.750	0.624	0.016	0.071
P值	0.057	0.418	0.007	＜0.001	＜0.001	＜0.001	0.376	0.074

统计量	TC	TG	HDL	LDL	BUN	Cr	UA	β2-微球蛋白	胱抑素-C
r值	0.274	0.034	0.056	0.268	0.021	0.121	0.756	-0.039	0.055
P值	＜0.001	0.245	0.127	＜0.001	0.335	0.007	＜0.001	0.217	0.132

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表 4 影响血清AFP浓度的多因素线性回归分析

变量	β	SE	β'	t值	P值
常量	-5.883	0.433		-13.467	＜0.001
收缩压	-0.003	0.002	-0.044	-1.479	0.140
舒张压	0.011	0.003	0.090	3.043	0.002
FBS	0.570	0.036	0.460	16.021	＜0.001
HbA1c	0.392	0.057	0.212	6.924	＜0.001
TC	0.038	0.041	0.037	0.943	0.346
LDL	0.121	0.071	0.067	1.709	0.088
Cr	0.002	0.001	0.049	1.989	0.047
UA	0.005	0.001	0.348	9.916	＜0.001

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参考文献(19)

[1]	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志, 2018, 10(1): 4-67. doi: 10.3760/cma.j.issn.1674-5809.2018.01.003
[2]	LU J, WANG L, LI M, et al. Metabolic syndrome among adults in China: The 2010 China noncommunicable disease surveillance[J]. J Clin Endocrinol Metab, 2017, 102(2): 507-515. http://www.onacademic.com/detail/journal_1000039743271610_c2c5.html
[3]	ABENAVOLI L, BOCCUTO L. New serum markers for detection of early hepatocellular carcinoma[J]. Panminerva Med, 2017, 59(4): 281-282. http://europepmc.org/abstract/MED/28714299
[4]	CHEN Y, ZHAO Y, FENG L, et al. Association between alpha-fetoprotein and metabolic syndrome in a Chinese asymptomatic population: a cross-sectional study[J]. Lipids Health Dis, 2016, 15: 85. doi: 10.1186/s12944-016-0256-x
[5]	SIMON T G, KING L Y, CHONG D Q, et al. Diabetes, metabolic comorbidities, and risk of hepatocellular carcinoma: Results from two prospective cohort studies[J]. Hepatology, 2018, 67(5): 1797-1806. doi: 10.1002/hep.29660
[6]	FERLAY J, SOERJOMATARAM I, DIKSHIT R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012[J]. Int J Cancer, 2015, 136(5): E359-E386. doi: 10.1002/ijc.29210
[7]	GALLE P R, FOERSTER F, KUDO M, et al. Biology and significance of alpha-fetoprotein in hepatocellular carcinoma[J]. Liver Int, 2019, 39(12): 2214-2229. doi: 10.1111/liv.14223
[8]	QIANG G, ZHANG L, YANG X, et al. Effect of valsartan on the pathological progression of hepatic fibrosis in rats with type 2 diabetes[J]. Eur J Pharmacol, 2012, 685(1-3): 156-164. doi: 10.1016/j.ejphar.2012.04.028
[9]	TSAMANDAS A C, ANTONACOPOULOU A, KALOGEROPOULOU C, et al. Oval cell proliferation in cirrhosis in rats. An experimental study[J]. Hepatol Res, 2007, 37(9): 755-764. doi: 10.1111/j.1872-034X.2007.00124.x
[10]	TING Y W, WONG S W, ANUAR ZAINI A, et al. Metabolic syndrome is associated with advanced liver fibrosis among pediatric patients with non-alcoholic fatty liver disease[J]. Front Pediatr, 2019, 7: 491. doi: 10.3389/fped.2019.00491
[11]	PATEL B M, GOYAL R K. Liver and insulin resistance: new wine in old bottle!!![J]. Eur J Pharmacol, 2019, 862: 172657. doi: 10.1016/j.ejphar.2019.172657
[12]	SERRADILLA MARTIN M, OLIVER GUILLEN J R, PALOMARES CANO A, et al. Metabolic syndrome, non-alcoholic fatty liver disease and hepatocarcinoma[J]. Rev Esp Enferm Dig, 2020, 112(2): 133-138.
[13]	SINGH A, AMIN H, GARG R, et al. Increased prevalence of obesity and metabolic syndrome in patients with alcoholic fatty liver disease[J]. Dig Dis Sci, 2020, 65(11): 3341-3349, doi: 10.1007/s10620-020-06056-1
[14]	MA Z, ZHANG J, KANG X, et al. Hyperuricemia precedes non-alcoholic fatty liver disease with abdominal obesity moderating this unidirectional relationship: Three longitudinal analyses[J]. Atherosclerosis, 2020, 311: 44-51. doi: 10.1016/j.atherosclerosis.2020.08.006
[15]	HUANG Q, YU J, ZHANG X, et al. Association of the serum uric acid level with liver histology in biopsy-proven non-alcoholic fatty liver disease[J]. Biomed Rep, 2016, 5(2): 188-192. doi: 10.3892/br.2016.698
[16]	LIU N, SUN Q, XU H, et al. Hyperuricemia induces lipid disturbances mediated by LPCAT3 upregulation in the liver[J]. FASEB J, 2020, 34(10): 13474-13493. doi: 10.1096/fj.202000950R
[17]	GOLMOHAMMADI S, TAVASOLI M, ASADI N. Prevalence and risk factors of hyperuricemia in patients with chronic kidney disease and non-alcoholic fatty liver[J]. Clin Exp Gastroenterol, 2020, 13: 299-304. doi: 10.2147/CEG.S253619
[18]	ZHAO T V, LI Y, LIU X, et al. ATP release drives heightened immune responses associated with hypertension[J]. Sci Immunol, 2019, 4(36): eaau6426. doi: 10.1126/sciimmunol.aau6426
[19]	KIM D, TOUROS A, KIM W R. Nonalcoholic Fatty Liver Disease and Metabolic Syndrome[J]. Clin Liver Dis, 2018, 22(1): 133-140. doi: 10.1016/j.cld.2017.08.010