代谢综合征合并冠心病患者氧化修饰型低密度脂蛋白与胰岛素抵抗的相关性研究

目的探讨代谢综合征（MS）及合并冠心病（CHD）患者氧化修饰型低密度脂蛋白（OX—LDL）水平与胰岛素抵抗及MS其他指标的关系。方法用酶联免疫吸附法（ELISA）测定单纯MS组（17例）、MS合并CHD组（40例）和正常对照组（19例）OX—LDL水平和空腹血浆真胰岛素水平，并收集MS的其他有关数据：腰围、体质量指数、空腹血糖和血脂，计算胰岛素敏感指数（IsI）。结果①OX—LDL水平在正常对照组为（6±5）ug／L，MS组为（25±12）ug／L，MS合并CHD组为（41±36）ug/L，三组比较差异有统计学意义（F=11．48，P〈0．05）；②OX—LDL水平与ISI呈负相关（r=-0．472，P〈0．05），与体质量指数、腰围、低密度脂蛋白胆固醇、空腹真胰岛素无明显相关性；③以OX—LDL水平为应变量的多元逐步回归分析提示，胰岛素敏感指数（r2=0．224）与OX—LDL具有相关性，体质量指数、腰围、低密度脂蛋白胆固醇、空腹真胰岛素与氧化低密度脂蛋白无明显相关性。结论MS患者的OX—LDL水平增加，合并CHD的MS患者更为明显，并与胰岛素抵抗相关，可能在MS发展为CHD中起一定作用。

Study on the relationship between oxidized low density lipoprotein and insulin resistance in patients with metabolic syndrome complicated with coronary heart disease

Objective To investigate the relationship between oxidized low density lipoprotein and insulin resistance, the metabolic parameters in patients with metabolic syndrome（MS） or MS complicated with coronary heart disease （ MS ＋ CHD）. Methods Oxidized low density lipoprotein level and fasting plasma insulin levels were measured by enzyme linked immunosorbent assay method in 17 MS patients, 40 MS ＋ CHD patients and 19 healthy controls. Other information on conventional clinical features of MS, such as waist, BMI, fasting blood glucose and blood fat were collected and the insulin sensitivity index（ISI） were calculated. Results （1）There was significant difference in oxidized low density lipoprotein concentrations between controls （6 ± 5 ） ug/L], patients with MS （25 ± 12 ） ug/L] and patients with MS ＋ CHD （41 ± 36 ） ug/L]. （2）Correlation analysis results suggested that the oxidized low density lipoprotein concentration was related to insulin sensitivity index （ r = -0.472, P 〈0.05）,there was no obvious relationship between oxidized low density lipoprotein concentration and the metabolic parameters including body mass index,waist, low density lipoprotein cholesterol and fasting insulin. （3）Logistic regression analysis indicated a statistically significant relationship between oxidized low density lipoprotein concentration and ISI （ r2 = 0. 224, P 〈 0.05 ） , the metabolic parameters including body mass index, waist, low density lipoprotein cholesterol, fasting insulin were not correlated with oxidized low density lipoprotein. Conclusions The oxidized low density lipoprotein concentration is highest in patients with MS ＋ CHD, and increased in patients with MS, which were significantly correlated with insulin resistance. This may contribute to the development to coronary heart disease from metabolic syndrome.