脂联素、同型半胱氨酸在退行性心瓣膜病患者中的水平变化及其临床意义

目的:探讨老年退行性心瓣膜病患者脂联素及同型半胱氨酸的水平变化及其意义。方法:选择老年退行性心瓣膜病患者80例作为观察组,健康者60例作为对照组。比较组间脂联素、同型半胱氨酸水平差异,分析其与瓣膜病变程度、瓣膜病变数量之间的关系。结果:观察组血清脂联素水平明显低于对照组(P<0.01)、同型半胱氨酸水平明显高于对照组(P<0.01);随着瓣膜病变数量增多及返流程度加重,脂联素水平进行性下降(P<0.05),同型半胱氨酸水平进行性升高(P<0.05)。结论:低脂联素血症及高同型半胱氨酸血症可能是老年退行性心瓣膜病的危险因素。     

Serum adiponectin levels predict the effect of short-term dietary interventions on insulin sensitivity in humans

Aims/hypothesis Fat-rich diets can acutely induce insulin resistance. Data from adiponectin knock-out mice suggest that this effect might be increased in the absence of adiponectin. In the present study we tested whether plasma adiponectin concentrations influence changes in insulin sensitivity induced by a short-term dietary intervention in humans.Methods We analysed data from 27 healthy, non-obese men with normal glucose tolerance. These men ate a diet high in fat and a diet high in carbohydrates for three days each.Results The high-fat diet induced a significant drop in insulin sensitivity (determined by euglycaemic–hyperinsulinaemic clamp) compared to baseline (0.100±0.009 vs 0.083±0.007 µmol·kg^–1·min^–1·(pmol·l^–1), p=0.01). The drop in insulin sensitivity was more pronounced in subjects with low serum adiponectin (0.094±0.011 vs 0.077±0.010 µmol·kg^–1·min^–1·(pmol·l^–1), p=0.02) than in subjects with high serum adiponectin (0.103±0.011 vs 0.090±0.040 µmol·kg^–1·min^–1·(pmol·l^–1), p=0.16). In the whole group the high-carbohydrate, low-fat diet did not cause an increase in insulin sensitivity (0.095±0.007 vs 0.102±0.009 µmol·kg^–1·min^–1·(pmol·l^–1), p=0.06). However, insulin sensitivity was significantly increased in the subgroup with low serum adiponectin levels (0.084±0.013 vs 0.099±0.018 µmol·kg^–1·min^–1·(pmol·l^–1), p=0.01). In an additional multivariate analysis post-intervention insulin sensitivity was predicted by pre-intervention insulin sensitivity (p<0.001) and adiponectin concentrations (p=0.001).Conclusions/interpretation These data indicate that the reduction in insulin sensitivity achieved by a short-term high-fat diet is more pronounced in non-obese subjects with low serum adiponectin. Thus it is possible that the restriction of dietary fat and a diet high in carbohydrates might be particularly effective in subjects with low adiponectin such as obese or Type 2 diabetic individuals.     

脂联素受体的表达与调节

脂联素受体1在骨骼肌中有丰富表达,而脂联素受体2主要在肝中表达。另外,两种脂联素受体也在胰岛β细胞、脂肪组织、单核细胞、巨噬细胞、成骨细胞、心肌组织和胎盘组织中表达。生长激素、胰岛素以及过氧化物酶体增殖物活化受体(PPAR)α、PPARγ和肝X受体激动剂等可影响脂联素受体的表达。研究脂联素受体在不同组织、细胞中的表达与调节可了解其组织特异性作用。     

替米沙坦对高血压合并糖尿病患者血清脂联素的影响

目的观察替米沙坦治疗前、后高血压合并糖尿病患者血清脂联素水平的变化。方法将50名门诊高血压合并糖尿病病人分为替米沙坦和氨氯地平两组。观察治疗前及治疗10周后患者血压、脂联素及血糖、胰岛素变化。结果与治疗前相比,替米沙坦组与氨氯地平组收缩压和舒张压均显著降低(P<0.01),替米沙坦组血清脂联素水平较治疗前显著升高(P<0.01),血糖、胰岛素和胰岛素抵抗较治疗前显著降低(P<0.01);氨氯地平组治疗前后血清脂联素、血糖、胰岛素和胰岛素抵抗无明显改变(P>0.05)。结论与氨氯地平相比,替米沙坦在降压的同时,显著增高了血清脂联素水平并显著改善胰岛素抵抗,显示其具有降压外良好的代谢效应。     

慢性肾炎患者血清Hcy、APN、BNP水平的变化及临床意义

目的 探讨了慢性肾炎患者血清HCY、APN、BNP水平的变化及临床意义.方法 采用免疫化学法和化学发光免疫法检测31例慢性肾炎和30例健康人血清HCY、APN和BNP水平.结果 慢性肾炎患者HCY、BNP水平高于对照组,差异具有统计学意义(P＜0.01),而APN水平低于对照组,差异具有统计学意义(P＜0.01),血清HCY水平与BNP水平呈正相关(r=0.6018,P＜0.01),而与APN水平呈显著负相关(r=-0.5082,P＜0.01).结论 联合检测血清HCY、APN和BNP水平的变化对疾病的诊断和治疗有重要的临床价值.     

A high-fat maternal diet decreases adiponectin receptor-1 expression in offspring

In early life, over-nutrition may increase the risk of insulin resistance in the adult stage. Adiponectin and its receptor may play a key role in this process. This study aimed to identify the effect of a high-fat (HF) maternal diet on metabolic parameters and muscle adiponectin signaling in young adult offspring. We found that offspring born to dams fed HF chow (HF; 31% of calories from fat) had elevated body and adipose tissue weight and higher serum glucose levels after glucose challenge at three weeks (W3) and eight weeks (W8) of age. Offspring exposed to a HF diet also had higher serum adiponectin levels at W3 compared to controls. However, adiponectin levels were significantly decreased compared to controls by W8. Adiponectin receptor 1?mRNA expression in skeletal muscle was decreased in the HF group at W3 and W8, and there was no difference between the two groups in adiponectin receptor 2 expression. Furthermore, glucose transporter 4?mRNA and protein expression was decreased in the skeletal muscle of the HF group at W3 and W8. Our results suggest that a HF maternal diet decreases adiponectin receptor 1 expression in the offspring, which could contribute to reduced sensitivity to adiponectin and to adverse nutritional programing outcomes.     

中药正肝汤对乙型肝炎肝硬化患者血清瘦素、脂联素水平以及胰岛素抵抗影响的分析

目的 观察中药制剂正肝汤治疗乙型肝炎(乙肝)肝硬化患者对其血清瘦素(LEP)、脂联素(ADP)水平及胰岛素抵抗(IR)的影响。方法 将入选的66例乙肝肝硬化患者随机分为对照组(31例)和治疗组(35例), 其中对照组选用肌苷片和维生素C口服治疗, 治疗组在此基础上, 应用正肝汤治疗, 疗程为3个月, 测定治疗前后患者血清LEP、ADP水平及IR指数。结果 对照组血清LEP、ADP水平和IR指数与治疗前比较, 差异无统计学意义(P>0.05);治疗组血清LEP、ADP水平和IR指数较治疗前明显下降, 差异有统计学意义(P<0.05), 治疗组血清LEP和ADP水平与对照组比较, 差异有统计学意义(P<0.05)。结论 正肝汤治疗乙肝肝硬化患者具有降低血清LEP、ADP水平, 并有改善IR的作用。     

健脾祛湿方对2型糖尿病并非酒精性脂肪肝患者脂联素、肿瘤坏死因子-α和肝脏脂肪含量的影响

【目的】观察健脾祛湿方对2型糖尿病（type 2 diabetes mellitus, T2DM）并非酒精性脂肪肝（non-alcoholic fatty liver disease, NAFLD）患者脂联素（adiponectin, APN）、肿瘤坏死因子-α（tumor necrosis facto al’pha, TNF-α）及肝脏脂肪含量变化的影响。【方法】将120例T2DM并NAFLD患者随机分为健脾祛湿方组（治疗组）和吡格列酮组（对照组）各60例,在基础降糖治疗的同时,分别给予健脾祛湿方和吡格列酮治疗,观察时间均为24周。利用声触诊组织量化成像技术（virtual touch tissue quantification technique, VTQ）、酶联免疫吸附（ ELISA）法和生化分析仪观察2组治疗前后肝脏脂肪含量、 APN、TNF-α、血糖、血脂和肝功能等指标的变化。【结果】治疗后,2组空腹血糖（FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、 TNF-α含量及肝实质ARFI (acoustic radiation force impulse)值较治疗前均显著下降(P<0．05),高密度脂蛋白胆固醇（HDL-C）、 APN含量较治疗前显著上升(P<0．05);治疗组治疗前后FINS、 TNF-α差值大于对照组(P<0．05)。【结论】健脾祛湿方可能通过升高APN、降低TNF-α,从而达到纠正糖脂代谢紊乱,保护胰岛功能以及减少肝脏脂肪含量的功效。     

Impact of Regular Physical Activity on Adipocytokines and Cardiovascular Characteristics in Spinal Cord–Injured Subjects

Objective

To investigate the relationship of carotid artery intima-media thickness (IMT) and cardiac structure and function with adipocytokines in sedentary (S-SCI) and physically active (PA-SCI) subjects with spinal cord injury (SCI).

The development of microalbuminuria is associated with raised longitudinal adiponectin levels in female but not male adolescent patients with type 1 diabetes

AIMS/HYPOTHESIS: We determined the longitudinal relationship between adiponectin levels and the development of microalbuminuria in an inception cohort of children with type 1 diabetes. METHODS: Blood samples collected annually over a median of 9.0 (range 1.3-14.9) years were assayed for adiponectin and HbA(1c) in 55 children (36 girls) with type 1 diabetes and microalbuminuria whose age of onset of diabetes was 9.4 years (range 2.2-15.4). Samples were also assayed from normoalbuminuric children (controls) matched for age, sex and duration of diabetes. RESULTS: Overall, adiponectin levels were higher in girls than in boys, but only after 11 years of age (median [range]: 15.3 [5.8-124.4] vs 11.6 [4.1-26.5] mg/l, p < 0.001). Furthermore, adiponectin levels were higher in girls with microalbuminuria than in control girls, but this was only apparent after the onset of microalbuminuria (p = 0.001, adjusted for BMI, daily insulin dose, HbA(1c) and age). In boys, adiponectin levels did not differ between those with microalbuminuria and controls. Further sex-related discordant associations with adiponectin levels were observed; in girls, adiponectin levels were positively related to HbA(1c) levels (r = 0.2, p = 0.05) and urine albumin excretion (r = 0.3, p < 0.05) and inversely related to BMI (r = -0.2, p < 0.05). These associations were absent in boys. CONCLUSIONS/INTERPRETATION: In adolescent girls with type 1 diabetes but not in boys, adiponectin levels increase with increasing urine albumin excretion and onset of microalbuminuria. Although causal links cannot be inferred, this sexual dimorphism may reflect interactive effects of hyperglycaemia and sex steroids on risk of complications and adiponectin production.