Monocyte chemoattractant protein‐1 gene polymorphism and its serum level have an impact on anthropometric and biochemical risk factors of metabolic syndrome in Indian population

Monocyte chemoattractant protein‐1 (MCP‐1), encoded by gene CCL‐2 (Chemokine C‐C motif 2), is the ligand of chemokine receptor CCR‐2. Concurrent clinical alteration in several metabolic aspects, including central obesity, dysglycemia, dyslipidemia and hypertension, is clinically characterized as metabolic syndrome (MetS). Role of MCP‐1 in each of these aspects has been established in vitro and in animal studies as well. We here report genetic association of ?2518 A>G MCP‐1 (rs 1024611) gene polymorphism and level of MCP‐1 with MetS in North Indian subjects. We analysed (n = 386, controls and n = 384, MetS subjects) for MCP‐1 gene polymorphism using PCR‐RFLP, its serum level using ELISA, anthropometric (body mass index, waist and hip circumferences, waist–hip ratio and blood pressure) and biochemical (serum lipids, plasma glucose and insulin levels) variables in a genetic association study. The body mass index, waist circumference, hip circumference, waist–hip ratio, blood pressure, serum lipids, insulin and fasting plasma glucose level were significantly high in MetS subjects. Regression analysis showed significant correlation of body mass index, waist and hip circumference, systolic/diastolic blood pressure, fasting glucose, total cholesterol, high‐density lipoprotein, low‐density lipoprotein fasting insulin and HOMA‐IR with MetS. MCP‐1 allele and genotype were significantly associated with MetS. Serum MCP‐1 level was high in overall cases. In conclusions, the MCP‐1 2518A>G (rs 1024611) polymorphism has significant impact on risk of MetS, and MCP‐1 level correlates with anthropometric and biochemical risk factors of MetS.     

Association of serum retinol binding protein 4 with adiposity and pubertal development in Korean children and adolescents

Retinol binding protein 4 (RBP4) has been postulated to provide a new link between obesity and insulin resistance. We aimed to assess the relationship between serum RBP4 and insulin resistance by investigating serum RBP4 levels in children and adolescents according to degree of obesity and pubertal stage. A total of 103 (30 lean, 39 overweight, 34 obese) were evaluated for serum RBP4, adiponectin, insulin, glucose and lipid profiles. RBP4 levels of obese and overweight groups were higher than those of lean group. RBP4 level was higher in pubertal group than in prepubertal group. RBP4 was positively correlated with age, height, weight, body mass index (BMI), abdominal circumference, systolic blood pressure, fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR), total cholesterol and triglyceride, and inversely with adiponectin. In the multiple linear regression analysis, RBP4 was found to be independently associated with pubertal stage, BMI and triglyceride but not with HOMA-IR. In conclusion, serum RBP4 level is related with degree of adiposity and pubertal development. The association of RBP4 with insulin resistance is supposed to be secondary to the relation between RBP4 and adipose tissue in children and adolescents.     

Circulating visfatin level and visfatin/insulin ratio in obese women with metabolic syndrome

Introduction

Visfatin is an adipokine secreted by visceral adipose tissue with insulin-mimetic properties. Higher circulating visfatin levels were reported in type 2 diabetes. The aim of this study was to analyse circulating visfatin and insulin levels and the visfatin/insulin ratio in obese women with and without metabolic syndrome (MetS).

Material and methods

The study involved 92 obese women. Subjects were diagnosed with MetS according to IDF 2005 criteria. The MetS group consisted of 71 subjects (age: 52.8 ±9.4 years, body mass index [BMI]: 39.1 ±5.6 kg/m², waist circumference: 109.6 ±11.4 cm and fat mass: 52.0 ±12.8 kg) while the non-MetS group consisted of 21 subjects (age: 51.7 ±9.5 years, BMI: 36.3 ±5.2 kg/m², waist circumference: 104.7 ±11.0 cm and fat mass: 45.2 ±10.7 kg). In addition to anthropometric measurements and assessment of serum glucose and lipids, plasma concentrations of visfatin were estimated by enzyme-linked immunosorbent assay (ELISA) and of insulin by radioimmunoassay (RIA). Homeostatic model assessment insulin resistance (HOMA-IR) and visfatin/insulin ratio were calculated.

Results

In the MetS group significantly higher (p < 0.01) plasma concentrations of insulin and HOMA-IR values but similar visfatin levels were observed than in the non-MetS group. As a consequence of the significantly higher plasma insulin concentration the visfatin/insulin ratio was significantly lower in the MetS group (p < 0.05). The visfatin/insulin ratio correlated inversely with anthropometric parameters such as body mass, BMI, body fat and waist circumference (r = –0.41, p = 0.0003; r = –0.42, p = 0.0002; r = –0.29, p = 0.01; r = –0.23, p = 0.04, respectively).

Conclusions

We conclude that the visfatin/insulin ratio declining with increasing visceral obesity may predispose to the development of insulin resistance.     

Role of Vitamin D in Intima Media Thickness in Patients with Type 1 Diabetes Mellitus

Increased carotid intima media thickness indicates subclinical atherosclerosis. We evaluated the relation between vitamin D level and intima media thickness in patients with type 1 DM. 93 patients (female/male: 48/45, aged 31.5 ± 11.9 years, A1c 9.48 ± 2.43, vitamin D [15.9 (12.1–19.2)]) with type 1 DM were included into the study. Common carotid artery IMT was measured by real time B mode ultrasonography (MyLab 70 XVG, Esaote SpA, Genoa, Italy). Vitamin D was measured using radioimmunassay. Male and female patients (n = 14, 15%) had similar rates of plaque presence (p = 0.377). IMT was similar according to gender. IMT [0.45 (0.40–0.50)] was positively correlated with age, duration of diabetes, creatinine, LDL/HDL ratio, and ALP. Median IMT was higher in current smokers, patients with retinopathy, and nephropathy, and overweight/obese patients. IMT was not different according to vitamin D status. However calcium level corrected for albumin was in positive correlation with mean IMT (r = 0.221, p = 0.033). We detected high frequency of vitamin D deficiency (78%) defined as less than 20 ng/ml. Vitamin D and diabetes control defined as A1c have no effect on intima media thickness in type 1 DM. Traditional cardiovascular risk factors including age, duration of DM, smoking, and BMI adversely affect intima media thickness.     

Intima-media thickness and pulse wave velocity in hypertensive adolescents

Increased intima-media thickness (IMT) and pulse wave velocity (PWV) are noninvasive markers of early arterial wall alteration and are more widely used in adult clinical research. We investigated whether IMT and PWV are useful predictors of cardiovascular risk in hypertensive adolescents. Fifteen hypertensive adolescents (13-18 yr old, systolic BP > or = 140 mmHg, diastolic BP > or = 90 mmHg) and seventeen normotensive subjects were included. Height, weight, obesity index, body mass index (BMI), and fat distribution were obtained from each group. Serum lipid, insulin, vitamine B12, folate, renin, aldosterone, angiotensin-converting enzyme (ACE), and homocysteine levels were compared. The carotid IMT and PWV were measured. Arterial wall compliance and distensibility were calculated with the equation. High systolic blood pressure significantly correlated with height, weight, BMI, obesity index, arm circumference, fat mass, and fat distribution. Hypertensive adolescents had significantly greater cIMT (carotid intima-media thickness) and lower elastic properties such as cross-sectional compliance and distensibility of the carotid artery. The carotid IMT significantly correlated with brachial-ankle PWV. In conclusion, the measurement of carotid IMT and brachial-ankle PWV might be useful to predict the development of atherosclerosis in hypertensive adolescents.     

Association of Plasma Levels of Resistin with Subcutaneous Fat Mass and Markers of Inflammation but not with Metabolic Determinants or Insulin Resistance

The aim of the present study was to investigate the relationship of plasma resistin levels with determinants of the metabolic syndrome (MetS) and anthropometric parameters in healthy Korean subjects. Plasma resistin levels were determined in 276 subjects. In subjects with MetS, the plasma resistin levels were not significantly increased compared to those without MetS (8.3±4.3 ng/mL vs. 8.5±3.6 ng/mL, respectively, P=0.84). In addition, the plasma resistin levels were not correlated with the body mass index, the waist circumference, homeostasis model assessment-insulin resistance (HOMA-IR), fasting plasma glucose or insulin levels. However, the plasma resistin levels were positively correlated with the abdominal subcutaneous fat (r=0.18, P<0.01) in all subjects and correlated with TNF α(r=-0.16, P<0.05) and hsCRP (r=0.15, P<0.05) in subjects without MetS but not with MetS. With multiple linear regression analysis, these linear associations remained to be significant. The results of this study show that plasma resistin levels in humans were not associated with markers of insulin resistance, obesity or other determinants of the MetS.     

The clustering patterns of metabolic risk factors and its association with sub-clinical atherosclerosis in Korean population

Background and aims: Metabolic syndrome (MetS) is considered to be an insulin-resistance syndrome, but recent evidence suggests that MetS has multiple physiological origins which may be related to atherosclerosis. This study investigated clustering patterns of metabolic risk factors and its association with sub-clinical atherosclerosis.

Subjects and methods: This study used factor analysis of 11 metabolic factors in 1374 individuals to define clustering patterns and determine their association with carotid intima-media thickness (CIMT). Eleven metabolic factors were used: body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), fasting blood insulin (FBI), serum triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), homeostasis model assessment-insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hsCRP) and adiponectin. Two regression analyses were done, the first using individual metabolic variables and the second using each factor from the factor analysis to evaluate their relationships with CIMT.

Results: Four clustering patterns, insulin-resistance factor (FBG, FBI, HOMA-IR), obesity-inflammatory factor (BMI, WC, hsCRP), blood pressure factor (SBP, DBP) and lipid metabolic factor (HDL-C, TG, adiponectin) were categorized. In a multivariate regression model after adjustment for age, sex, low-density lipoprotein cholesterol and smoking history (pack year), insulin resistance factor (B = 11.09, p = 0.026), obesity-inflammatory factor (B = 18.50, p < 0.001), blood pressure factor (B = 12.84, p = 0.010) and lipid metabolic factor (B = ? 11.55, p = 0.023) were found to be significantly associated with CIMT.

Conclusion: In conclusion, metabolic risk factors have four distinct clustering patterns that are independently associated with sub-clinical atherosclerosis.     

Obesity is associated with insulin resistance and components of the metabolic syndrome in Lebanese adolescents

Background: Prevalence of metabolic syndrome (MS) in obese adolescents has been reported to range between 18–42%, depending on country of origin, thus suggesting an ethnic-based association between obesity and MS.

Aim: This study aims to investigate the magnitude of the association between obesity, insulin resistance and components of MS among adolescents in Lebanon.

Subjects and methods: The sample included 263 adolescents at 4^th and 5^th Tanner stages of puberty (104 obese; 78 overweight; 81 normal weight). Anthropometric, biochemical and blood pressure measurements were performed. Body fat was assessed using dual-energy X-ray absorptiometry.

Results: According to International Diabetes Federation criteria, MS was identified in 21.2% of obese, 3.8% of overweight and 1.2% of normal weight subjects. The most common metabolic abnormalities among subjects having MS were elevated waist circumference (96.2%), low HDL (96.2%) and hypertriglyceridemia (73.1%). Insulin resistance was identified in all subjects having MS. Regression analyses showed that percentage body fat, waist circumference and BMI were similar in their ability to predict the MS in this age group.

Conclusions: MS was identified in a substantial proportion of Lebanese obese adolescents, thus highlighting the importance of early screening for obesity-associated metabolic abnormalities and of developing successful multi-component interventions addressing adolescent obesity.     

Objective snoring time and carotid intima‐media thickness in non‐apneic female snorers

Controversy persists about whether snoring can affect atherosclerotic changes in adjacent vessels, independently of obstructive sleep apnea and other cardiovascular risk factors. This study examined the independent association between snoring and carotid artery intima‐media thickness (IMT) in non‐apneic snorers and non‐snorers. We studied 180 non‐apneic snorers and non‐snorers participating in a full‐night home‐based sleep study. Snoring sound was measured objectively by a microphone. Based on snoring time across the night, participants were classified as non‐snorers (snoring time: 0%), mild snorers (1–25%) and moderate to heavy snorers (≥25%). We measured IMT on both common carotid arteries. The three groups were matched by age, body mass index, cholesterol, blood pressure and glucose levels, using weights from generalized boosted‐propensity score models. Mean carotid IMT increased with increased snoring time across the night in women: non‐snorers (0.707 mm), mild (0.718 mm) and moderate to heavy snorers (0.774 mm), but not in men. Snoring during at least one‐fourth of a night's sleep is associated independently with subclinical changes in carotid IMT in women only.     

Association of abdominal obesity with atherosclerosis in type 2 diabetes mellitus (T2DM) in Korea

The aim of this study was to investigate the relationship between obesity, insulin resistance and atherosclerosis in type 2 diabetes mellitus (T2DM) patients. Total 530 patients with T2DM were included. To evaluate the severity of atherosclerosis, we measured the coronary artery calcification (CAC) score, intima-media thickness (IMT) of the common carotid artery, and the ankle-brachial pressure index (ABPI). Subjects were classified according to body mass index (BMI), a marker of general obesity, and waist-to-hip ratio (WHR), a marker of regional obesity. The insulin sensitivity index (ISI) was measured by the short insulin tolerance test. All subjects were classified into four groups, according to BMI: the under-weight group, the normal-weight (NW) group, the over-weight (OW) group, and the obese (OB) group. WHR and systolic blood pressure, triglycerides (TG), HDL-cholesterol (HDLC), free fatty acids (FFA), fibrinogen, and fasting c-peptide levels were significantly different between BMI groups. TG, HDL-C, FFA, fibrinogen and ISI were significantly different between patients with and without abdominal obesity. In the OW group as well as in the NW group, carotid IMT, ABPI and CAC score were significantly different between patients with and without abdominal obesity. This study indicates that abdominal obesity was associated with atherosclerosis in T2DM patients.     

Metabolic changes associated with obesity in adults

In order to find if the metabolic disorders more frequently found in our obese population were similar to the ones reported in the literature for other countries, a study was conducted in a group of 34 obese subjects (10 men and 24 women) whose only apparent alteration was a body mass index above 30 (mean value: 36.8 +/- 4.6) to obtain the relation between anthropometric measurements (Quetelet index, skinfold measures and waist/hip ratio) and plasma levels of nine biochemical parameters (including lipids, lipoproteins and glucose and insulin levels after an oral glucose load). The results revealed a tendency to the android distribution of fat in the female population, a significantly elevated triglyceride and total lipids levels and a decreased in HDL-cholesterol in both sexes. Hypercholesterolemia was present mainly in the male population. The most frequent dyslipidemia was Type IV (23%) followed by type IIb (15%). Practically none of the subjects had abnormal glycemic values after the glucose load, however the insulin levels were highly elevated in 80% of the patients, resulting in a great insulin/glucose ratios. Correlation analysis showed no association of the BMI with any biochemical parameter; only the insulin area was positively associated with anthropometric measures (mainly waist/hip ratio) and with the most altered biochemical parameter, the triglycerides. Variance analysis showed that only low HDL-cholesterol values were significantly different in patients presenting high blood pressure and familiar history of diabetes.     

肥胖伴高胆固醇血症患者胰岛素抵抗代谢指标的变化

目的观察肥胖伴高胆固醇血症患者胰岛素抵抗的程度。方法将2007年度门诊体检人群中体重指数(BMI)28kg/m2者96例纳入本研究,测量血压、身高、体重、腰围、臀围、体脂含量及重量,并抽血检测空腹及口服75g葡萄糖后2h血糖(FBS,2hPBS)、胰岛素水平(FIns,2hIns),采用稳态模型评估法(HOMA)中的HOMA-IR公式评价胰岛素抵抗程度;空腹检测血脂、尿酸及糖化血红蛋白(HbA1c)水平。结果①本组肥胖症患者中,高胆固醇血症、高TG血症、混合型高脂血症及血脂水平正常者分别占37.5%,7.3%,31.2%及24%;②高Cho血症组WHR,HOMA-IR大于胆固醇正常组(0.92vs0.89,P=0.037;4.42vs3.56,P=0.032);③胰岛素抵抗组体重、腰围、臀围、WHR、BMI、脂含量、脂重量、胆固醇、FBS、UA高于非胰岛素抵抗组(73.04vs67.78,P=0.026;94.49vs87.83,P=0.001;105.14vs100.97,P=0.009;0.90vs0.87,P=0.049;29.74vs27.44,P=0.002;34.63vs32.25,P=0.049;25.11vs21.24,P=0.003;5.74vs5.44,P=0.041;5.40vs4.45,P=0.006;440.52vs355.86,P=0.017);④HOMA-IR与体脂重量、Cho、TG、WHR及BMI水平分别呈正相关(r=0.260,P=0.03,N=70;r=0.636,P=0.023,N=87;r=0.228,P=0.033,N=87;r=0.306,P=0.04,N=87;r=0.344,P=0.001,N=87)。结论②本研究所观察到的肥胖伴高胆固醇血症患者存在胰岛素抵抗,对于肥胖患者应尽早进行相关代谢指标的筛查。     

北京市3—18岁人群腰围和腰围身高比分布特征及其适宜界值的研究

目的 研究北京市3～18岁人群腰围（WC）、腰围身高比（WHtR）的分布特征；在心血管疾病（CVD）危险因素评估的基础上提出6—18岁人群WC和WHtR的适宜界值。方法 对2004年北京市儿童青少年代谢综合征研究项目总人群中3—18岁人群的WC、WHtR进行描述性分析；基于CVD危险因素评估，采用工作者特征曲线分析方法，研究6—18岁人群WC和WHtR的适宜界值；并利用《北京市学校卫生防病工作规划》（2006）血脂健康调查中6—17岁人群生理、生化检测数据，对上述界值进行交叉验证。结果 基于CVD危险因素评估基础上的WC适宜界值为性别年龄组的第80百分位值，WHtR的适宜界值为0．46。交叉验证显示：按WC和WHtR适宜界值划分的肥胖组血压、血脂等CVD危险因素无论均值还是检出率均显著高于正常体重组。结论 上述WC、WHtR适宜界值可敏感地区分高血压、高三酰甘油和低高密度脂蛋白胆固醇等CVD危险因素，WC作为相对简单的测量方法应列入学生体检的常规测量项目。     

Effect of weight reduction on metabolic syndrome in Korean obese patients

The Third Report of the National Cholesterol Education Program Adult Treatment Panel III emphasized the importance of management of the metabolic syndrome. However, little information is available about the effect of weight reduction on the metabolic syndrome in obese patients among Koreans. A longitudinal clinical intervention study from the 12-week of weight reduction program, including life style modification and adjuvant appetite suppressants, in 78 obese persons was performed. Anthropometry and metabolic risk factors were measured before and after weight reduction. Visceral (VAT), subcutaneous (SAT), and total adipose tissue (TAT) on abdomen were determined by CT scan. Moderate decrease in weight (9.3%) induced significant reduction of waist circumference, systolic and diastolic blood pressure, and triglyceride. Weight reduction also resulted in significant decrease in total cholesterol, LDL-C, uric acid, fasting insulin, and HOMA score. The subjects with metabolic syndrome showed more improvements of metabolic components than those without metabolic syndrome through weight reduction. The reductions of visceral-subcutaneous fat ratio (VSR) and waist circumference were observed as for the predictable variables related to the improvement of metabolic component and insulin resistance in Korean obese patients.     

纳西族成人各项肥胖指标与体脂率的关系

目的 探讨纳西族各项肥胖指标与体脂率的关系。 方法 选取云南省丽江市玉龙县687名18~90岁成年纳西族人,运用人体测量法和生物电阻抗法测量其体重、身高、胸围、腰围、臀围、肱二头肌皮褶、肱三头肌皮褶、肩胛下皮褶、髂嵴上皮褶、髂前上棘皮褶、体质量指数（BMI）、内脏脂肪等级和体脂率等指标,并将各项指标分别与体脂率进行统计分析。 结果 纳西族成人的平均体脂率男性为正常水平,女性属于肥胖。按照内脏脂肪等级为标准,纳西族男性和女性均在正常范围内。根据腰围的判断标准,纳西族男性腰围在正常范围内,而女性腰围属于腹型肥胖。相关分析表明,纳西族成人的体重、胸围、腰围、臀围、肱二头肌皮褶、肱三头肌皮褶、肩胛下皮褶、髂嵴上皮褶、髂前上棘皮褶、BMI、内脏脂肪等级与体脂率均成正相关。纳西族男性内脏脂肪等级与体脂率相关性最强,其次是BMI;纳西族女性胸围与体脂率相关性最强,其次是腰围。 结论 纳西族成人各项肥胖指标均与体脂率成正相关,相关程度存在性别、地区和民族差异。     

冠心病患者动脉粥样硬化与人巨细胞病毒检测结果的相关性分析

目的 观察人巨细胞病毒(HCMV)在冠心病患者动脉粥样硬化发病过程的相关性.方法 选取我院2014年8月至2016年4月心内科收治的动脉粥样硬化患者136例为观察对象,其中冠心病(CHD)患者103例,非CHD患者33例.使用多普勒超声对颈动脉内膜—中层厚度(IMT)进行监测,酶联免疫吸附试验法对血清HCMV-IgM进行检测.结果 HCMV感染组心肌梗死发生几率明显高于非HCMV感染组.HCMV感染组冠状动脉多支病变的发生几率亦显著高于非HCMV感染组.病变过程中HCMV感染和患者颈动脉IMT的相关性发现:HCMV感染患者颈动脉IMT(1.31 ±0.27) mm,非HCMV感染(1.14±0.22)mm,P＜0.05,差异有统计学意义;HCMV感染组的MMP-9以及软斑组织水平明显高于非HCMV感染组.将HCMV感染作因变量,将其他因素作自变量,筛选出3个影响因素,即:颈动脉IMT、MMP-9、软斑组织.结论 冠心病动脉粥样硬化与HCMV感染呈正相关,作为其影响因素可能会增加HCMV感染的几率.     

颈围预测成人肥胖的可行性分析

目的 通过对颈围与肥胖关系的分析,探讨颈围对肥胖预测的可行性,进而为早期预防肥胖及相关疾病提供参考。 方法 选取临高人、黎族、羌族、白马人4个族群共1859名成人（男性911名,女性948名）作为研究对象,分别将其颈围与身体质量指数（BMI）、体脂率、内脏脂肪等级、腰围、腰臀比、身体肥胖指数 6项国内外公认的肥胖指标进行相关性分析、u 检验及受试者工作特征（ROC）曲线分析和 Kappa 一致性检验。 结果 颈围与其他几种肥胖指标均具有显著正相关性,与身体肥胖指数和腰臀比相关性最小,与腰围、内脏脂肪等级、体脂率相关性较大,与BMI相关性最大。不同肥胖指标判断的肥胖组颈围均值都大于正常组,且差异具有统计学意义。ROC曲线分析和 Kappa 一致性检验表明,颈围与各项肥胖指标的曲线下面积（AUC）均>0.7,且颈围与BMI和腰围在判断肥胖时一致性最好。 结论 当男性颈围值>临界切点值364.5时,女性颈围值>319.5时,可预测为BMI值达到超重或肥胖;而男性颈围值>370.5,女性颈围值>319.5时,可以预测腰围超标,中心性肥胖的危险性增大。     

Hepatic lipase promoter C-480T polymorphism is associated with serum lipids levels, but not subclinical atherosclerosis: The Cardiovascular Risk in Young Finns Study

The common C‐480T polymorphism (rs1800588) of the hepatic lipase gene (LIPC) has been associated with high‐density lipoprotein (HDL) cholesterol, atherosclerosis, and coronary artery disease. In this study, we examined whether the polymorphism is associated with serum lipid and lipoprotein concentrations, as well as with subclinical atherosclerosis in Young Finns. The participants comprised 2041 men and women (aged 24–39 years) enrolled in the Cardiovascular Risk in Young Finns Study with complete data concerning the rs1800588 polymorphism and serum lipids concentration. All participants underwent an ultrasound examination for brachial artery flow‐mediated vasodilatation (FMD) and carotid artery intima‐media thickness (IMT) measurement. The marker of arterial elasticity, carotid artery compliance (CAC), was also calculated by means of ultrasound and concomitant brachial blood pressure measurements. In all subjects, serum total cholesterol (p < 0.001), HDL cholesterol (p = 0.006), apolipoprotein AI (apoAI, p < 0.001), and triglyceride (p = 0.009) concentrations increased according to rs1800588 genotype in the order CC, CT, and TT. The same order applied only to apoAI after adjustment for age, body mass index, systolic and diastolic blood pressure, smoking, alcohol consumption, physical activity, diabetes, hypertension, contraceptive hormone use in women, and concentrations of glucose, insulin and C‐reactive protein in men and women separately (p = 0.007 and p = 0.003, respectively). The polymorphism was also associated with HDL cholesterol, total cholesterol, and triglyceride levels in women (adjusted p = 0.004, p = 0.007 and 0.02, respectively), but not in men (p was not significant for all). No significant association between the rs1800588 and brachial FMD, carotid IMT, or CAC was found among the entire study population or among women or men separately, with or without adjustment for the above‐mentioned factors. The rs1800588 is associated with serum lipid and apolipoprotein concentrations, especially in women, but does not seem to be a determinant of brachial artery FMD, carotid IMT, or CAC in young healthy adults.     

2型糖尿病患者载脂蛋白e4等位基因与颈动脉中内膜厚度的关系

目的：了解2型糖尿病（diabetes mellitus,DM)患者载脂蛋白E（apolipoprotein E,apoE)基因型与颈动脉中内膜厚度的关系。方法：选择255例无血管并发症的2型DM患者和107名健康个体，采用聚合酶链反应等位基因特异寡核苷酸探针杂交技术检测其apoE基因型。结果：2型DM组与对照组apoE基因型及等位频率差异无显著性（P＞0．05）；两组中e4/4、e4/3亚组总胆固醇、低密度脂蛋白胆固醇、脂蛋白（a)水平明显高于e3/2、e2/2亚组（P＜0．05）；两组中e4/4、e4/3亚组颈动脉中内膜厚度明显高于e3/2,e2/2亚组（P＜0．05）。不论在对照组还是在2型DM ，当调整总胆固醇、低密度脂蛋白胆固醇、甘油三酯、脂蛋白（a)、血糖、年龄、体重指数、吸烟等因素的影响后，协方差分析结果显示，颈动脉中内膜厚度在这两个基因型亚组喑差异有显著性（P＜0．05）。结论：不论在健康人还是在2型DM患者，e4等位基因与早期颈动脉粥样硬化关联。     

Variation in the anthropometric dimensions for estimating upper and lower body obesity

A literature review identified 29 anthropometric methods to estimate body fat distribution, but no valid standardized set of criterion values to categorize upper and lower body obesity. The purpose of this investigation was to observe the influence of different anthropometric methods for categorizing upper and lower body obesity. Three common girth methods (waist:iliac crest, iliac crest: hip, and waist:hip) for waist to hip ratios (WHR) and one common skinfold method for trunk to extremity ratio were compared in 119 obese women (38.4 ± 5.3% fat) and 81 obese men (31.3 ± 5.2% fat). Significant differences were found in the WHR among all three girth methods for women, but for only the waist:hip method for men. A significant interaction between method and sex was also apparent. The different WHR methods resulted in a significantly different percentages of the population categorized as having lower, normal, and upper body obesity. Kappa statistics demonstrated significant agreement among the three methods to place subjects into similar fat distribution categories for men (κ = 0.133; z = 4.03), but not for women (κ = 0.059; z = 2.20). There was also no significant correlation between any of the circumference and skinfold methods for men (r = 0.20, 0.10 and 0.15, respectively); yet, significant correlations were found between the iliac crest:hip (r = 0.30) and waist:hip (r = 0.45) methods and the skinfold method for women. In summary, girth methods for estimating body fat distribution in terms of lower and upper body obesity need validation and standardization. © 1994 Wiley-Liss, Inc.