高血压病患者血清脂蛋白、载脂蛋白异常与胰岛素抵抗的关系

目的：探讨高血压病患者血脂／载脂蛋白异常与胰岛素抵抗的关系。方法：以空腹胰岛素／空腹葡萄糖比值和口服葡萄糖负荷后胰岛素曲线下面积／葡萄糖曲线下面积比值作为胰岛素抵抗指标，与空腹血脂／载脂蛋白进行直线相关分析。结果：与正常对照组（ｎ＝２１）比较，高血压病组（ｎ＝３２）血清甘油三酯（ＴＧ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、载脂蛋白（Ａｐｏ）Ｂ、空腹胰岛素、空腹胰岛素／空腹葡萄糖比值以及胰岛素曲线下面积、葡萄糖曲线下面积和胰岛素曲线下面积／葡萄糖曲线下面积比值均显著增加（Ｐ＜０．０５～０．００１），高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）、ＨＤＬ２－Ｃ、ＡｐｏＡＩ及ＡｐｏＡＩ／ＡｐｏＢ比值均显著降低（Ｐ＜０．０５～０．００１）。高血压病组空腹胰岛素／空腹葡萄糖比值和胰岛素曲线下面积／葡萄糖曲线下面积比值均分别与甘油三酯、低密度脂蛋白胆固醇和ＡｐｏＢ呈正相关（Ｐ＜０．０５～０．０１），与ＨＤＬ２－Ｃ、ＡｐｏＡＩ和ＡｐｏＡＩ／ＡｐｏＢ比值呈负相关（Ｐ＜０．０５～０．００１）。正常对照组上述指标间则无相关（Ｐ＞０．０５）。结论：高血压病患者血脂／载脂蛋白异常与胰岛素抵抗密切相关。     

老年男性冠心病患者血清硫酸脱氢表雄酮含量变化的临床意义

目的观察老年男性冠心病患者血清硫酸脱氢表雄酮（ＤＨＥＡ－Ｓ）含量变化，探讨其与睾酮（Ｔ）、胰岛素（ＩＮＳ）、血糖（Ｇｌｕ）、甘油三酯（ＴＧ）、总胆固醇（ＴＣ）、载脂蛋白Ｂ（ａｐｏＢ）及年龄的相关性。方法用放免法测定６９例老年男性冠心病患者血清ＤＨＥＡ－Ｓ含量，并与３５例年龄匹配的男性健康人对照。结果冠心病组ＤＨＥＡ－Ｓ含量（２．９６±１．８０μｍｏｌ／Ｌ）显著低于对照组（４．０６±１．７６μｍｏｌ／Ｌ，Ｐ＜０．０１），病情重组（２．４４±１．３６μｍｏｌ／Ｌ）又明显低于病情轻组（３．３２±２．１２μｍｏｌ／Ｌ，Ｐ＜０．０５）；冠心病组ＤＨＥＡ－Ｓ含量与年龄呈负相关（ｒ＝－０．３０５４，Ｐ＜０．０１），对照组两者也呈负相关（ｒ＝－０．３６１５，Ｐ＜０．０５）；冠心病患者ＤＨＥＡ－Ｓ降低与空腹血清ＩＮＳ、ＴＧ及ａｐｏＢ增高均呈负相关（分别为ｒ＝－０．３２９７、－０．２５１９及－０．２４１３，Ｐ＜０．０１或０．０５）。结论老年男性冠心病患者血清ＤＨＥＡ－Ｓ含量降低，并与冠心病某些危险因素如老年、高胰岛素血症、高甘油三酯血症、血清ａｐｏＢ高值相关，但其确切的发病机理有待深入研究。     

38例高血压病患者血脂与胰岛素抵抗

对３８例高血压病（ＥＨ）患者及２４例正常人空腹血清胰岛素（Ｉｎｓ）、Ｃ肽（ＣＰ）、血糖（ＳＧ）、甘油三酯（ＴＧ）、总胆固醇（ＴＣ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）及载脂蛋白（Ａｐｏ）含量进行测定，并推算胰岛素敏感指数（ＩＳＩ）。结果ＥＨ组Ｉｎｓ、ＣＰ升高，但ＩＳＩ显著降低，表明ＥＨ患者存在胰岛素抵抗（ＩＲ）。同时伴有ＴＧ、ＴＣ、ＡｐｏＢ１００、脂蛋白（ａ）［ＬＰ（ａ）］升高，ＨＤＬ－Ｃ、ＡｐｏＡＩ降低。相关分析表明，ＥＨ患者Ｉｎｓ与ＴＧ、ＡｐｏＢ１００、ＬＰ（ａ）呈显著正相关，与ＨＤＬ－Ｃ、ＡｐｏＡＩ呈显著负相关。ＩＳＩ与ＴＧ、ＡｐｏＢ１００呈显著负相关，提示ＥＨ患者ＩＲ可能是影响脂代谢的重要因素之一。     

高血压患者血脂,脂蛋白,载脂蛋白及胰岛素分析

本文就４９例高血压患者血脂、脂蛋白、载脂蛋白及血胰岛素（Ｉｎ）水平与４０例正常人比较分析发现：高血压患者体重指数（ＢＭＩ）、总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、低密度脂蛋白胆固醇（ＬＤＬＣ）、低密度脂蛋白胆固醇／高密度脂蛋白胆固醇（ＬＤＬ－ｃ／ＨＤＬ－Ｃ）、载脂蛋白Ｂ（ａｐｏＢ）、血糠（Ｇ）及Ｉｎ均较对照组显著升高、ＨＤＬ－Ｃ、ＨＤＬ２－Ｃ、ａｐｏＡＩ、ａｐｏＡＩ／ａｐｏＢ及Ｇ／Ｉｎ较对照组显著降低。Ｉｎ水平随ＢＭＩ增加而升高。相关分析发现：ＨＢＰ患者Ｉｎ与ＢＭＩ和ａｐｏＢ呈正相关，与ＨＤＬ－Ｃ、ａｐｏＡＩ／ａｐｏＢ呈负相关。Ｇ／Ｉｎ与ＨＤＬ－Ｃ呈正相关。血浆ＴＧ与ＨＤＬ－Ｃ呈负相关。     

老年人不同体质对心脏结构、血流、功能及血压的影响

目的观察体重对老年人心血管系统的影响。方法６２３例老年人根据体质指数（ＢＭＩ）分为肥胖、超重、正常及消瘦４组，检测血压、空腹血糖（ＢＳ）、胆固醇（ＴＣ）、甘油三酯（ＴＧ）及超声心动图。结果肥胖及超重组较正常体重及消瘦组收缩压（ＳＢＰ）及舒张压（ＤＢＰ）均增高（均为Ｐ＜０．０５），主动脉径（ＡｏＤ）、左房径（ＬＡＤ）、左室舒张及收缩末径（ＥＤＤ及ＥＳＤ）及心肌质量（ＬＶＭ）增加（均为Ｐ＜０．０５）。ＳＢＰ、ＤＢＰ均与体重、ＢＭＩ、ＴＣ、ＬＶＭ及心房收缩期与舒张早期充盈峰值流速（ＡＰＦＶ与ＥＰＦＶ）之比值（Ａ／Ｅ）呈明显正相关（Ｐ＜０．０５、０．０１或０．００１），ＤＢＰ与年龄呈明显负相关（Ｐ＜０．００１）。多元逐步回归分析证实ＬＶＭ、ＡＰＦＶ及ＬＡＤ均与ＢＭＩ呈正相关（均为Ｐ＜０．０１），ＥＰＦＶ与ＢＭＩ呈负相关（Ｐ＜０．０５）；射血分数（ＥＦ）、年龄、ＢＳ与ＳＢＰ呈正相关（Ｐ＜０．０５、０．００１及０．０１），与ＤＢＰ呈负相关（Ｐ＜０．０５或０．００１）。结论体重是影响心脏结构、血流、功能及血压的重要因素；ＥＦ、年龄、ＢＳ是分别影响ＳＢＰ及ＤＢＰ的独立因素。     

心肌梗塞患者载脂蛋白E基因多态性研究及其对临床与血脂代谢的影响

目的：研究载脂蛋白（Ａｐｏ）Ｅ基因多态性对心肌梗塞发生、发展及预后的作用及其对血脂水平的影响。 方法;应用聚合酶链反应－限制性片段长度多态性检测方法,测定１０４例心肌梗塞患者（心肌梗塞组）和１８０例正常对照者（对照组）的Ａｏｐ　Ｅ基因型;并按常规方法测定血脂水平。 结果：共检测出 ５种 Ａｐｏ Ｅ基因型,分别为 Ａｐｏ Ｅ３／３、Ａｐｏ　 Ｅ３／２、Ａｐｏ Ｅ４／３、Ａｐｏ Ｅ４／２及 Ａｐｏ Ｅ４／４。心肌梗塞组Ａｐｏ　Ｅ４／３基因型和ＡｐｏＥε４等位基因频率均显著高于对照组（Ｐ＜０．０１）;心肌梗塞组总胆固醇（ＴＣ）和低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）高于对照组（Ｐ＜０．０５）;心肌梗塞组泵功能Ⅲ～Ⅳ级患者ＡｐｏＥ４／３基因型频率高于泵功能Ⅰ～Ⅱ级患者（Ｐ＜０．０５）;Ａｐｏ　Ｅε４等位基因具有升高ＴＣ、ＬＤＬ－Ｃ的作用,Ａｐｏ　Ｅε２等位基因则有降低ＴＣ、ＬＤＬ－Ｃ的作用。 结论：ＡｐｏＥ基因多态性与心肌梗塞的发生、发展和血脂的代谢水平密切相关;Ａｐｏ　Ｅε４等位基因可能是心肌梗塞重要的遗传标记,Ａｐｏ　Ｅ４／３亦影响心肌梗塞泵功能分级。     

90例85岁以上老人血脂,脂蛋白和载脂蛋白的研究

对９０例８５岁以上高龄老人的血脂、脂蛋白和载脂蛋白进行测定，并与陈旧性心肌梗塞（ＯＭＩ）组对比。结果显示：与ＯＭＩ组比较，高龄老人血清ＴＣ、ＬＤＬ－Ｃ、ＡｐｏＡⅠ和ＡｐｏＢ_（１００）的明显低，而ＨＤＬ－Ｃ／ＴＣ、ＨＤＬ－Ｃ／ＬＤＬ－Ｃ和ＡｐｏＡⅠ／ＡｐｏＢ_（１００）明显高；ＴＧ、ＨＤＬ－Ｃ和ＶＬＤＬ－Ｃ在两组之间无统计学差异。单因素相关分析显示，ＨＤＬ－Ｃ／ＴＣ，ＨＤＬ－Ｃ／ＬＤＬ－Ｃ和ＡｐｏＡⅠ／ＡｐｏＢ_（１００）与长寿呈正相关，与ＯＭＩ呈负相关；而ＴＣ、ＬＤＬ－Ｃ、ＡｐｏＡⅠ和ＡｐｏＢ_（１００）则与长寿呈负相关，与ＯＭＩ呈正相关；ＨＤＬ－Ｃ、ＴＧ和ＶＬＤＬ－Ｃ与长寿和ＯＭＩ几乎无相关关系。对各检测指标进行多元逐步回归分析，ＡｐｏＢ_（１００）对长寿作用最大，其次为ＡｐｏＡⅠ／ＡｐｏＢ_（１００）和ＨＤＬ－Ｃ．因此认为血清ＡＰｏＢ_（１００）水平的低值、ＨＤＬ－Ｃ和ＡｐｏＡⅠ／ＡｐｏＢ_（１００）的高值，是高龄老人血脂、脂蛋白和载脂蛋白的特点，亦是长寿的指标。     

国产洛伐他汀对高脂血症患者血脂代谢的影响

目的：研究国产洛伐他汀对高脂血症患者血脂代谢的影响。方法：将１２０例患者随机分为洛伐他汀组（ｎ＝８０）及美降之组（ｎ＝４０），分别口服国产洛伐他汀及进口洛伐他汀（美降之），每次２０ｍｇ，每日２次，服用８周。观察用药４周及８周患者血清总胆固醇（ＴＣ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）、（ＴＣ－ＨＤＬ－Ｃ）／ＨＤＬ－Ｃ、甘油三酯、载脂蛋白ＡⅠ（ＡｐｏＡⅠ）、载脂蛋白Ｂ１００（ＡｐｏＢ１００）及ＡｐｏＡⅠ／ＡｐｏＢ１００变化。结果：服用国产洛伐他汀４周及８周可分别使患者血清ＴＣ降低２３．０％及２７．３％，ＬＤＬ－Ｃ降低２７．９％及３４．１％，高甘油三酯血症患者甘油三酯水平降低２１．６％及２６．２％；ＨＤＬ－Ｃ升高９．１％及１０．１％，（ＴＣ－ＨＤＬ－Ｃ）／ＨＤＬ－Ｃ降低２９．６％及３７．１％。血清ＡｐｏＢ１００降低９．６％及１５．５％，ＡｐｏＡⅠ升高１８．９％及１４．５％，ＡｐｏＡⅠ／ＡｐｏＢ１００升高３９．９％及４４．９％。服药４周即有明显疗效。结论：国产洛伐他汀调血脂作用疗效肯定，与其相应进口产品美降之比较基本相同     

绝经后女性冠心病性激素与血脂,载脂蛋白的关系

测定３６例绝经后女性冠心病病人和２４例对照者的血清雌二醇（Ｅ２）、睾酮（Ｔ）、总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、载脂蛋白ＡⅠ（ＡｐｏＡⅠ）、载脂蛋白Ｂ１００（ＡｐｏＢ１００）水平。结果显示：ＣＨＤ组Ｅ２、ＨＤＬ－Ｃ、ＡｐｏＡⅠ显著低于对照组。ＴＣ、ＴＧ、ＬＤＬ－Ｃ、ＡｐｏＢ１００显著高于对照组。Ｅ２和Ｔ与ＡｐｏＡⅠ呈显著正相关。表明绝经后女性ＣＨＤ存在性激素环境失衡，Ｅ２水平不足，引起血脂、脂蛋白代谢紊乱，支持Ｅ２对女性ＣＨＤ有直接保护作用。     

老年冠心病病人血清脂质水平研究

测定１０２例老年冠心病病人血清ＴＣ、ＴＧ、ＨＤＬ－Ｃ、ＡｐｏＡ１和ＡｐｏＢ含量并计算ＡｐｏＡ１和ＡｐｏＢ的比值，与１００例健康人进行比较。结果表明：冠心病病人ＡｐｏＢ明显高于对照组（Ｐ＜０．０１），ＡｐｏＡ１／ＡｐｏＢ低于对照组（Ｐ＜０．０５）。９１．２％男性病人和７８．９％女性病人ＡｐｏＡ１／ＡｐｏＢ低于对照组，男女之间下降比例有差异，提示ＡｐｏＡ１／ＡｐｏＢ比值下降同样是老年冠心病病人的危险因素     

Ⅱ型糖尿病血清超敏C-反应蛋白与胰岛素抵抗的关系

目的探讨血清CRP与胰岛素抵抗之间的相关性及其临床意义。方法Ⅱ型糖尿病患者122例,测定其血清超敏CRP、空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、胆固醇(TCH)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、糖化血红蛋白(HbA1c)等生化指标。并测定每个病人的血压(收缩压SBP,舒张压DBP),体重指数(BMI)。计算胰岛素抵抗(IR)和胰岛素敏感指数(ISI)。结果高CRP组SBP、DBP、TG、BMI均显著高于正常CRP组(P<0.05),而高CRP组的HDL-C则显著低于正常CRP组(P<0.01)。血清超敏C-反应蛋白与各项指标之间的相关性分析表明,糖尿病病人血清hs-CRP与DBP、BMI、FPG、FINS、TG、UAI、R均存在显著正相关(P<0.05或P<0.01),hs-CRP与HDL-CI、SI之间则存在显著负相关(P<0.05)。结论糖尿病病人血清超敏CRP与胰岛素抵抗之间存在较好的相关性,CRP在糖尿病发生及发展中起一定的作用,超敏CRP可作为Ⅱ型糖尿病的一个早期协助诊断指标。     

脑梗死患者血清抵抗素水平变化及与糖代谢的相关性分析

目的探讨血清抵抗素水平变化在脑梗死发病中的作用。方法采用ELISA法测定82例急性脑梗死患者（脑梗死组）及50例健康查体者（对照组）血清抵抗素、瘦素、胰岛素、空腹血糖（FBG）、TG、TC、HDL-C、LDL-C、超敏C反应蛋白（hs-CRP）,计算定量胰岛素敏感性检测指数（QUICKI）;测量身高、体质量、腰围、臀围,计算BMI及腰臀比（WHR）。对上述指标间的相关性进行统计学分析。结果①脑梗死组血清抵抗素、胰岛素、FBG、瘦素、LDL-C及hs-CRP均明显高于对照组（P〈0.05）,QUICKI和血清HDL-C均低于对照组（P均〈0.05）。②多因素Logistic回归分析显示,脑梗死与年龄、抵抗素、瘦素、hs-CRP、TG、LDL-C呈显著正相关（P均〈0.05）,与QUICKI呈显著负相关（P〈0.05）。③单因素直线相关分析显示,抵抗素与胰岛素、FBG呈显著正相关（P均〈0.05）,与QUICKI呈显著负相关（P〈0.05）。结论急性脑梗死患者血浆抵抗素水平升高与糖代谢指标密切相关;此可能在脑梗死发生过程中发挥重要作用。     

Left ventricular mass and correlated atherosclerotic risk factors in young adolescents: report from Chin-Shan community cardiovascular study in Taiwan

Various subclinical disease indicators can be used as an early stage marker of atherosclerosis. Left ventricular (LV) mass has been related to cardiovascular morbidity and mortality. The distribution of LV mass in Chinese is rarely studied and nothing is known about its relationships with various atherosclerotic risk factors in young teenagers, in particular, aspects of lipid profiles. We performed a community-based survey of 523 males and 555 females, aged 12-15, in Chin-Shan, a suburb area near Taipei, Taiwan. LV mass was calculated from the Penn convention. Normalized LV mass by height with power of 2.7 was defined. LV mass and normalized LV mass were significantly greater in males than in females. There were significant positive correlation coefficients between LV mass and age, blood pressure, body mass index, low density lipoprotein cholesterol (LDL-C), apolipoprotein (Apo) B, fasting insulin levels and significant negative correlation coefficients between LV mass and high density lipoprotein cholesterol (HDL-C) and Apo A1 level in both genders. Multiple linear regression models showed gender and body mass index (BMI) were important factors associated with LV mass or normalized values for adolescents. Age and systolic blood pressure were also significant predictors of LV mass, but not of normalized LV mass values. LV mass values were found to be negatively associated with HDL-C values at marginal statistically significant level. Age and BMI are the most significant factors of echocardiographic LV mass distributions in young adolescent in Taiwan. LV mass may also be associated with atherosclerotic risk factors.     

Relationship of adiponectin to serum paraoxonase 1

Correlation of the plasma levels of insulin-sensitizing, anti-inflammatory and anti-atherosclerotic adiponectin with HDL has been demonstrated. However, its relation to HDL-bound paraoxonase 1 (PON1) has not been clarified. The association of serum PON1 activity with findings of metabolic syndrome was investigated in three age and sex-matched groups: (1) non-diabetic overweight subjects with BMI 28-39.9 kg/m(2) (n=25); (2) non-diabetic obese subjects with BMI>or=40 kg/m(2) (n=25); and (3) healthy, normal-weight controls (n=24). Of the parameters investigated, PON1 activity correlated positively with concentrations of HDL-C and adiponectin, and correlated negatively with BMI, waist circumference, systolic BP, levels of HbA(1C), and insulin, HOMA-IR, and TBARS. The positive correlation between adiponectin and PON1 remained significant even after adjustments for age, gender, BMI, blood pressure, HOMA-IR, HDL-C, LDL-C, and lipid peroxidation. CONCLUSIONS: PON1 activity shows negative association with markers of metabolic syndrome. We demonstrate that adiponectin is an independent variable of serum PON1, which may contribute to the anti-atherosclerotic effect of adiponectin.     

胰岛素抗体阳性的2型糖尿病患者血清同型半胱氨酸水平变化的研究

目的探讨胰岛素抗体(INS-Ab)阳性T2DM患者血清同型半胱氨酸(Hcy)水平的变化。方法选取305例行重组人胰岛素治疗的T2DM患者,其中INS-Ab阳性患者(INS-Ab阳性组)82例,INS-Ab阴性患者(INS-Ab阴性组)223例,另选取同期我院健康体检人群200名为正常对照(NC)组。研究对象进行体格检查和血脂、血糖、胰岛素、血清Hcy、INS-Ab等相关指标的测定。结果INS-Ab阳性组血清Hcy水平高于INS-Ab阴性组和NC组[(15.94±3.28)vs(12.68±3.58)vs(7.89±2.16)μmol/L,P<0.01]。Pearson相关分析显示,INS-Ab阳性组血清Hcy水平与BMI、LDL-C、TC、TG、FPG、FIns、HbA1c呈正相关(r=0.158、0.197、0.191、0.176、0.204、0.211、0.208,P=0.021、0.011、0.018、0.025、0.005、0.001、0.002),与年龄、SBP、DBP、胰岛素用量和HDL-C不相关;INS-Ab阴性组与上述相似。Logistic回归分析显示,血清Hcy水平是T2DM患者INS-Ab阳性的影响因素(P=0.008);按照血清Hcy水平三分位数将T2DM患者分为3组,随着Hcy升高,INS-Ab阳性率逐渐升高(9.81%vs 23.52%vs 46.15%,P<0.05)。结论INS-Ab阳性T2DM患者血清Hcy升高,血清Hcy水平是INS-Ab阳性的影响因素。     

宁波市人群血尿酸水平及其影响因素

目的:分析本地区不同年龄阶段人群的血尿酸水平及其影响因素。方法:记录在本院进行体检的24965人的性别、年龄,测量受检者的身高、体重、血压、进行血生化检测,按年龄进行分组,并进行统计学分析。结果:男性血尿酸水平高于女性(P<0.01)。女性血尿酸水平随年龄增长的幅度明显,各年龄组间比较均有显著性差异(P<0.01)。在50岁以下人群中血尿酸水平与年龄、性别、体重指数、舒张压、总胆固醇、甘油三酯呈正相关(P<0.01),与空腹血糖、低密度脂蛋白、高密度脂蛋白呈负相关(P<0.01)。70岁以上人群中血尿酸与年龄、性别呈正相关(P<0.05),与血糖成负相关(P<0.01)。结论:中青年人群血尿酸水平升高与多种心血管危险因素显著相关,老年人血尿酸水平的相关因素与中青年不同,在干预上应分别对待。     

Correlation of plasma homocysteine and mitochondrial DNA content in peripheral blood in healthy women

Hyperhomocysteinemia is an independent risk factor of cardiovascular disease and associated with insulin resistance, although their causal relationship remains unclear. A previous report has shown that high concentration of homocysteine damages mitochondrial gene expression, function and structure. As we found recently, the mitochondrial DNA (mtDNA) contents are inversely correlated with insulin resistance parameters. Thus there is possibility that plasma total homocysteine (tHcy) level is somewhat correlated with mtDNA content. Sixty healthy women (mean age 40.3+/-20.9 yr, range 18-78 yr) were recruited to investigate the correlation of plasma tHcy level and mtDNA content in peripheral blood. A significant negative correlation was found between plasma tHcy levels and mtDNA content (r=-0.507, P<0.01). Plasma tHcy and mtDNA content have an independent effect on each other and on insulin resistance (HOMA-insulin resistance (IR) score) respectively in multiple regression model. Plasma tHcy showed positive correlations with age (r=0.407), W/H ratio (r=0.370), total cholesterol (r=0.338), LDL-cholesterol (r=0.317) and insulin resistance (HOMA-IR score) (r=0.261); and a negative correlation with folate (r=-0.273). MtDNA content showed negative correlations with age (r=-0.407), BMI (r=-0.440), W/H ratio (r=-0.659), SBP (r=-0.350), total cholesterol (r=-0.340), triglyceride (r=-0.376), LDL-cholesterol (r=-0.349), fasting plasma insulin (r=-0.483), and insulin resistance (HOMA-IR score) (r=-0.423); and a positive correlation with folate (r=0.299). In this study, there was a significant inverse correlation between plasma tHcy level and mtDNA content. Further study will be warranted to elucidate the mechanism by which two factors are associated.     

Low-grade systemic inflammation, hypoadiponectinemia and a high concentration of leptin are present in very young obese children, and correlate with metabolic syndrome

OBJECTIVE: To determine the concentration levels of C-reactive protein (CRP), leptin and adiponectin in obese pre-pubertal children, and their possible relation with metabolic syndrome, fibrinogen and plasminogen activator inhibitor-1. METHODS: A study was carried out in 51 obese children (aged 6 to 9 years) and the same number of non-obese children (control group), matched by age and sex. (Cross-sectional study of obese children). Body mass index (BMI), waist/hip ratio (WHR) and blood pressure were determined for each child. Serum CRP, leptin, adiponectin, glucose, insulin, lipid profile, plasminogen activator inhibitor-1 (PAI-1) and fibrinogen were all measured. RESULTS: The levels of CRP serum (1.67+/-0.222 vs 0.92+/-0.16 mg/l) and leptin (15.56+/-1.27 vs 4.68+/-0.62 ng/ml) were significantly higher in obese children. The adiponectin level was significantly higher in non-obese children (11.58+/-0.63 vs 9.64+/-0.49 microg/dl). In the obese group, log. CRP showed a positive correlation with BMI, insulin, homeostasis model assessment (HOMA), triglycerides, alanine aminotransferase (ALT), uric acid, PAI-1, fibrinogen and interleukin 6 (IL-6), and correlated negatively with apolipoprotein A-I and high-density lipoprotein cholesterol (HDL-C). The leptin was positively correlated with BMI, insulin, HOMA, triglycerides and PAI-1 and negatively with Apo A-I and HDL-C. Adiponectin correlated negatively with BMI, insulin, HOMA, and triglycerides. CONCLUSIONS: Low-grade systemic inflammation, elevated leptin concentration and low adiponectin level are described in very young obese children, correlating with a range of variables of metabolic syndrome. Inflammation and adipocytokines can play an important role in the etiopathogeny of metabolic syndrome.     

Modification of the relationship between simple anthropometric indices and risk factors by ethnic background

Current targets for body mass index (BMI) and waist circumference (WC) may not be appropriate for those of South Asian origin. The objectives of this study were to determine whether the relationship between BMI and WC with risk factors for cardiovascular disease (CVD) is the same for men and women of South Asian and European descent. Apparently healthy men and women of European (n = 88) and South Asian (n = 93) descent were recruited from 3 hospital communities and assessed for BMI, WC, waist-to-hip ratio (WHR), blood pressure (BP), lipids, insulin, glucose, and CRP. The study cohort was stratified by sex, and regression analyses were performed with individual risk factors as outcomes and ethnicity with either BMI or WC as predictors adjusting for age and height (WC only). BMI and WC were similar between the European and South Asian men and women. South Asian men had significantly higher values for total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), total cholesterol:high-density lipoprotein-cholesterol (HDL-C) and CRP, and significantly lower values of HDL-C. South Asian women had significantly higher values for TG, TC:HDL-C and CRP and significantly lower values of HDL-C, glucose, systolic BP and diastolic BP. In men, ethnicity was an independent predictor for all risk factors except for glucose and insulin, after adjusting for either BMI or WC independent of age and height. For women, ethnicity was an independent predictor for all risk factors except for total cholesterol (WC model only) and insulin (BMI model only), after adjusting for either BMI or WC independent of age and height. The relationship between BMI or WC and risk factors is such that men and women of South Asian descent present with a more adverse risk profile than those of European descent at the same BMI and/or WC.     

上海市崇明区老年人成纤维活化蛋白与代谢综合征的相关性分析

目的探讨老年人血浆成纤维活化蛋白(FAP)水平与代谢综合征的相关性。方法2011年6月—12月,采取随机整群抽样的方法,以上海市崇明区城桥镇587例常住居民为研究对象,其中男性202例、女性385例。通过问卷调查和体格检查采集人体基本参数,采集标本完成相关实验室检查,分析FAP水平与代谢综合征的相关性。结果男性血浆FAP水平与年龄、心率、身体质量指数(BMI)、高密度脂蛋白胆固醇(HDL-C)、HDL-C/总胆固醇(TC)、胰岛素水平、稳态模型评估胰岛素抵抗指数、稳态模型评估胰岛β细胞功能及估计肾小球滤过率(eGFR)相关(均P<0.05)。女性血浆FAP水平与心率、HDL-C、三酰甘油、HDL-C/TC、空腹血糖、餐后2h血糖(2hPG)相关(均P<0.05)。Stepwise线性回归模型显示,年龄、心率、胰岛素和eGFR是男性血浆FAP水平的独立影响因素,而心率、2 hPG和HDL-C/TC是女性血浆FAP水平的独立影响因素。二元Logistic回归分析显示,女性血浆FAP水平Q4组代谢综合征发生风险较Q1组增加(OR=2.28,95%CI:1.27~4.10,P<0.01),校正其他危险因素后仍然存在相关性(OR=1.93,95%CI:1.01~3.67,P<0.05)。结论血浆FAP水平与糖脂代谢指标有一定的相关性,FAP可能是老年女性代谢综合征发病风险中的一个独立危险因素。