脂联素基因多态性与中国大城市汉族老年人代谢综合征相关性研究

目的探讨脂联素基因rs2241766(T45G)和rs15011299(G276T)多态性位点(SNP)与中国大城市汉族老年人代谢综合征(MS)的相关性。方法根据国际糖尿病联盟(IDF)的MS定义,从2002年营养与健康状况调查对象中选取大城市60岁以上汉族老年人,分为MS组和正常对照组,共907人。检测这些研究对象血浆脂联素和胰岛素浓度,提取全血基因组DNA,采用Taqman方法检测所有研究对象脂联素基因rs2241766(T45G)和rs15011299(G276T)位点的基因型。并分析各SNP位点基因型与MS的相关性。结果 rs15011299的三种基因型在MS组和正常对照组间的总体分布差异有显著性,MS组T等位基因频率显著高于正常对照组。在rs15011299位点,GG、GT、TT三组基因型的研究对象的BMI、脂联素浓度差异有显著性,GG+GT型研究对象的BMI、腰围、血浆胰岛素浓度显著低于TT型研究对象,而血浆脂联素浓度显著高于TT型研究对象;在rs2241766位点,TT、TG、GG三组基因型的研究对象间BMI及舒张压差异有显著性,TT型研究对象BMI、腰围及舒张压显著高于TG+GG型研究对象。logistic回归分析显示rs15011299TT型研究对象与GG型研究对象相比发生MS的风险高,其校正的OR值为3.19(1.31,7.78)。结论脂联素基因rs15011299位点的变异可能与MS相关,G→T突变可能增加MS的发生,使腰围、BMI增加,并降低血浆脂联素水平。     

肥胖青少年血清脂联素水平与胰岛素抵抗关系

目的 研究青少年肥胖与血清脂联素水平与胰岛素抵抗的关系.方法 中学生健康体检时选择47名体质指数(BMI)在同年龄、同性别第95百分位数或以上的中学生为肥胖组,对照组为50名健康学生.检测血压、血糖、血脂、胰岛素和脂联素等指标,计算胰岛素抵抗指数(HOMA-IR),并采用双能x线吸收检测体脂含量.结果 肥胖组血压高于对照组(P＜0.05),BMI、HOMA-IR和躯干部体脂百分比高于对照组(均P＜0.01),而血清脂联素水平显著低于对照组(P＜0.05).多元逐步回归分析显示,总体脂百分比、躯干部体脂百分比和HOMA-IR是血清脂联素独立相关因素,呈负性相关.结果 肥胖青少年存在显著低脂联素血症.血清脂联素与体脂含量和胰岛素抵抗呈显著负相关.     

血清网膜素-1水平与儿童非酒精性脂肪肝的关系

目的 探索网膜素-1与儿童非酒精性脂肪肝(NAFLD)的相关性,为儿童脂肪肝的防治提供参考。方法 将116名肥胖儿童分为肥胖伴脂肪肝组(61名)、肥胖不伴脂肪肝组(55名),同时选择正常体重儿童55名作为对照组,对每位儿童进行身高、体重、腰围、血压等测量,并行血脂、血糖、肝功等化验,留取静脉血清标本测血清胰岛素、网膜素-1、瘦素、脂联素水平等,判断三组间指标差异及网膜素-1与其他指标相关性。采用Logistics回归判断有无脂肪肝与其他指标的关系,采用ROC曲线评估腰围、体重指数(BMI)、网膜素-1水平对儿童脂肪肝诊断标准有无价值。结果 血清网膜素-1在肥胖伴脂肪肝患儿中水平较另两组水平低(P<0.05)。矫正年龄及腰围后网膜素-1与有无合并脂肪肝、瘦素/脂联素(LAR)、低密度脂蛋白胆固醇(LDL-C)为负相关,与脂联素呈正相关(P<0.05)。Logistics回归分析发现BMI、胰岛素抵抗指数(HOMA-IR)为脂肪肝的危险因素,网膜素-1为脂肪肝的保护因素。腰围、BMI、血清网膜素-1水平对儿童脂肪肝诊断有一定价值。结论 血清网膜素-1水平与儿童中心性肥胖、脂代谢紊乱及脂肪肝密切相关,在儿童脂肪肝的发病中有保护作用。     

血清瘦素 内脂素及脂联素水平与肥胖儿童代谢紊乱的相关性

目的分析血清瘦素、内脂素及脂联素水平与肥胖儿童代谢紊乱的相关性,探讨肥胖儿童代谢异常的发生机制,为肥胖儿童代谢紊乱的防治提供有效依据。方法选取2018年1月-2019年12月杭州市余杭区妇幼保健院收治的87例肥胖儿童,根据是否发生代谢异常分为单纯肥胖组(56例)和代谢紊乱组(31例)。另选取同期进行健康体检的30例儿童为对照组。详细记录3组儿童一般资料、生化指标及血清瘦素、内脂素、脂联素水平。分析血清瘦素、内脂素、脂联素与肥胖儿童代谢紊乱的相关性。结果 3组体质指数(BMI)、腰围、臀围、舒张压、收缩压及血清三酰甘油(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDL-C)、瘦素、内脂素、脂联素水平比较差异均有统计学意义(均P0.05)。Spearman分析结果显示:血清瘦素、内脂素与肥胖儿童代谢紊乱呈正相关,脂联素与肥胖儿童代谢紊乱呈负相关。结论血清瘦素、内脂素在肥胖伴代谢紊乱儿童中呈高表达,脂联素呈低表达,血清瘦素、内脂素、脂联素可能参与肥胖儿童代谢。     

超重、肥胖男青少年血清脂联素与转氨酶关系

目的分析超重、肥胖男青少年血清脂联索水平与肝转氨酶活性的关系。探讨脂联索对肝脏脂代谢异常疾病的影响。方法随机抽选132名14～16岁超重、肥胖男中学生，测量身高、体重和血压，检测血脂、血清脂联紊、胰岛索和转氨酶水平。结果转氨酶增高组与正常组体质指数（BMI）、腰围（WAIST）、低密度脂蛋白胆固醇（LDL—C）、甘油三酯（TG）、胰岛素抵抗指数（HOMA—IR）和脂联索水平差异有统计学意义（P〈0．05）。脂联索与转氨酶（ALT）对数呈显著负相关（r=-0．209，P〈0．05），校正BMI、WAIST后相关性差异无统计学意义。结论低脂联紊血症可引发与脂代谢异常有关的肝脏疾病；这一损害受体成分和脂肪分布的影响。     

超重和肥胖人群血清脂联素水平

目的研究深圳地区超重、肥胖人群血清脂联素水平。方法调查深圳地区21～75岁人群共29799例,测量体质指数(BMI)、腰围(WC)、腰臀围比(WHR)及血糖(FPG,OGTT2hPG)测定,按BMI将其分成3个组:正常组(男10267人,女14268人)、超重组(男2952人,女1800人)和肥胖组(男245人,女267人),调查各组人群糖尿病(DM)的患病率,分析BMI、WC、WHR与DM的关系,并用ELISA法测定3组人群的血清脂联系水平。结果DM患病率正常组男性为3.91%,女性为3.53%;超重组男性为12.58%,女性为10.62%;肥胖组男性为22.31%,女性为19.17%。WC≤87cm者,DM患病率为4.01%,WC>98cm,DM患病率达20.76%。脂联素浓度:正常组男性(7.15±5.53)mg/L,女性(7.92±5.83)mg/L;超重组男性(5.95±2.67)mg/L,女性(6.21±2.35)mg/L;肥胖组男性(5.86±2.64)mg/L,女性(5.97±2.16)mg/L。结果显示,肥胖及超重组脂联素水平低于正常组(P<0.01)。脂联素水平与BMI、WC、WHR呈负相关。结论脂联素水平变化可能与肥胖及DM密切相关。     

脂联素基因多态性与青少年肥胖的相关性分析

目的研究脂联素基因第+45位点单核苷酸多态性与青少年肥胖的相关性,为青少年肥胖防治提供依据。方法选择台州市第二中学初中二年级健康体检时肥胖中学生47名为肥胖组,选择体重正常中学生50名为对照组,检查血压、血糖、血脂、胰岛素、脂联素和体脂含量。采用聚合酶链反应-单链构象多态性(PCR-RFLP)检测+45位点单核苷酸多态性。结果肥胖组血压、BMI、HOMA-IR、躯干部体脂百分比均高于对照组,而血清脂联素水平低于对照组。多元逐步回归分析显示,总体脂百分比、躯干部体脂百分比和HOMA-IR是血清脂联素的独立相关因素,为负性相关。2组学生+45位点基因型频率差异无统计学意义,等位基因频率差异也无统计学意义。结论青少年肥胖存在低脂联素血症,血清脂联素与体脂含量和胰岛素抵抗呈负相关,未发现脂联素基因第+45位点单核苷酸多态性及其与青少年肥胖相关。     

女性青少年血清脂联素水平与血压的关系研究

目的分析女青少年血清脂联素水平与血压的关系,探讨脂联素对代谢综合征和心血管疾病的影响。方法随机抽选172名14~16岁女中学生,测量身高、体重、腰围和血压,检测血脂、血糖、血清脂联素、胰岛素水平。结果血清脂联素与收缩压(SBP)和舒张压(DBP)均呈显著负相关。多元线性回归模型分别校正BMI、腰围及代谢综合征其他因素后,SBP和DBP均与脂联素水平独立负相关。结论血清脂联素下降可能是导致SBP和DBP升高的因素之一,且该影响作用似独立于代谢综合征的其他成分。     

单纯肥胖及糖尿病患者血清脂联素水平研究

目的 探讨脂联素与体脂含量、血糖、血脂和胰岛素抵抗的相关性。方法 放射免疫法测定19例正常对照者，23例单纯肥胖者，31例2型糖尿病非肥胖者，26例2型糖尿病合并肥胖患者血浆中脂联素水平。结果 正常对照组和单纯肥胖组的血清脂联素水平没有显著性差异，而2型糖尿病组和2型糖尿病肥胖组的血清脂联素水平显著低于前两组，但可以看到在2型糖尿病的前提下，非肥胖组与肥胖组的血清脂联素水平的差异没有显著性。以性别分组进行独立两样本t检验，血清脂联素水平存在显著差异。血清脂联素与体重指数、腰围、腰臀比、体脂含量、空腹血糖、胰岛素敏感指数、血清甘油三酯、高密度脂蛋白显著相关。多元逐步回归分析发现血清高密度脂蛋白、空腹血糖、腰围、体脂含量进入回归方程。结论 血清脂联素水平存在性别差异，其与肥胖、2型糖尿病和胰岛素抵抗相关。     

血清脂联素与肥胖、脂代谢异常的相关性研究

脂联素是主要由脂肪组织分泌的一种细胞因子，在肥胖和糖脂代谢中起重要作用；许多临床研究表明，低脂联素血症和肥胖及脂代谢密切相关；在肥胖、糖尿病和冠状动脉疾病的人群中脂联素水平是降低的。     

中国成年人体质指数和腰围与肾结石住院风险的关联研究

目的分析中国成年人体质指数(BMI)和腰围与肾结石住院风险的关联。方法本研究利用中国慢性病前瞻性研究的长期随访数据, 剔除基线自报患有慢性肾病、恶性肿瘤、BMI和腰围为极端值的研究对象, 最终纳入502 096人。采用Cox比例风险回归模型分析BMI和腰围与肾结石住院风险之间的关联。结果研究对象随访(10.7±2.2)年, 随访期间记录肾结石导致的首次住院共12 396例。调整潜在混杂因素后, 以BMI(kg/m2)20.5～22.4者为参照组, <18.5、18.5～20.4、22.5～23.9、24.0～25.9、26.0～27.9、28.0～29.9、≥30.0者的风险比(HR)(95%CI)依次为:0.96(0.87～1.05)、0.94(0.88～1.00)、1.11(1.05～1.17)、1.25(1.18～1.32)、1.29(1.21～1.37)、1.39(1.28～1.50)、1.54(1.40～1.71);BMI每增加1 kg/m2, 肾结石住院风险的HR值增加4%(HR=1.04, 95%CI:1.04～1.05)。与腰围(cm)75.0～79.9者相比, ...     

Adiponectin/ACP30, a collagen-like plasma protein in relation to anthropometric measurement in Thai overweight and obese subjects

Adiponectin, anthropometric parameters including weight, height, body mass index (BMI), arm circumference, triceps skinfold, subscapular skinfold, waist, hip circumferences and waist/hip ratio were recorded in 48 male and 166 female overweight and obese Thai volunteers (BMI?≥?25.0 kg/m²), and in 26 male and 81 female normal subjects (BMI?=?18.5???24.9 kg/m²). Thai volunteers were investigated. Statistically significantly lower adiponectin concentrations in overweight and obese subjects were found when compared with control subjects of both sexes. Anthropometric parameters, including weight, height, BMI, arm circumference, triceps skinfold, subscapular skinfold, waist, hip circumferences and waist/hip ratio, except arm span, were statistically significantly higher in overweight and obese subjects than in control subjects. The overweight and obese subjects had higher glucose concentrations than the control subjects. The BMI and glucose concentrations were found to be significantly related, under these conditions, to adiponectin.     

Adiponectin/ACP30, a collagen-like plasma protein in relation to anthropometric measurement in Thai overweight and obese subjects

Adiponectin, anthropometric parameters including weight, height, body mass index (BMI), arm circumference, triceps skinfold, subscapular skinfold, waist, hip circumferences and waist/hip ratio were recorded in 48 male and 166 female overweight and obese Thai volunteers (BMI=25.0 kg/m(2)), and in 26 male and 81 female normal subjects (BMI=18.5-24.9 kg/m(2)). Thai volunteers were investigated. Statistically significantly lower adiponectin concentrations in overweight and obese subjects were found when compared with control subjects of both sexes. Anthropometric parameters, including weight, height, BMI, arm circumference, triceps skinfold, subscapular skinfold, waist, hip circumferences and waist/hip ratio, except arm span, were statistically significantly higher in overweight and obese subjects than in control subjects. The overweight and obese subjects had higher glucose concentrations than the control subjects. The BMI and glucose concentrations were found to be significantly related, under these conditions, to adiponectin.     

Effect of adiposity and fat distribution on endometrial cancer risk in Shanghai women

The authors conducted a population-based case-control study of 832 endometrial cancer cases and 846 frequency-matched controls in Shanghai, China (1997-2001), to examine the association of overall adiposity and body fat distribution with disease risk. Overall adiposity was estimated using weight and body mass index (BMI); upper body fat distribution was evaluated using waist circumference and waist:hip ratio. Overall and upper-body obesity were both associated with an elevated risk of endometrial cancer. Adjusted odds ratios and 95% confidence intervals for highest-versus-lowest quartile comparisons were 2.6 (95% confidence interval (CI): 2.0, 3.5) for weight, 2.9 (95% CI: 2.2, 3.9) for BMI, 4.7 (95% CI: 3.4, 6.4) for waist circumference, and 3.5 (95% CI: 2.6, 4.8) for waist:hip ratio. The positive associations with weight and BMI vanished after results were controlled for waist circumference, while associations with waist circumference and waist:hip ratio persisted after adjustment for BMI. The positive association with upper-body obesity was more pronounced among younger women, women who had never used oral contraceptives, and women with a history of diabetes mellitus (p for multiplicative interaction < 0.05). Upper-body obesity was related to increased risk among women with low BMI. These results suggest that obesity, particularly upper-body fat deposition, is associated with an increased risk of endometrial cancer.     

Peer Reviewed: Associations Between Severe Obesity and Depression: Results From the National Health and Nutrition Examination Survey, 2005-2006

Introduction

My objectives were to investigate the association between obesity and depression in a representative sample of American adults, investigate sex and severity of obesity as modifiers of the association between depression and body mass index, determine whether large waist circumference is associated with depression, and explore whether specific health behaviors and poor physical health are possible mediators of the association between obesity and depression, if found.

Methods

The sample consisted of 3,599 nonpregnant adults aged 20 years or older from the National Health and Nutrition Examination Survey, 2005-2006. I operationalized obesity as body mass index (BMI) and waist circumference from the anthropometric measurements of participants and current depression from Patient Health Questionnaire (PHQ-9) scores. I ran logistic regression models with depression as the dependent variable.

Results

In unadjusted analyses, large waist circumference (≥88 cm for women and ≥102 cm for men) and class III obesity (BMI ≥40 kg/m²) were associated with higher prevalence of depression in women only. All of these associations dramatically weakened after adjusting for demographic factors, self-rated health status, and number of chronic conditions.

Conclusion

These findings support an association between depression and obesity in women who are severely obese. Future studies should investigate poor physical health as a possible mediator of the association between obesity and depression in this population of women.     

Race/Ethnicity differences in the relationship between obesity and gait speed among older Americans

Projections indicate that the older American population will become more racially diverse in the future. Therefore, eliminating health disparities among older adults should be a public health priority. Using data from the 1999-2002 National Health and Nutrition Examination Survey, we examined the relationship between obesity, measured by BMI and waist circumference, and gait speed, a performance-based measure of physical function, in 2,285 older adults (≥60 y) in order to determine whether this relationship varies by race/ethnicity. Overweight and obesity, indicated by a BMI ≥ 25 kg/m(2) and a waist circumference in quartiles 3 (male: 102.4-109.9 cm; female: 97.3-106.3 cm) and 4 (male: 110.2-156.6 cm; female: 106.4-147.5 cm), were associated with slower gait speed in non-Hispanic Whites. Among non-Hispanic Blacks, only extreme obesity, indicated by a BMI ≥ 35 kg/m(2) and a waist circumference in quartile 4 (male: 110.2-149.6 cm; female: 106.4-137.7 cm), was associated with a slower gait speed. Among Mexican Americans, only extreme obesity, indicated by a BMI ≥ 35 kg/m(2), was associated with a slower gait speed. Thus we found the relationship between obesity and gait speed differed by race/ethnicity. The goal of eliminating health disparities in access to and quality of health care is only possible when differences in the associations between possible risk factors and physical function are identified.     

Serum adiponectin in young adults--interactions with central adiposity, circulating levels of glucose, and insulin resistance: the CARDIA study

PURPOSE: To study adiponectin, a circulating adipocytokine secreted by adipocytes inversely associated with diabetes and insulin resistance, and factors affecting its levels in the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS: Adiponectin in serum was measured by radioimmunoassay in 3355 participants (ages: 23-45 years) categorized by fasting glucose levels as normal, impaired fasting glucose, or diabetes mellitus. RESULTS: Levels of adiponectin were higher in women, in white participants, and with age. Waist circumference, estimating visceral fat, strongly and inversely correlated with levels of adiponectin, more than body mass index. Adiponectin values adjusted for gender and race were lower with higher fasting glucose values in the normal range and still lower with impaired fasting glucose and untreated diabetes mellitus, even further adjusting for waist circumference and fasting insulin levels (p < 0.0001). Gender- and race-adjusted adiponectin levels were inversely associated with insulin resistance at year 15 and with insulin resistance measured 15 years previously and with its change from baseline to year 15 (p < 0.0001). CONCLUSIONS: These data suggest complex and significant physiologic interactions among circulating levels of adiponectin and measures of insulin action throughout young adulthood, even from several years earlier. Central obesity, as measured with waist circumference, is a primary factor affecting levels of circulating adiponectin. Furthermore, levels of glucose and levels of adiponectin may directly influence one another.     

The association between obesity and the prevalence of low back pain in young adults: the Cardiovascular Risk in Young Finns Study

Both low back pain (LBP) and obesity are common public health problems, yet their relation remains controversial. The aim of this study was to investigate the associations between weight-related factors and the prevalence of LBP in young adults in Finland. Participants in the ongoing Cardiovascular Risk in Young Finns Study aged 24-39 years were included (N = 2,575). In 2001, 31.2% of men and 39.5% of women reported LBP with recovery within a month or recurrent or continuous pain during the preceding 12 months. For women only, those with higher body mass index, waist circumference, hip circumference, waist-to-hip ratio, serum leptin level, and C-reactive protein level showed an increased prevalence of LBP. With all weight-related factors in the model, only waist circumference was related to LBP in women. For women, the odds ratios of LBP were 1.2 (95% confidence interval: 0.8, 1.8) for a waist circumference of 80-87.9 cm and 1.8 (95% confidence interval: 1.0, 3.2) for a waist circumference of > or =88 cm compared with a waist circumference of <80 cm. This association was independent of C-reactive protein, leptin, and adiponectin levels. The authors' findings in a relatively young population suggest that abdominal obesity may increase the risk of LBP in women.