内脂素、视黄醇结合蛋白4与冠心病的相关性分析

目的 探讨内脂素（visfatin）、视黄醇结合蛋白4（RBP4）与冠心病的相关性。方法 病例组选取某医院心内科住院的冠心病患者159例,对照组选取同时期参与体检的无冠心病及高血压者185例。测定研究对象的身高、体重、血压、血脂、血糖、肝功能等指标、visfatin和RBP4,并分析visfatin和RBP4与冠心病的相关性。结果 冠心病组的GGT（t=2.270,P<0.05）、visfatin（z=-2.613,P<0.05）、RBP4（z=-3.667,P<0.05）的水平高于对照组,而DBIL（t=-3.182,P<0.05）水平低于对照组;visfatin与DBP（r=0.13,P<0.05）、TC（r=0.17,P<0.05）、TG（r=0.52,P<0.05）、LDL-C（r=0.16,P<0.05）、GLU（r=0.11,P<0.05）均呈正相关,而与HDL-C（r=-0.11,P<0.05）、AST（r=-0.15,P<0.05）、DBIL（r=-0.13,P<0.05）呈负相关,RBP4与TC（r=0.20,P<0.05）、TG（r=0.43,P<0.05）、LDL-C（r=0.15,P<0.05）、GLU（r=0.18,P<0.05）呈现正相关,而与DBIL（r=-0.17,P<0.05）呈现负相关;未调整时visfatin的上三分位组冠心病的患病危险是下三分位组的1.86倍（95%CI:1.10-3.14）,调整各种因素后冠心病的患病危险消失（95%CI:0.70~2.20）;未调整时RBP4的上三分位组冠心病的患病危险是下三分位组的2.57倍（95%CI:1.51~4.38）,调整各种因素后冠心病的患病危险是下三分位组的2.28倍（95%CI:1.31~3.98）。结论 Visfatin、RBP4与冠心病之间存在相关性。     

The Possible Role of Adipokines in HCV Associated Hepatocellular Carcinoma

Background: Adipokines play an important role in the regulation of inflammation and tumor progression. Aim: Assessment of the possible role of adiponectin, leptin and visfatin in HCV associated hepatocellular carcinoma (HCC). Methods: patients were classified into 85 patients with HCV associated HCC, 100 patients with chronic hepatitis C viral (HCV) infection compared to 50 normal control (NC) subjects. All subjects included in the study were assessed for HCV infection by seropositive HCV antibodies, as well as HCV RNA by RT-PCR. Serum levels of adiponectin, leptin and visfatin were assessed using enzyme linked immunosorbent assay (ELISA). The data were correlated to the relevant clinic-pathological features of the patients, and the overall survival (OS) rate. Results: There was a significant difference in the serum levels of adiponectin and visfatin among HCC, HCV and NC groups (P<0.001). The serum levels of leptin and alpha fetoprotein (AFP) were significantly higher in HCC group (P<0.001). There was a significant association between the serum level of adiponectin and advanced Child class liver cirrhosis (P=0.03), as well as with poor performance status (ECOG, P=0.02). Serum leptin associated significantly with the number of lesions in the liver (P=0.006), visfatin associated with increased mortality rate (P<0.001). Adiponectin, leptin and visfatin associated significantly with liver cirrhosis in HCV patients (P<0.01). Leptin achieved the highest sensitivity (98.8%). visfatin achieved the highest specificity (100%) and PPV (100%) for detection of HCC. The combination of serum leptin and visfatin for the diagnosis of HCV associated HCC showed sensitivity, specificity, PPV, NPV and accuracy (100%, 96.6%, 93.4%, 100% and 97.4%; respectively). Conclusion: Adiponectin, leptin and visfatin have an important role(s) in the pathogenesis of HCV associated HCC.     

Role of visfatin in obesity-induced insulin resistance

The growing worldwide burden of insulin resistance (IR) emphasizes the importance of early identification for improved management. Obesity, particularly visceral obesity, has been a key contributing factor in the development of IR. The obesity-associated chronic inflammatory state contributes to the development of obesity-related comorbidities, including IR. Adipocytokines, which are released by adipose tissue, have been investigated as possible indicators of IR. Visfatin was one of the adipocytokines that attracted attention due to its insulin-mimetic activity. It is released from a variety of sources, including visceral fat and macrophages, and it influences glucose metabolism and increases inflammation. The relationship between visfatin and IR in obesity is debatable. As a result, the purpose of this review was to better understand the role of visfatin in glucose homeostasis and to review the literature on the association between visfatin levels and IR, cardiovascular diseases, and renal diseases in obesity.     

Serum visfatin and omentin levels in slow coronary flow

ObjectiveThe adipocytokines visfatin and omentin have a direct effect on inflammation and endothelial injury. The expression of visfatin is closely associated with the expression of proinflammatory cytokines. Omentin has an anti-inflammatory effect and is inversely associated with coronary artery disease (CAD). The slow coronary flow phenomenon is an angiographic finding characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. The pathophysiology of SCF has not been clearly identified, although multiple abnormalities including endothelial dysfunction, atherothrombosis and inflammation have been reported. However, the relationship between visfatin, omentin and SCF is still unknown. In this study, we aimed to investigate the relationship of these adipocytokines with SCF.MethodsThe study included slow coronary flow (n=45) and normal coronary flow (n=55) subjects, according to the corrected TIMI frame count, who underwent angiography in the catheterization laboratory of Duzce University. Statistical analyses were performed with SPSS version 12.ResultsVisfatin levels were significantly higher in patients with SCF than in controls (p<0.001). Plasma omentin levels were lower in the SCF group than in controls, although without statistical significance. Visfatin, gender and platelet count were significant predictors of SCF in multivariate logistic regression analysis (OR 0.748, 95% CI 0.632–0.886, p=0.01; OR 30.016, 95% CI 4.355–206.8, p=0.01; OR1.028, 95% CI 1.006–1.050, p=0.011, respectively).ConclusionAdipocytokines such as visfatin and omentin may play a role in the pathogenesis of coronary slow flow.     

急性心肌梗死患者血清内脏脂肪素水平的变化及其临床意义

目的观察急性心肌梗死患者血清内脏脂肪素(简称内脂素)水平变化及其与冠状动脉病变严重程度和心脏功能的关系,并探讨其临床意义。方法选择急诊行经皮冠状动脉介入治疗的急性心肌梗死(AMI)患者作为观察组(AMI组,n=30),其中男性22例,女性8例,平均年龄为54.77±10.09岁,其冠状动脉病变程度根据冠状动脉病变支数及Gensini积分进行评估;另选同期行冠状动脉造影检查正常者作为对照组(n=30),其中男性20例,女性10例,平均年龄为54.07±11.07岁。采用双抗体夹心酶联免疫吸附法检测两组术前及AMI组术后24 h血清内脂素水平;应用心脏超声测量各组左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)。结果 AMI组各时间点血清内脂素水平(术前:80.82±7.63μg/L,术后24 h:91.96±7.37μg/L)均显著高于对照组(19.32±4.37μg/L),且AMI组术后24 h血清内脂素水平较术前明显升高,差异均有统计学意义(P0.01)。不同冠状动脉病变支数血清内脂素水平分别为:单支:72.85±2.56μg/L,双支:82.24±5.77μg/L,多支:88.22±6.07μg/L;不同冠状动脉狭窄程度血清内脂素水平分别为:轻度:74.58±4.40μg/L,中度:80.13±4.71μg/L,重度:87.57±6.39μg/L;组间比较差异均有统计学意义(P0.05)。与对照组相比,AMI组LVEF明显降低(P0.01),LVEDD无显著差异。AMI组血清内脂素水平与冠状动脉病变支数、冠状动脉病变Gensini积分呈正相关(r=0.754,r=0.672,P0.01),与LVEF呈负相关(r=-0.459,P0.01)。结论血清内脂素水平可以作为推测AMI患者冠状动脉病变严重程度的指标。     

妊娠期糖尿病孕妇血清内脂素表达的研究

目的：探讨内脂素(visfatin)与体质量指数(BMI)、血脂[甘油三酯(TG)、总胆固醇(TC)]、胰岛素抵抗(IR)的关系。方法采用电化学发光法和酶联免疫吸附法(ELISA)以及全自动生化仪分别测定52例妊娠期糖尿病孕妇(GDM组)和52例糖耐量正常孕妇(NGT组)的空腹血糖(FPG)、空腹胰岛素(FINS)、visfatin水平。计算BMI和胰岛素抵抗指数(IRI)。结果①GDM组孕妇BMI明显高于NGT组,差异有统计学意义(P<0.05)。②GDM组孕妇TG高于NGT组,差异有统计学意义(P<0.05);两组孕妇TC比较差异无统计学意义(P>0.05)。③GDM组孕妇FPG、FINS、visfatin、IRI均高于NGT组,差异有统计学意义(P<0.05)。结论 GDM孕妇血清visfatin水平明显升高,与机体针对甘油三酯升高和胰岛素抵抗产生的代偿反应有关。     

Plasma visfatin levels in normal weight women with polycystic ovary syndrome

BACKGROUND: The present study was designed to measure plasma visfatin levels in normal weight women with polycystic ovary syndrome (PCOS) and to assess possible correlations between visfatin and the hormonal or metabolic parameters of the syndrome. METHODS: Twenty-five normal weight [body mass index (BMI)<25 kg/m(2)] women with PCOS, 24 obese and overweight (BMI>25 kg/m(2)) controls (ovulating women without clinical or biochemical hyperandrogenism), and 24 normal weight controls were studied. Blood samples were collected between the 3rd and the 7th days of a menstrual cycle in the control groups and during a spontaneous bleeding episode in the PCOS groups at 9:00 A.M., after an overnight fast. Circulating levels of LH, FSH, prolactin (PRL), testosterone (T), Delta(4)-androstenedione (Delta(4)-Alpha), dehydroepiandrosterone sulfate (DHEA-S), 17alpha-OH-progesterone (17OH-P), sex hormone-binding globulin (SHBG), insulin, glucose, and visfatin were measured. RESULTS: Plasma visfatin levels and the visfatin-to-insulin ratio were significantly lower in normal weight controls than in both normal weight women with PCOS and overweight or obese controls. The visfatin-to-insulin ratio was significantly higher in normal weight women with PCOS than in overweight or obese controls. Plasma visfatin levels were found to be positively correlated with LH and Delta(4)A levels, as well as with free androgen index (FAI) values, and negatively correlated with SHBG. LH and SHBG levels were found to be the only independent significant determinants of circulating visfatin. In the control groups, plasma visfatin levels were significantly correlated with BMI, waist (W) measurement, and waist-to-hip ratio (WHR). CONCLUSIONS: Visfatin levels are positively associated with obesity in healthy women of reproductive age. Moreover, the present study indicates, for the first time, a possible involvement of increased visfatin levels in PCOS-associated metabolic and hormonal disturbances.     

内脂素促进巨噬细胞向致血栓表型转化

目的研究内脂素对巨噬细胞中组织因子(TF)和纤溶酶原激活物抑制剂-1(PAI-1)表达的影响及可能的机制。方法体外培养的THP-1细胞中加入不同浓度的内脂素(包括空白对照,50ng/ml,100ng/ml三个浓度组),每组分别孵育6小时,12小时和24小时各3个时间点。同时设立2-羟基萘甲基磷酸三乙酸甲基酯(HNMPA;100umol/L)组。将各组细胞进行realtime PCR和Western blot检测,比较各组TF和PAI-1表达的情况。结果内脂素增加巨噬细胞中TF和PAI-1的mRNA转录和蛋白质表达水平,HNMPA不影响内脂素的这些效应。结论内脂素促进巨噬细胞向促血栓表型转化,机制与胰岛素受体相关的途径无关。     

血清内脂素及氧化应激状态评价在妊娠糖尿病患者病情评估中的意义

目的探讨血清内脂素及氧化应激状态评价在妊娠糖尿病患者病情评估中的意义。方法选择妊娠糖尿病患者68例为糖尿病组,对照组选择非糖尿病孕妇60例。人选后分别检测两组对象血清内脂素、空腹血糖、胰岛素抵抗指数、丙二醛、过氧化氢酶、超氧化物歧化酶、谷胱甘肽并计算体重指数。结果糖尿病组空腹血糖、胰岛素抵抗指数,内脂素较非糖尿病组差异有统计学意义（P〈0．05）。糖尿病组的MDA、CAT较非糖尿病组有显著性增高（P〈0．05）,糖尿病组SOD水平较非糖尿病组有极显著性下降（P〈0．01）,GSH较非糖尿病组有显著性下降（P〈0．05）。空腹血糖与内脂素、MDA呈显著正相关（P〈0．05）,空腹血糖与SOD、GSH呈显著负相关（P〈0．05）;胰岛素抵抗指数与内脂素、MDA呈显著正相关（P〈0．05）,胰岛素抵抗指数与SOD、GSH呈显著负相关（P〈0．05）。结论血清内脂素及氧化应激状态评价可有效反映妊娠糖尿病患者病情严重程度,对判断病情进展具有重要意义。     

内脂素经核因子κB途径诱导人单核细胞基质金属蛋白酶-2和9表达的实验研究

目的 探讨内脂素对核因子κB(NF-κB)通路的激活及其在调节人单核细胞基质金属蛋白酶(MMP)-2和MMP-9的表达中的作用,以期进一步了解内脂素与动脉粥样硬化的关系.方法 以健康人外周血单核细胞为研究对象.抽取健康志愿者静脉血,分离、纯化单核细胞后随机分为空白对照组;内脂素组(100、200、400 ng/ml,24 h);Bay11-7082抑制剂组(Bay11-7082 40μmol/ml预孵育30 min,内脂素400 ng/ml刺激24 h).荧光定量PCR检测各组细胞MMP-2和MMP-9 mRNA的表达;Western blot检测MMP-2和MMP-9蛋白的表达;明胶酶谱法检测细胞培养基质中MMP-2和MMP-9的酶活性.内脂素刺激细胞后的核转位分别用Western blot和ELISA进行检测.结果 人外周血单核细胞经不同浓度的内脂素干预培养后24 h单核细胞MMP-2和MMP-9 mRNA及蛋白的表达均明显高于空白对照组(P均<0.05),且呈浓度依赖性.内脂素还上调细胞分泌到细胞培养基中的MMP-2和MMP-9酶活性,内脂素100 ng/ml组MMP-9、MMP-2的酶活性分别为空白对照组的(1.139 ±0.055)和(1.102±0.011)倍(P均<0.05).加入NF-κB抑制剂Bay11-7082后MMP-2、MMP-9的mRNA、蛋白的表达及酶活性均明显低,与内脂素400ng/ml组比较差异均有统计学意义(P均<0.001).内脂素浓度越高,核蛋白NF-κBp65表达越高,内脂素100 ng/ml组相对灰度值为空白对照组的(1.334±0.148)倍(P均<0.05);内脂素浓度越高,NF-κBp65亚单位核内转移越多,内脂素100ng/ml组为0.763±0.056,内脂素400 ng/ml组为1.290±0.065,均大于对照组的0.467±0.046(P均<0.05).结论 内脂素可通过激活NF-κB途径上调人单核细胞中MMP-2和MMP-9表达及活性.这可能是内脂素致动脉粥样硬化及与急性冠状动脉综合征密切相关的机制之一.