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首页> 外文期刊>Journal of Clinical & Translational Endocrinology >Discriminatory metabolic and inflammatory parameters in serum and omental adipose tissue of obese patients with different insulin sensitivity
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Discriminatory metabolic and inflammatory parameters in serum and omental adipose tissue of obese patients with different insulin sensitivity

机译：胰岛素敏感性不同的肥胖患者血清和网膜脂肪组织中的代谢和炎症参数差异

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ObjectiveMetabolically healthy obese phenotype is defined by high insulin sensitivity and lack of metabolic syndrome, parameters regulated by omental adipose tissue inflammation, ectopic fat deposition and adipose tissue dysfunction. Our study aimed to identify novel metabolic and inflammatory markers in serum and omental adipose tissue which characterize the “unhealthy” obese patients and distinguish them from obese patients with better metabolic profile.DesignCross-sectional study.PatientsSubjects included 75 obese patients undergoing bariatric surgery at the Tel-Aviv Medical Center (mean age 43.9?±?13.9, mean BMI 41?±?8.4). The HOMA median value was used as a cut-off to differentiate between patients with better or worse insulin resistance.MeasurementsDemographic data, fasting serum insulin, glucose, bile acids, serum metabolic and inflammatory markers were obtained. During the bariatric surgery, omental adipose tissue was harvested and analyzed for metabolic and inflammatory markers using qRT-PCR. Logistic regressions were used to calculate odds ratio and 95% confidence interval for the prediction of the metabolic profile.ResultsSerum markers that were significantly higher among the obese with HOMA >6 were total bile acids. In the omental adipose tissue the inflammatory markers TNFα and ADAM17 were significantly higher among obese patients with HOMA >6. In multivariate analysis, the strongest predictor for insulin resistance was ADAM17 (OR?=?1.82, 1.06–3.14,P?=?0.031).ConclusionsThe study highlighted the predictive value of serum bile acids in identifying obese patients at high risk. Secondly, omental adipose tissue ADAM17 was revealed as a novel and strongest independent predictor for higher insulin resistance in morbidly obese patients.
机译：目的代谢健康的肥胖表型是由高胰岛素敏感性和缺乏代谢综合征，网膜脂肪组织炎症，异位脂肪沉积和脂肪组织功能障碍调节的参数定义的。我们的研究旨在鉴定血清和网膜脂肪组织中新的代谢和炎性标志物，这些标志物是“不健康”肥胖患者的特征，并将其与代谢状况更好的肥胖患者区分开。设计横断面研究。患者受试者包括75例在肥胖患者中进行减肥手术的肥胖患者。特拉维夫医疗中心（平均年龄43.9±13.9，平均BMI 41±8.4）。 HOMA中值用作区分胰岛素抵抗更好或更差的患者的临界值。测量人口统计学数据，空腹血清胰岛素，葡萄糖，胆汁酸，血清代谢和炎症标志物。减肥手术期间，收集网膜脂肪组织并使用qRT-PCR分析代谢和炎症标记。 Logistic回归用于计算比值比和95％置信区间，以预测代谢谱。结果在HOMA> 6的肥胖人群中，血清标记物明显更高，是总胆汁酸。在网膜脂肪组织中，HOMA> 6的肥胖患者的炎症标志物TNFα和ADAM17显着较高。在多变量分析中，最强的胰岛素抵抗预测因子是ADAM17（OR？=？1.82，1.06-3.14，P？=？0.031）。结论该研究强调了血清胆汁酸在识别高危肥胖患者中的预测价值。其次，网膜脂肪组织ADAM17被揭示为病态肥胖患者较高胰岛素抵抗的一种新颖且最强的独立预测因子。

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