文献简介

出版社:DIABETIC Medicine

作  者:J. Galhardo, L. P. Hunt and J. P. H. Shield

编  号:10.1111/j.1464-5491.2012.03592.x

关键字:acanthosis nigricans, obesity, pigment epithelium-derived factor (PEDF), serine protease inhibitor (SERPIN) F1

年  份:2012   点击量:827

文献摘要

Introduction Circulating pigment epithelium-derived factor, or serine protease inhibitor F1, is upregulated during adipogenesis, contributing to obesity-induced insulin resistance. Furthermore, pigment epithelium-derived factor is abundant in stage I melanosomes and has been reported to increase pigment granules and the appearance of mature melanosomes in retinal pigment epithelium. As acanthosis nigricans is a well-recognized clinical marker of insulin resistance, we hypothesized that increased pigment epithelium-derived factor might be associated with the generation of acanthosis nigricans.
简介介绍 
在脂肪细胞形成过程中,循环色素上皮衍生因子、或丝氨酸蛋白酶抑制剂F1的上调导致肥胖诱导的胰岛素抵抗。此外,色素上皮衍生因子在黑素体I期是非常丰富的,并且已被报道可以增加色素颗粒和成熟的黑素体在视网膜色素上皮细胞的外观。。由于黑棘皮症是临床上是一个公认的胰岛素抵抗标记物,因此我们推测色素上皮衍生因子的增加可能与黑棘皮病的发生有关。

Methods Acanthosis nigricans, anthropometric measurements, circulating total PEDF and metabolic profiles were assessed in 28 obese adolescents in a hospital-based obesity clinic.
方法

对在医院肥胖门诊处就诊的28名肥胖青少年进行黑棘皮病、人体测量、循环总PEDF以及代谢特征的评估。

Results Subjects with acanthosis nigricans (n = 10) showed greater plasma levels of pigment epithelium-derived factor (PEDF) than those without [geometric mean 23.55 (range 15.2–40.2) vs. 9.01 (range 5.5–18.7) lg ⁄ ml; P < 0.001]. Although pigment epithelium-derived factor was positively correlated with the homeostasis model assessment for insulin resistance (HOMA-IR) (r = 0.779, P < 0.001; 95% CI 0.573–0.892), as previously reported, for the same degree of insulin resistance, those with acanthosis nigricans exhibited a 2.1-fold (95%CI 2.0–2.3) higher level of pigment epithelium-derived factor. 
结果

与那些健康者相比,黑棘皮病的受试者 (n = 10)的色素上皮衍生因子(PEDF)的血浆水平较高[几何平均值23.55(范围15.2-40.2)vs 9.01(范围5.5-18.7)lg ⁄ ml; P <0.001]。根据先前的报道,虽然色素上皮衍生因子与胰岛素抵抗指数(HOMA-IR稳态模型呈)正相关(r = 0.779, P < 0.001; 95% CI 0.573–0.892),但是对于胰岛素抗性程度相同时黑棘皮病的患者呈现出高于2.1倍的色素上皮衍生因子。

Conclusions While acanthosis nigricans is undoubtedly associated with insulin resistance, its appearance is not ubiquitous in patients at any given level of HOMA-IR. The higher levels of pigment epithelium-derived factor in those with acanthosis nigricans compared with those without, with similar levels of resistance, suggest that pigment epithelium-derived factor levels are associated with acanthosis nigricans. 
结论

虽然黑棘皮病无疑与胰岛素抵抗有关,但其临床表现并不普遍存在于任何水平的HOMA-IR患者中。在具有类似的抵抗水平前提下,患有黑棘皮病的患者色素上皮细胞衍生因子与那些没有患黑棘皮病患者相比,水平更高,这表明色素上皮衍生因子水平与黑棘皮病相关。