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目的:探讨干预治疗对代谢综合征(Metabolic Syndrome,MS)患者血清抵抗素水平的影响,并分析影响血清抵抗素的因素。方法:入选2006年3月~2008年1月于我院门诊或住院的MS初诊患者48例,连续检测患者入选时基线水平、治疗后4周、24周及48周的血清抵抗素水平,根据预测未来10年冠心病发生概率的Framingham危险评分将患者分为3组:低危组(<10%),中危组(10~20%),高危组(>20%)。干预治疗措施包括:治疗性生活方式转变(减重、增加体力活动、饮食调节等),药物治疗(降压、降糖、调脂等)。比较三组间同一时间点及同组内不同时间点血清抵抗素水平的差异。多元线性回归分析影响血清抵抗素的因素。结果:MS的血清抵抗素水平于基线、治疗后4周、24周及48周时分别为72±38μg/L,56±29μg/L,40±21μg/L,30±11μg/L(F=23.836,P<0.001);3组间不同时间点血清抵抗素水平均有差异(P<0.001),各组内不同时间点的比较均有差异(P<0.01)。Spearman秩相关分析显示Framingham危险评分和血清抵抗素水平的相关性系数rs=0.792(P<0.001),控制C-RP后,偏相关分析显示两者间仍呈正相关(rs=0.766,P<0.001);多元线性回归分析显示Framingham危险评分和C-RP是影响血清抵抗素水平的主要因素(前者β=0.589,t=7.216,P<0.001;后者β=0.483,t=6.123,P<0.001)。结论:规范化的干预治疗可明显降低代谢综合征患者的血清抵抗素水平,而Framingham危险评分和C-RP是影响血清抵抗素水平的主要因素。
Objective: To investigate the effect of intervention on the level of serum resistin in patients with Metabolic Syndrome (MS) and to analyze the factors influencing serum resistin. Methods: Forty-eight newly diagnosed MS patients were recruited from March 2006 to January 2008 in our hospital for baseline screening, serum resistin levels at 4 weeks, 24 weeks and 48 weeks after treatment, The Framingham risk score predicting the probability of coronary heart disease over the next 10 years divided the patients into three groups: low-risk (10%), moderate-risk (10-20%) and high-risk (> 20%). Treatment interventions include: treatment of lifestyle changes (weight loss, increase physical activity, diet regulation, etc.), drug treatment (antihypertensive, hypoglycemic, lipid-lowering, etc.). The differences of serum resistin levels at the same time point and at different time points in the same group were compared. Multiple linear regression analysis of serum resistin factors. Results: Serum resistin levels in MS were significantly higher than those in the baseline at 4 weeks, 24 weeks and 48 weeks after treatment (72 ± 38μg / L, 56 ± 29μg / L, 40 ± 21μg / L, 30 ± 11μg / 23.836, P <0.001). The levels of serum resistin at different time points in the three groups differed significantly (P <0.001). There were significant differences among different time points in each group (P <0.01). Spearman rank correlation analysis showed that the correlation coefficient between Framingham risk score and serum resistin level was 0.792 (P <0.001). After C-RP control, partial correlation analysis still showed a positive correlation between them (rs = 0.766, P < 0.001). Multiple linear regression analysis showed that Framingham risk score and C-RP were the main factors influencing serum resistin levels (former β = 0.589, t = 7.216, P <0.001; latter β = 0.483, t = 6.123, P < 0.001). Conclusions: Standardized intervention can significantly reduce serum resistin levels in patients with metabolic syndrome, while Framingham risk score and C-RP are the major factors affecting serum resistin levels.