瘦素与代谢综合征组成成分的聚集特性分析

目的　探讨瘦素水平与代谢综合征 (MS)组成成分的关系 ,分析MS危险因素聚集的特征和规律。方法　观测 795名非糖尿病成人的空腹血清真胰岛素 (FTI)、瘦素、血脂、血糖水平以及血压、体重指数、腰臀围比值和定量胰岛素敏感检测指数 (QUICKI)等指标 ,采用因子分析等方法探讨瘦素水平与上述变量的关系。结果　血清瘦素浓度随代谢异常组合个数的增多而上升。瘦素水平处于上三分位人群检出肥胖、高血压、血脂紊乱以及MS的比例比处在下三分位的人群明显升高。因子分析结果显示 ,男性与女性组包括瘦素等 11个变量的变化各受 3个因子支配 ,累计方差贡献率分别为6 2 0 %和 6 6 7% ,分别由瘦素与体重指数、腰臀围比值、FTI、QUICKI和高甘油三酯和低的高密度脂蛋白胆固醇等变量构成的核心因子 ,由血糖、FTI、QUICKI和高甘油三酯 (女 )构成的糖耐量因子以及由血压和体重指数 (男 )构成的高血压因子 ,其中高胰岛素和胰岛素抵抗 (IR)同时连接前两个因子。结论　该人群的瘦素水平与MS的多个关键组成成分密切相关 ,高瘦素血症可能是MS的 1个新成分。MS危险因素的聚集受多个因子支配 ,IR虽起重要作用 ,但不能单独解释其成因。

Leptin and clustering of the components of risk factors for metabolic syndrome

OBJECTIVES: To evaluate relationship between serum level of leptin and the components of risk factors for metabolic syndrome and to analyze the characteristics and laws of clustering of the risk factors. METHODS: Totally, 795 non-diabetic adult Chinese subjects (691 men and 104 women, aged 40 - 75 years) from a diabetes prevalence survey in 2000 were involved in this study. Measurements included serum levels of true insulin (TI), leptin, fasting lipids, fasting glucose (FBG) and 2 h postchallenge glucose, as well as seated blood pressure (BP), body mass index (BMI), ratio of waist circumference to hip circumference (WHR), calculated quantitative insulin sensitivity check index (QUICKI), etc. Relationship between serum level of leptin and all the variables mentioned above was studied by statistical methods such as factor analysis, etc. RESULTS: Serum level of leptin in the study subjects increased with the number of components of abnormal metabolism they had. Detection rates of obesity, hypertension, dyslipidemia and metabolic syndrome were significantly higher in those with the upper tertile of serum leptin level than in those with the lower tertile. Factor analysis revealed that variation of the 11 variables including serum level of leptin was affected by the three factors, i.e., the central factor associated with BMI, WHR, FTI, QUICKI and higher serum level of triglyceride (TG) and lower serum level of high-density lipoprotein-cholesterol (HDL-C), the glucose intolerance factor loaded with blood glucose level, FTI, QUICKI and higher serum level of TG (in women only) and the hypertension factor loaded with blood pressure and BMI (in men only), which could explain 62.0% and 66.7% of total variance in men and women, respectively, and higher serum level of TI and insulin resistance also loaded with both the central factor and glucose tolerance factor. CONCLUSIONS: Serum level of leptin was significantly associated with the key markers of metabolic syndrome. Hyperleptinaemia could be a new component of metabolic syndrome. Clustering of the risk factors for metabolic syndrome could be affected by many factors, and although insulin resistance played an important role in it, insulin resistance alone could not explain its etiology.