Abstract:

Objective To investigate the correlation between serum angiopoietin-like protein 4（ANGPTL4），heat shock protein（HSP）70，interleukin-34（IL-34） levels and insulin resistance in overweight and obese patients with type 2 diabetes mellitus（T2DM）. Methods From May 2020 to May 2022，182 patients with T2DM who were treated in Baoding First Central Hospital were enrolled as research group. According to the World Health Organization obesity diagnostic criterion，they were classified into overweight and obese group（90 cases） and normal weight group（92 cases）. Totally，90 healthy subjects were enrolled as healthy control group，including 40 overweight and obese subjects（overweight and obese control group） and 50 normal weight subjects（normal weight control group）. Serum ANGPTL4，HSP70，IL-34，insulin and blood glucose levels were determined，and homeostasis model assessment for insulin resistance（HOMA-IR） was calculated. Serum levels of ANGPTL4，HSP70，IL-34 and HOMA-IR in T2DM group were determined again after 3 months of treatment. Pearson correlation analysis was used to evaluate the correlation between serum ANGPTL4，HSP70，IL-34 and HOMA-IR. Results Compared with healthy control group and normal weight T2DM group，serum ANGPTL4 and HSP70 levels in overweight and obese T2DM group were decreased（P<0.05），and serum IL-34 level and HOMA-IR were increased（P<0.05）. Compared with healthy control group，the levels of serum ANGPTL4 and HSP70 in normal weight T2DM group were decreased（P<0.05），and the levels of serum IL-34 and HOMA-IR were increased（P<0.05）. Serum ANGPTL4 and HSP70 were negatively correlated with HOMA-IR（r values were -0.733 and -0.758，P<0.001），and IL-34 was positively correlated with HOMA-IR（r=0.705，P<0.001）. After treatment，serum ANGPTL4 and HSP70 levels were increased in overweight and obese T2DM group and normal weight T2DM group，while serum IL-34 level and HOMA-IR were decreased. Compared with overweight and obese T2DM group，serum ANGPTL4 and HSP70 in normal weight T2DM group were increased（P<0.05），and serum IL-34 level and HOMA-IR were decreased（P<0.05）. Conclusions ANGPTL4，HSP70 and IL-34 are correlated with insulin resistance in overweight and obese patients with T2DM，which may be used as the indicators for monitoring the efficacy of overweight and obese patients with T2DM.

Key words: Angiopoietin-like protein 4, Heat shock protein 70, Interleukin-34, Insulin resistance, Overweight, Obesity, Type 2 diabetes mellitus