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目的探讨代谢综合征(MS)患者血清抵抗素、瘦素水平与血脂、肥胖和胰岛素抵抗的关系。方法按体重指数将60例MS患者分为肥胖组和非肥胖组,采用ELISA方法测定受试者空腹血清抵抗素及瘦素水平,同时检测其身高、体重、腰围、臀围、血压、血糖、血脂及胰岛素,并计算体重指数(BM I)、腰臀比(WHR)和胰岛素抵抗指数(HOMA-IR)并与对照组比较。结果MS患者肥胖组和正常对照组相比其血清抵抗素及廋素水平明显升高(P<0.01)。MS非肥胖组和正常对照组相比其血清抵抗素及廋素水平明显升高(P<0.05,或P<0.01)。肥胖组和非肥胖组相比其血清抵抗素、瘦素水平无统计学意义。显示血清抵抗素水平与腰臀比、空腹胰岛素、胰岛素抵抗指数呈显著正相关(r=0.22,0.22,0.19;P<0.05);与体重指数、腰围、臀围、瘦素呈显著正相关(r=0.31,0.32,0.36,0.28;P<0.01);与高密度脂蛋白胆固醇(HDL-C)呈显著负相关(r=-0.24;P<0.05)。相关分析也显示血清瘦素水平与体重指数、腰围、臀围、腰臀比、收缩压、舒张压、甘油三酯、空腹胰岛素、胰岛素抵抗指数呈显著正相关(r=0.59,0.64,0.53,0.64,0.47,0.53,0.49,0.39,0.32;P<0.01),与血糖呈显著正相关(r=0.23;P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈显著负相关(r=-0.40;P<0.01)。结论MS患者血清抵抗素、瘦素水平均明显升高,并存在一定的瘦素抵抗,且与肥胖、腹型肥胖及胰岛素抵抗程度有明显相关性,因而抵抗素、瘦素、瘦素抵抗可能在肥胖和胰岛素抵抗、MS的发生及发展中具有重要的作用。
Objective To investigate the relationship between serum resistin, leptin and lipid, obesity and insulin resistance in patients with metabolic syndrome (MS). Methods Sixty patients with MS were divided into obesity group and non-obese group according to body mass index. Fasting serum resistin and leptin levels were measured by ELISA. Height, weight, waist circumference, hip circumference, blood pressure, blood glucose, Blood lipids and insulin were measured. Body mass index (BM I), waist-to-hip ratio (WHR) and insulin resistance index (HOMA-IR) were calculated and compared with the control group. Results Compared with the normal control group, the levels of serum resistin and caspase-3 were significantly increased in MS patients with obesity (P <0.01). Serum resistin and caspase-3 levels were significantly higher in non-obese MS group than in normal control group (P <0.05, P <0.01). Obesity group and non-obese group compared to its serum resistin, leptin levels were not statistically significant. Serum resistin level showed a significant positive correlation with waist-hip ratio, fasting insulin and insulin resistance index (r = 0.22,0.22,0.19; P <0.05), but was positively correlated with body mass index, waist circumference, hip circumference and leptin r = 0.31,0.32,0.36,0.28; P <0.01), but negatively correlated with high density lipoprotein cholesterol (HDL-C) (r = -0.24, P <0.05). Correlation analysis also showed that serum leptin level was positively correlated with body mass index, waist circumference, hip circumference, waist-hip ratio, systolic blood pressure, diastolic blood pressure, triglyceride, fasting insulin and insulin resistance index (r = 0.59,0.64,0.53, 0.64,0.47,0.53,0.49,0.39,0.32; P <0.01), and had a significant positive correlation with blood glucose (r = 0.23; P <0.05), and had a significant negative correlation with high density lipoprotein cholesterol = -0.40; P <0.01). Conclusion Serum levels of resistin and leptin are significantly elevated in patients with MS, and there is a certain level of leptin resistance, which is significantly correlated with the degree of obesity, abdominal obesity and insulin resistance. Therefore, resistin, leptin, leptin resistance may be In obesity and insulin resistance, the occurrence and development of MS plays an important role.