维吾尔族肥胖患者脂肪和血清内脂素、脂联素的改变及相关因素

目的 探讨维吾尔族肥胖患者内脂素、脂联素(APN)在腹部网膜、皮下脂肪组织的表达和血清水平改变及其与体重指数(BMI)、腰臀围比(WHR)和血脂的关系.方法 用半定量RT-PCR方法检测41例肥胖患者和20例非肥胖对照脂肪组织内脂素和APN mRNA表达水平,ELISA法检测血清内脂素和APN浓度,并测量腰围(WC)、臀围(HC)、血压(BP)、空腹血糖(FPG)和血脂等.结果 ① 网膜脂肪组织内脂素mRNA表达水平在肥胖组与非肥胖对照组之间差异无显著性,肥胖组APN mRNA表达水平显著低于非肥胖对照组(P<0.05);内脂素、APN在两组网膜和皮下脂肪组织mRNA的表达水平均无显著性部位差异;血清内脂素肥胖组显著高于非肥胖对照组(P<0.05),APN在两组之间比较差异无显著性.② 肥胖组舒张压(DBP)和收缩压(SBP)均显著高于非肥胖对照组(P<0.01和P<0.01),高密度脂蛋白(HDL-C)明显低于非肥胖对照组(P<0.05).③ 网膜脂肪组织内脂素mRNA表达量与血清内脂素、BMI和TG显著正相关,APN mRNA表达量与血清APN显著正相关,与BMI、LDL-C显著负相关.结论 维吾尔族肥胖患者血清内脂素水平升高,网膜和皮下脂肪组织内脂素mRNA表达水平无显著性部位差异;APN mRNA在网膜脂肪组织的表达显著降低,内脂素和脂联素可能在维吾尔人中心性肥胖相关的代谢紊乱性疾病中起一定作用.     

青少年肥胖与胰岛素抵抗、血清脂联素水平及心理因素的关系

目的研究青少年肥胖与胰岛素抵抗、血清脂联素水平及心理因素的关系。方法中学生健康体检时选择体质量指数（BMI）在同年龄、同性别第95百分位数或以上者47例为肥胖组,对照组50例。检查血压、血糖、血脂、胰岛素和脂联素等指标,计算胰岛素抵抗指数,双能χ线吸收法检查体脂含量,采用症状自评量表评价心理状况。结果肥胖组血压、BMI、空腹胰岛素、血清TG、胰岛素抵抗指数、总体脂及躯干部体脂百分比高于对照组,而血清脂联素水平显著低于对照组。总体脂、躯干部体脂百分比和胰岛素抵抗指数是血清脂联素独立相关因素,为负性相关。肥胖组心理问题高于对照组,尤其在抑郁、焦虑和人际关系方面明显升高。结论青少年肥胖导致心理问题明显增加,血清脂联素与青少年肥胖呈负相关。     

血清脂联素与肥胖的关系

目的　探讨中国人血清脂联素水平与肥胖及肥胖类型的关系。方法　对 390名居住上海地区中国人应用MRI测定局部体脂,放射免疫分析法测定血清脂联素水平。结果　 ( 1 )女性血清脂联素水平显著高于男性(P<0. 01)。(2)超重 /肥胖者血清脂联素水平较正常体重者显著下降〔男性 (8. 59±0. 64)mg/Lvs (10. 73±0. 95)mg/L(P<0. 05); 女性 (11. 42±0. 58)mg/Lvs (13. 59±0. 84)mg/L(P<0. 05)〕,腹内型肥胖者血清脂联素水平较非腹内型肥胖者显著下降〔男性(8. 32±0. 82)mg/Lvs(9. 58±0. 99)mg/L(P<0. 05);女性(10. 74±0. 58)mg/Lvs(12. 16±0. 88)mg/L(P<0. 05)〕。(3)多元逐步回归表明,无论性别,腰臀比、腹部脂肪面积 /股部脂肪面积 (VA SA/FA)、低密度脂蛋白胆固醇、HOMA IR是血清脂联素水平的独立相关因素,表现为两者之间的负性影响。结论　血清脂联素水平存在性别差异;腹内型肥胖者伴有显著的低脂联素血症;血清脂联素与腹内型肥胖、胰岛素抵抗指数显著负相关。     

血清高密度脂蛋白及其亚型胆固醇与肝功能关系的探讨

本文了测定了45例失代偿期肝硬化及24例慢性活动性肝炎（包括早期肝硬化）患者血胆固醇含量，血甘油三酯和高密度脂蛋白及其亚型胆固醇含量，结果表明失代偿期肝硬化患者血清高密度脂蛋白胆固醇（HDLch)，高密度脂蛋白3胆固醇（HDL3ch），血总胆固醇（Tc)与正常对照组及慢活肝组之间存在非常显著的差异（P＜0．001），而其高密度脂蛋白2胆固醇与后二者尽管也存在显著差异，但其敏感性较差（P＜0．01），提示HDLch,HDL3ch可以作为判断肝功能状态敏感的指标。     

血清脂联素水平与肥胖度的关系

目的 研究上海地区人群血清脂联素(adiponeetin)水平与年龄、性别、体脂及血清瘦素水平的关系。方法 用放射免疫分析法测定104例正常非肥胖和57例超重或肥胖个体[体重指数(BMI)≥25kg/m~2]的血清脂联素水平。结果 正常非肥胖者脂联素男性(10.15±6.33)mg/L,女性(13.82±6.09)mg/L;超重或肥胖者脂联素男性(5.78±3.55)mg/L,女性(8.13±4.32)mg/L。正常女性血清脂联素水平高于男性,肥胖及超重个体血清脂联素水平显著低于正常人。脂联素浓度与BMI、腰围和体脂％呈显著负相关,与血清瘦素呈负相关,但扣除体脂因素后两者并尤明显相关性。在本年龄段中,脂联素与年龄关系不大。结论 脂联素作为脂肪细胞分泌的一种激素蛋白,其浓度变化可能与肥胖及其相关疾病密切相关,表明脂联素的增加可能是有益的。     

2型糖尿病患者血清脂联素和内脂素水平与糖尿病肾病的相关性

目的评估2型糖尿病患者血清脂联素和血清内脂素水平与糖尿病肾病间的相关性。方法 2型糖尿病患者96例,根据尿蛋白及尿微量白蛋白的水平分为单纯糖尿病组(36例)和糖尿病肾病组(60例)。同时,以同期行常规体检的健康者30例为对照组。分析和比较各组受试者的血清脂联素和内脂素水平,筛选可用于预测2型糖尿病肾病发生的血清标记物。结果糖尿病患者的血清脂联素均明显低于对照组,血清内脂素水平均明显高于对照组(P<0.05)。而且,糖尿病肾病组血清脂联素和内脂素水平均明显高于单纯糖尿病组(P<0.05)。进一步多因素Logistic回归分析显示,血清内脂素是2型糖尿病患者发生糖尿病肾病的独立危险因素。结论血清脂联素水平降低和血清内脂素水平升高与2型糖尿病肾病的发生密切相关,血清内脂素水平升高可能预示2型糖尿病患者糖尿病肾病的发生或加重。     

糖尿病和肥胖症患者网膜脂肪组织中的内脂素表达及其影响因素

目的探讨糖尿病、肥胖症患者网膜脂肪组织细胞内脂素的表达及其影响因素。方法选择糖尿病组、肥胖症组、健康对照组各60例,测定血清内脂素、脂联素、肿瘤坏死因子α（TNF-α）浓度。同时,选取三组共66例（糖尿病组23例、肥胖症组22例、对照组21例）行外科手术时切割的各内脏器官网膜脂肪组织提取总mRNA,然后进行Northern b lot印迹技术研究,分析内脂素mRNA差异表达以及与其他脂肪因子的相关关系。结果糖尿病和肥胖症患者血清内脂素浓度较对照组明显升高（P均〈0.01）,糖尿病、肥胖症血清内脂素浓度与TNF-α呈正相关（r=0.441,P=0.045;r=0.541,P=0.037）。网膜脂肪组织中内脂素mRNA的灰度值与血清内脂素、TNF-α水平呈正相关（r=0.771,P=0.021;r=0.500,P=0.041）。结论内脂素在2型糖尿病内脏脂肪及血清中高表达,TNF-α可能促进内脂素表达。     

血清高密度脂蛋白胆固醇水平与原发性高血压预后的关系

<正>资料显示,我国老年高血压患病率将近20%,并且高血压的控制率仅为6.1%〔1,2〕。大量流行病学调查研究表明,血浆高密度脂蛋白胆固醇(HDL-C)水平降低与冠心病(CAD)呈负相关〔3〕,其保护作用机制为逆向转运胆固醇、抗氧化、抗炎、纠正内皮功能紊乱等〔4〕。本研究拟探讨血清HDL-C水平与原发性高血压(EH)预后的关系。     

高血压伴肥胖患者血清脂联素水平与左心室肥厚及动脉粥样硬化的关系

目的 观察高血压伴肥胖患者血清脂联素(APN)水平变化,探讨其与左心室肥厚(LVH)、动脉粥样硬化(AS)的关系. 方法 选取50例原发性高血压患者分为单纯高血压组(23例)和高血压肥胖组(27例),另选45例血压正常者分为对照组(24例)和单纯肥胖组(21例).酶联免疫吸附法(ELISA)测定血清APN水平,采用彩色多普勒超声仪测量颈总动脉内中膜厚度(CCA-IMT)、颈总动脉内径(CADIA)及左心室各相关指数,计算左心室质量指数(LVMI). 结果 对照组、单纯肥胖组、单纯高血压组和高血压肥胖组的空腹血糖(FPG)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDLC)和高密度脂蛋白胆固醇(HDL-C)差异具有统计学意义(F=81.97、8.56、25.53、15.19,均P＜0.05);两两比较结果显示,高血压肥胖组FPG与对照组、单纯肥胖组比较差异具有统计学意义,单纯肥胖组、单纯高血压组、高血压肥胖组TG、LDL-C均较对照组升高、HDL-C较对照组降低,而高血压肥胖组TG、TC、LDL-C较单纯高血压组增高(均P＜0.05).对照组、单纯肥胖组、单纯高血压组、高血压肥胖组中血清APN水平依次降低、CADIA逐渐减小,LVMI依次升高、CCA-IMT逐渐增高(F=28.34、10.26、36.52、14.73,均P＜0.01),经两两比较差异均有统计学意义(均P＜0.05).相关分析显示,APN与LVMI、CCA-IMT呈明显的负相关(r=-0.870、-0.710,均P＜0.01),与CADIA呈正相关(r=0.742,P＜0.01).逐步回归分析显示,APN、收缩压和体质指数(BMI)是影响左心室肥厚的主要因素(β值分别为-0.909、0.126、0.053). 结论 高血压与肥胖同时存在时,两者可能起协同作用,APN水平的降低、BMI的增加可能加速高血压伴肥胖患者LVH和AS的发生和发展.     

妊娠期高血压疾病患者血清脂联素及内脂素水平与胰岛素抵抗的相关性研究

目的 探讨妊娠期高血压疾病(HDCP)患者血清脂联素(APN)、内脂素(Visfatin)水平与胰岛素抵抗(IR)的关系.方法 以HDCP孕妇(129例)、同期正常孕妇(40例)及正常非孕妇(40例)为研究对象.采用酶联免疫吸附(ELISA) 法检测血清APN、Visfatin水平,同时检测空腹血糖(FBG)、空腹胰岛素(Fins)水平,计算胰岛素抵抗指数(HOMA-IR).结果 正常晚孕组及HDCP组血清FPG、Fins、Visfatin水平及HOMA-IR值均高于正常非孕组,血清APN水平低于正常非孕组,差异有统计学意义(P＜0.01).HDCP组血清FPG、Fins、Visfatin 水平及HOMA-IR值均高于正常晚孕组,血清APN水平低于正常晚孕组,差异有统计学意义(P＜0.01).HDCP组轻度子痫前期和重度子痫前期患者血清Visfatin水平及HOMA-IR值均高于妊娠期高血压患者,血清APN水平低于妊娠期高血压患者,差异均有统计学意义(P＜0.01);重度子痫前期患者血清Visfatin水平及HOMA-IR值均高于轻度子痫前期患者,血清APN水平低于轻度子痫前期,差异均有统计学意义(P＜0.01).HDCP患者血清APN水平与HOMA-IR值呈负相关(r=-0.593,P＜0.01),血清Visfatin水平与HOMA-IR值呈正相关(r=0.687,P＜0.01),且血清APN与Visfatin呈负相关(r=-0.809,P＜0.01).结论 HDCP患者血清APN、Visfatin水平与IR相关,APN、Visfatin参与了HDCP的发生、发展,检测血清APN及Visfatin水平可作为判定病情的重要指标.     

Serum visfatin concentrations in obese adolescents and its correlation with age and high-density lipoprotein cholesterol

Visfatin was recently identified as an adipocytokine and has insulin mimetic properties, but its role in adolescents remains largely unknown. In this study, we examined the impact of adolescent obesity on circulating visfatin levels and the relationship between visfatin and anthropometric indices, insulin sensitivity, and blood lipids in Chinese adolescents (11-18 years). Serum visfatin, adiponectin, leptin, and blood lipids were measured in 76 non-obese and 72 obese adolescents. The medians of serum visfatin levels were significantly higher in obese subjects of 34.68ng/ml than in non-obese subjects of 28.67ng/ml (P=0.002). There were no significant correlations in the non-obese group between the serum visfatin concentration and the anthropometric indices or the lipid parameters. However, visfatin levels were negatively correlated with age, early insulin secretion index (EISI), Tanner stage, and positively correlated with HDL-c in the obese adolescents. These relationships, except that for EISI and Tanner stage, remained significant (P<0.05) after adjusting for age, gender, and body mass index. Moreover, unlike adiponectin and leptin, visfatin concentration did not correlate with testosterone in non-obese and obese boys. In conclusion, visfatin levels may decrease with age and be related to the HDL metabolism in obese adolescents.     

Serum visfatin levels, adiposity and glucose metabolism in obese adolescents

Objective: Visfatin, an adipokine, has insulin-mimetic effects. The main determinants of both the production and the physiologic role of visfatin are still unclear. The aim of this study is to determine the relation of serum visfatin to adiposity and glucose metabolism.Methods: 40 pubertal adolescents (20 females, 20 males; age range: 9-17 years) with exogenous obesity and 20 age- and sex-matched healthy adolescents (10 females, 10 males) were enrolled in the study. Oral glucose tolerance test (OGTT) was performed in the obese group. Serum glucose, insulin and visfatin levels were analyzed in the fasting state in the controls and at 0, 60 and 120 minutes during the OGTT in the obese group.Results: The obese group had higher serum visfatin levels than the control group [11.6 (3.3-26) ng/mL vs. 7.5 (3.3-10.5) ng/mL, p<0.001]. Visfatin levels were correlated positively with body mass index, waist/hip ratio, insulin, and homeostasis model assessment for insulin resistance and negatively with glucose/insulin ratio in the combined group (obese subjects plus controls). Visfatin levels were essentially similar in obese subjects with and without insulin resistance (p>0.05). Serum visfatin levels did not change at 60 and 120 minutes of the OGTT compared to the baseline levels (p>0.05).Conclusions: Serum visfatin levels are elevated in obese adolescents and do not change with acute changes in glucose metabolism. Visfatin levels are related with adiposity and glucose metabolism parameters. However, the role and contribution of adiposity and glucose metabolism to the circulating visfatin levels in obese patients remain to be explored. Conflict of interest:None declared.     

吡格列酮与二甲双胍对初诊肥胖2型糖尿病患者血清内脏脂肪素影响的研究

目的观察吡格列酮与二甲双胍对初诊肥胖T2DM患者血清内脏脂肪素（visfatin）水平的影响,探讨visfatin与T2DM发病的关系和药物的治疗机制。方法100例初诊肥胖T2DM患者随机分为吡格列酮组50例,每日口服盐酸吡格列酮片30mg,二甲双胍组50例,每日早晚口服二甲双胍缓释片500mg,疗程24周。结果吡格列酮组空腹血清visfatin、IR、TG较用药前明显降低,B细胞功能有改善（P〈0．05或P〈0．01）。二甲双胍组血清visfatin、TG无统计学改变。两组治疗后比较,吡格列酮组的visfatin、IR、TG降低明显,差异有统计学意义（P〈0．05或〈0．01）,但二甲双胍组的BMI较吡格列酮组下降更明显（P〈0．05）。结论对初诊肥胖T2DM患者吡格列酮与二甲双胍均能较好地控制血糖,吡格列酮还能明显降低血清visfatin的水平,提示吡格列酮通过下调visfatin水平发挥抗炎作用。     

2型糖尿病非糖尿病一级亲属中肥胖患者血浆内脂素水平

检测了2型糖尿病一级亲属、单纯肥胖和健康对照者内脂素（visfatin）、内皮依赖性血管舒张功能、颈总动脉内膜中层厚度，并用MRI评价内脏脂肪和皮下脂肪面积。结果提示2型糖尿病一级亲属中肥胖患者和单纯肥胖患者内脂素水平高于2型糖尿病一级亲属非肥胖者和健康对照组，并且内脂素与空腹血糖呈独立负相关。     

Plasma visfatin levels in normal weight women with polycystic ovary syndrome

BACKGROUND: The present study was designed to measure plasma visfatin levels in normal weight women with polycystic ovary syndrome (PCOS) and to assess possible correlations between visfatin and the hormonal or metabolic parameters of the syndrome. METHODS: Twenty-five normal weight [body mass index (BMI)<25 kg/m(2)] women with PCOS, 24 obese and overweight (BMI>25 kg/m(2)) controls (ovulating women without clinical or biochemical hyperandrogenism), and 24 normal weight controls were studied. Blood samples were collected between the 3rd and the 7th days of a menstrual cycle in the control groups and during a spontaneous bleeding episode in the PCOS groups at 9:00 A.M., after an overnight fast. Circulating levels of LH, FSH, prolactin (PRL), testosterone (T), Delta(4)-androstenedione (Delta(4)-Alpha), dehydroepiandrosterone sulfate (DHEA-S), 17alpha-OH-progesterone (17OH-P), sex hormone-binding globulin (SHBG), insulin, glucose, and visfatin were measured. RESULTS: Plasma visfatin levels and the visfatin-to-insulin ratio were significantly lower in normal weight controls than in both normal weight women with PCOS and overweight or obese controls. The visfatin-to-insulin ratio was significantly higher in normal weight women with PCOS than in overweight or obese controls. Plasma visfatin levels were found to be positively correlated with LH and Delta(4)A levels, as well as with free androgen index (FAI) values, and negatively correlated with SHBG. LH and SHBG levels were found to be the only independent significant determinants of circulating visfatin. In the control groups, plasma visfatin levels were significantly correlated with BMI, waist (W) measurement, and waist-to-hip ratio (WHR). CONCLUSIONS: Visfatin levels are positively associated with obesity in healthy women of reproductive age. Moreover, the present study indicates, for the first time, a possible involvement of increased visfatin levels in PCOS-associated metabolic and hormonal disturbances.     

不同血糖状态人群血浆内脂素水平及其相关因素

空腹血浆内脂素水平在正常糖耐量、糖耐量受损或空腹血糖受损、2型糖尿病组分别为[(17.64±1.37,27.423±1.34和26.55±1.64)μg/L,P<0.05],但与肥胖无关.血浆内脂素水平与HbA1c呈正相关(r=0.317,P<0.01).多元线性逐步回归分析表明HbA1c、空腹血糖是影响血浆内脂素的独立相关因素.提示血浆内脂素水平与糖代谢状态有关,可能在2型糖尿病的发生、发展中具有一定的作用.     

肥胖儿童血清脂联素水平与代谢综合征、早期动脉粥样硬化的相关性研究

目的 研究脂联素在肥胖儿童极早期动脉粥样硬化形成过程中所起的保护性作用,评价血清脂联素水平对儿童代谢综合征的诊断价值.方法 选择176例肥胖和88名非肥胖年龄9～12岁的儿童,酶联免疫法(ELISA)检测血清脂联素水平,收集身高、体重、腰围、血压、胰岛素、超敏C反应蛋白(hsCRP)、血脂、血糖等临床资料,计算稳态模型评估的胰岛素抵抗指数(HOMA-IR).超声测量颈动脉内中膜层厚度(IMT)、颈动脉血管顺应性(CAC)、内皮依赖的血管舒张功能(FMD)和最大的腹膜前脂肪厚度(Pmax).结果 (1)脂联素与肥胖指标、血压、低密度脂蛋白胆固醇、空腹胰岛素、HOMA-IR、hsCRP、IMT呈显著负相关(P<0.05或P<0.01),与甘油三酯、空腹血糖、CAC、高密度脂蛋白胆固醇(HDL-C)、FMD无显著相关性(P>0.05).(2)以脂联素水平7.060 mg/L为切点,<7.060 mg/L的儿童发生代谢综合征的危险是>7.060 mg/L的4.43倍.(3)用血清脂联素水平判断代谢综合征诊断的敏感性,曲线下面积为0.769(95%CI0.714～0.816,P<0.01).(4)根据血清脂联素水平将肥胖儿童分为高、中、低3组,重度肥胖、内脏脂肪积聚、高血压、高胰岛素血症、低HDL-C、代谢综合征患病率3组间比较有显著性差异(P<0.05).结论 提高肥胖儿童血清脂联素水平有助于预防极早期动脉粥样硬化的发生.脂联素越低的儿童,患代谢综合征的可能性似越大.     

超重肥胖青少年空腹血糖受损的特点及其相关影响因素分析

目的 研究儿童青少年空腹血糖受损（IFG）的特点及其相关影响因素。方法 超重肥胖组（0b）459例，体重正常对照组（NC）221名，测量身高体重、FPG、Fins、瘦素及血脂，计算HO—MA—IR、HOMA-β、QUICKI，分析FPG的分布及相关因素。结果 （1）Ob组的Fins、瘦素、血脂、HOMA—IR、HOMA-β显著高于NC组（P〈0．05）。QUICKI显著低于NC组（P〈0．05）。（2）在正常血糖组和IFG组，NC组的Fins显著低于Ob组（P〈0．05）。（3）Ob组的IFG（17．21％）比例显著高于NC组（2．26％），NC组的IFG患者其FPG主要介于5．6～6．0mmol／L。FPG与年龄、性别、BMI、Fins、瘦素、TG、TC和HOMA—IR均显著相关。结论 本组Ob患者IFG的发生率显著高于NC组，FPG与其他代谢综合征（MS）组分显著相关，进一步研究儿童青少年FPG和IFG变化规律，将有助于儿童青少年T2DM及相关MS的防治。     

Association of acylation stimulating protein and adiponectin with metabolic risk marker in North Indian obese women

BackgroundPlasma concentrations of Acylation stimulating protein (ASP) and adiponectin are associated with body weight and energy homeostasis. The purpose of this study is to describe the potential role of acylation stimulating protein and adiponectin with metabolic risk marker in North Indian obese women.MethodsThis is a case control study. Total 520 women were recruited for the study n = 260 women with obesity (BMI>30) study group and n = 260 women without obesity (BMI<25) control group. Serum ASP and adiponectin level were determined by enzyme linked immunosorbent assay.ResultsResult indicated that WC, BP, lipid profile, FPG, FPI, IR (HOMA-IR), ASP were significantly higher but adiponectin and HDL were significantly lower in women with obesity than in women without obesity. Furthermore ASP was significantly positive correlated with WC, FPG, TG, VLDL, FPI and IR, whereas the correlation of adiponectin was significantly negative correlated with WC, FPG, TG, IR, ASP and significantly positive correlated with HDL in women with obesity.ConclusionThe study shows that high level of ASP and low level of Adiponectin could be a potential marker of women with obesity among metabolic syndrome.     

内脂素研究进展

内脂素是一种主要由内脏脂肪分泌的细胞因子,通过与胰岛素受体结合发挥类胰岛素样的降血糖作用,并促进脂肪组织的分化与合成。有研究认为内脂素由于结构缺陷可能并非真正具类胰岛素样作用。尽管如此,内脂素仍为肥胖和糖尿病治疗提供可能靶点。