代谢综合征患者血清色素上皮衍生因子水平变化的研究

目的 探讨代谢综合征(MS)患者血清色素上皮衍生因子(PEDF)水平的变化及其在MS发生、发展中的意义.方法 将93例门诊及住院MS患者按指标异常个数分为3个代谢指标异常组(Ⅲ组,n=30)、4个代谢指标异常组(Ⅳ组,n=42)、5个代谢指标异常组(Ⅴ组,n=20).35名门诊体检正常人群作为正常对照组(NC组).采用酶联免疫吸附试验测定血清PEDF浓度,同时测量身高、体重、腰围、血压,测定血脂、空腹血糖、空腹胰岛素、血清纤维蛋白原含量,计算稳态模型评估-胰岛素抵抗指数(HOMA-IR).采用多元逐步回归法分析PEDF的相关危险因素.结果 4组患者血清PEDF及纤维蛋白原水平逐渐升高(F=23.852、9.671,P均＜0.01).PEDF与体重指数、腰围、收缩压、舒张压、甘油三酯、纤维蛋白原、空腹血糖、空腹胰岛素、HOMA-IR呈正相关(r=0.253 ～0.440,P均＜0.01),与高密度脂蛋白-胆固醇(HDL-C)呈负相关(r=-0.334,P＜O.01).纤维蛋白原、HDL-C、空腹血糖、HOMA-IR是PEDF的相关危险因素(t=-2.977 ～3.793,P均＜0.05).结论 随着MS代谢异常指标个数的增多,PEDF水平升高,且与糖、脂代谢紊乱和胰岛素抵抗相关.PEDF可能是MS发病的预测因子.

Changes of serum pigment epithelium-derived factor in patients with metabolic syndrome

Objective To investigate the level of serum pigment epithelium-derived factor (PEDF) in patients with metabolic syndrome (MS) and its significance in the occurrence and development of MS.Methods A total of 93 outpatients and inpatients with MS were divided into three groups by the number of MS components:three abnormal components group (group Ⅲ,n =30),four abnormal components group (group Ⅳ,n =42) and five abnormal components group (group Ⅴ,n =21).A total of 35 normal subjects from outpatients received physical examination were included in control group.ELISA was used to detect the level of serum PEDF.Height,weight,waist circumference,blood pressure were measured and the level of blood lipid,fasting plasma glucose,fasting plasma insulin and fibrinogen were determined.Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated.Multiple stepwise regression was used to analyze the related risk factors for PEDF.Results The level of serum PEDF and fibrinogen increased gradually in the four groups (F =23.852,9.671,all P ＜ 0.01).The level of PEDF was positively correlated with body mass index,waist circumstance,systolic blood pressure,diastolic blood pressure,triglycerides,fibrinogen,fasting plasma glucose,fasting plasma insulin and HOMA-IR(r =0.253-0.440,all P ＜0.01),but negatively correlated with HDL-C (r =-0.334,P ＜ 0.01).Fibrinogen,high density lipoprotein-cholesterol,fasting plasma glucose and HOMA-IR were risk factors of PEDF (t =-2.977-3.793,all P ＜0.05).Conclusions PEDF increases along with the increased number of abnormal components of MS.PEDF correlates with glycolipid metabolic disorders and insulin resistance and may have predictive value for the risk of MS.