| Backgrounds:With the development of society and the improvement of life,diabetes mellitus especially type 2 diabetes mellitus have became the chronic disease that seriously affects public health worldwide.As for China,there’s a large population base,which leads to the increase of morbidity and a large amount of potential cases.Especially in middle aged and aged population,diabetes severely reduces the:ir survival rate and quality of life.It’s very meaningful to recognize population with high risk of impaired glucose metabolism using proper indicators,as we can provide guidance and intervention timely to reduce the morbidity of diabetes in the future.There’s a significant correlation between obesity and diabetes,especially abdominal obesity and visceral obesity.Estimate of the accumulation of body fat benefits for the prediction of diabetes.Recently lipid accumulation product(LAP),visceral adipose index(VAI),cardiac metabolism index(CMI)and Chinese visceral adipose index(CVAI)have been proposed to represent the accumulation of adipose and indicate the incidence of diabetes.Surveys in different areas,ages and certain population have made different conclusions.Also,it was reported that the change of lipid spectrum preceded metabolic diseases and nowadays the development of lipidomics has provided tools for the analysis of lipid components.Screening changed lipids before the onset of type 2 diabetes mellitus using lipidomics can help us find new predctors for predicting type 2 diabetes mellitus,as well as provide new ideas for studying pathogenesis.Objective and methods:Middle-aged and aged sujects over 40 with normal glucose metabolism participating in epidemiological investigation conducted by Qilu Hospital of Shandong University in 2012 were admitted in this survey and were followed up 3 years later.LAP,CMI,VAI and CAI were estimated for the prediction value of impaired glucose metabolism including prediabetes and diabetes.35 newly diagnosed diabetes patients in 2015 were randomly selected as the case group.Age,sex,smoking and alcohol history were used as the matching factors for matching as control group in people with normal glucose metabolism.Case group and control group were 1:1 matched.Lipid mass spectrometric detection was conducted on serum samples of 2012 from both groups.After that we analyze the general differentiation of lipids and screen differential lipid components between two groups using lipidomics.Results:Before adjustment,RRs of impaired glucose metabolism of all indicators show significant linear increase with the rise of LAP,CMI,VAI and CVAI levels.After adjustment of age,alcohol intake,smoking,FPG,LDL-C,ALT and SBP,the significant linear association between VAI and RRs of impaired glucose metabolism disappears in both men and women.The RRs of the highest quartile groups of LAP,CMI,and CVAI are 2.554,2.264 and 2.709 times higher of the lowest quartile groups respectively in men and 1.980,2.025 and 2.431 in women.ROC analyses show that in both men and women,AUC of CVAI is the highest,0.607 and 0.608 respectively.In men,the AUCs of LAP,CMI and VAI are all lower than WHtR,but higher than TG/HDL-C and BMI.In women,AUCs of LAP,CMI and V)AI are higher than TG/HDL-C,WHtR and BMI.The lipid spectrum shows no significant general differentiation but two lipid components named N-(2-fluro-ethyl)2-methyl-arachidonoyl amine and 4,4’-Diapolycopene are significantly different between case and control groups.The AUC of the two lipids are 0.664 and 0.687 respectively,higher than CVAI.Conclusion:Among the anthropometric measures of obesity,CVAI has the highest predictive value for impaired glucose metabolism in 3 years of Chinese middle aged and aged population over 40.The change of N-(2-fluro-ethyl)2-methyl-arachidonoyl amine and 4,4’-Diapolycopene can predict the onset of type 2 diabetes mellitus 3 years in advance and their prediction value are higher than CVAI.The two lipids may play roles in the pathogenesis of type 2 diabetes mellitus. |
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