脂联素瘦素比值在老年男性代谢综合征患者中的诊断价值

目的 研究血脂联素瘦素比值与老年男性代谢综合征的相关性. 方法 选择老年男性患者256例,分为代谢综合征组109例和非代谢综合征组(对照组)147例,代谢综合征的诊断采用2004年中国糖尿病学会制定的标准;采用LINCO放射免疫试剂盒测定空腹血脂联素、瘦素水平.结果 (1)老年男性代谢综合征组与对照组瘦素水平分别为(10.3±7.0)μg/L和(6.8±4.9)μg/L,脂联素分别为(7.8±5.6)g/L和(9.5±5.9)g/L,脂联素瘦素比值分别为0.94±0.78和2.15±2.13;(2)脂联素瘦素比值与体质指数、血三酰甘油、血尿酸水平均呈负相关,而与高密度脂蛋白水平显著正相关(P<0.001);(3)随着脂联素瘦素比值升高,代谢综合征发生的可能性减小,当比值在5以上,代谢综合征的患病率降至O(X2=34.891,P<0.001);(4)代谢异常组分数越多.脂联素瘦素比值越低(F=10.876,P<0.001). 结论 血脂联素瘦素比值可用于评价老年男性患者代谢紊乱程度,对老年男性代谢综合征的诊断有辅助作用.     

2型糖尿病脂联素、瘦素、脂联素与瘦素比值与代谢综合征组分关系的研究

目的观察脂联素、瘦素、脂联素与瘦素的此值（A／L）和代谢综合征的关系。方法初诊2型糖尿病患者260例,放免法检测Fins、脂联素、瘦素水平,计算胰岛素抵抗指数,并以脂联素、瘦素及其比值作为因变量进行多元回归分析。结果肥胖较非肥胖患者有较低的脂联素、A／L,较高的瘦素;胰岛素敏感的患者相对于胰岛素抵抗的患者,有较高的脂联素、A／L和较低的瘦素;A／L与代谢有关变量、胰岛素抵抗及相关变量都有明显的相关性。结论2型糖尿病患者脂联素、瘦素和A／L与肥胖、胰岛素抵抗及代谢综合征的表达有明显的相关性。据此推测脂联素、瘦素、A／L有可能成为进一步研究代谢综合征的发病机制及其诊断标准的指标。     

Low adiponectin levels at baseline and decreasing adiponectin levels over 10 years of follow-up predict risk of the metabolic syndrome

AimAdiponectin is the most abundant adipokine and may play a key role in the interplay between obesity, inflammation, insulin resistance and the metabolic syndrome (MetS). Thus, this large population-based cohort investigated whether adiponectin at baseline and/or a decrease in adiponectin during follow-up is associated prospectively with the risk of incident MetS.MethodsUsing a prospective study design, the development of MetS was examined in 1134 healthy participants from the community. Plasma adiponectin was measured at study entry and again after a median follow-up of 9.4 years (IQR: 9.2–9.7). During follow-up, 187 participants developed MetS, and 439 presented with at least two components of MetS.ResultsDuring follow-up, adiponectin decreased in participants who developed MetS, whereas adiponectin was increased in those who did not develop MetS (P < 0.001). Those with low adiponectin levels (quartile 1) at baseline had an increased risk of developing MetS (OR: 2.92, 2.08–6.97; P < 0.001) compared with those with high levels (quartile 4). After adjusting for confounding variables, low adiponectin levels at baseline remained independently associated with MetS (OR: 2.24, 1.11–4.52; P = 0.017). Similarly, participants with a decrease in adiponectin during follow-up also had an increased risk of MetS (OR: 2.96, 2.09–4.18; P < 0.001). This association persisted after multivariable adjustments, including for baseline adiponectin (OR: 4.37, 2.77–6.97; P < 0.001). Finally, adiponectin levels at follow-up were inversely associated with an increase in the number of components of MetS (P < 0.001); geometric mean adiponectin levels were 9.5 mg/L (95% CI: 9.0–10.0) for participants with no components vs 7.0 mg/L (95% CI: 6.3–7.9) for those with four to five components.Conclusions/interpretationLow plasma adiponectin levels at baseline and decreasing adiponectin levels during follow-up are both associated with an increased risk of MetS.     

不同他汀类药物对代谢综合征患者血清脂联素和瘦素的影响研究

目的探讨不同他汀类调脂药物对代谢综合征患者血清脂联素、瘦素的影响。方法选取明确诊断代谢综合征患者100例,随机分为两组,A组口服阿托伐他汀10mg/d,B组口服普伐他汀40mg/d,其他治疗相同。检测治疗前后血脂和脂联素及瘦素水平。结果两组治疗后血脂水平明显下降,两组无显著差异,而血清脂联素水平显著高于治疗前,瘦素水平低于治疗前,A组优于B组。结论两种他汀类调脂药物都可以明显升高代谢综合征患者的血清脂联素水平以及降低瘦素水平,阿托伐他汀优于普伐他汀。     

冠心病患者血浆脂联素水平与代谢综合征的相关性研究

目的 检测冠心病病人血浆脂联素水平,并采用多个代谢综合征（metabolic syndrome,MS）诊断标准判断是否合并MS,探讨脂联素与MS的关系,评价MS标准的敏感性.方法 冠心病60例,分别采用美国国家胆固醇教育计划成人治疗指南Ⅲ（national cholesterol education program adult treatment panel Ⅲ,NCEP ATP Ⅲ）和2005年国际糖尿病联盟（international diabetes federation,IDF）的MS诊断标准判断合并MS者,分析冠心病合并MS与单纯冠心病者之间血浆脂联素水平的差异.结果 符合NCEP ATP Ⅲ标准的MS 16例（占25%）,其血浆脂联素水平（4.7±1.2）mg/L;单纯冠心病病人为（5.1±1.1）mg/L,差异无统计学意义（P＞0.05）.符合IDF标准的MS者30例（占50%）,其血浆脂联素水平为（4.3±1.5）mg/L,较单纯冠心病病人（5.4±2.2）mg/L显著降低（P＜0.05）.结论 冠心病合并MS病人的血浆脂联素水平低于单纯冠心病病人,IDF的MS诊断标准对早期发现MS人群更敏感.     

腹部内脏脂肪沉积的老年非代谢综合征患者脂联素瘦素比值的变化

目的 观察体质指数正常、腹部内脏脂肪沉积的非代谢综合征老年男性患者血清脂联素、瘦素水平及脂联素瘦素比值的变化.方法 将入选的老年非代谢综合征男性患者109例分为2组,内脏无脂肪沉积组67例,内脏脂肪沉积组42例.采用CT方法测定内脏脂肪面积,当腹部内脏脂肪面积≥100cm2,为内脏脂肪沉积;采用LINCO公司提供的放射免疫试剂盒测定空腹血脂联素、瘦素水平;代谢综合征的诊断采用2004年中国糖尿病学会制定的标准.结果 (1)脂肪沉积组与无脂肪沉积组比较,体质指数、内脏脂肪面积均显著升高,体质指数分别为(22.94±1.35)kg/m2对(21.38±2.55)kg/m2(P＜O.001),内脏脂肪面积(135.6±31.7)cm2对(68.6±22.6)cm2(P＜O.001);脂联素瘦素比值降低.分别为2.17±1.77对4.54±7.00(P=0.031);而脂联素、瘦素水平在两者间差异无统计学意义;(2)脂联素瘦素比值与体质指数(r=-0.552,P＜0.001)、腰围(r=-0.390,P＜0.001)、腹部内脏脂肪面积(r=-0.311,P＜0.001)呈负相关.结论 体质指数正常有内脏脂肪沉积与无内脏脂肪沉积的老年男性比较.脂联素瘦素比值明显下降.并与腹部脂肪面积显著负相关.提示血清脂联素瘦素比值可能可用于筛选体质指数正常有腹部内脏脂肪肪沉积的患者.     

The associations of leptin and adiponectin with the metabolic syndrome in an Indonesian and a Dutch population

Background and aimsAt the same BMI, Asian populations develop cardiometabolic complications earlier than Western populations. We hypothesized that a different secretion of the adipocyte-derived hormones leptin and adiponectin plays a role and investigated the associations of the two hormones with the metabolic syndrome (MetS) in an Indonesian and a Dutch population.Methods and resultsWe performed cross-sectional analyses of the Netherlands Epidemiology of Obesity Study (n = 6602) and the SUGAR Scientific Programme Indonesia–Netherlands Study (n = 1461). We examined sex-stratified associations of leptin and adiponectin with MetS, using multivariate logistic regression including adjustment for total body fat. The mean (SD) leptin (mcg/L) were 4.7 (6.0) in Indonesian men, 18.6 (12.0) in Indonesian women, 9.1 (7.7) in Dutch men, and 23.4 (17.4) in Dutch women. The mean (SD) adiponectin (mg/L) were 5.7 (5.4), 7.5 (7.1), 6.6 (3.3), and 11.3 (4.9), respectively. Within the same BMI category, leptin concentrations were similar in the two populations, whereas adiponectin was lower in the Indonesian population. Per SD of leptin, adjusted prevalence odds ratios (ORs, 95%CI) of MetS were 0.9 (0.6–1.2) in Indonesian men, 1.1 (0.9–1.4) in Indonesian women, 2.2 (1.6–2.8) in Dutch men, and 1.2 (1.0–1.5) in Dutch women. Per SD of adiponectin, the ORs were 0.9 (0.7–1.2), 0.8 (0.7–1.0), 0.6 (0.6–0.8), and 0.4 (0.4–0.5), respectively.ConclusionsDespite lower adiponectin levels, adiponectin was not related to the MetS in the Indonesian population and can not explain their increased cardiometabolic risk at the same BMI.     

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.     

回、汉族代谢综合征患者血浆脂联素水平的比较及相关研究

目的:比较回、汉族代谢综合征(MS)患者血浆脂联素水平与胰岛素抵抗(IR)等因素的关系。方法:用胰岛素抵抗指数(HOMA-IR)评价IR程度,ELISA检测血浆脂联素水平,比较两民族间脂联素水平的差异及脂联素水平与其他因素之间的关系。结果:不论汉族还是回族,MS组脂联素水平低于正常对照组,HOMA-IR高于正常对照组。回族脂联素水平均低于汉族。多元回归分析显示:汉族脂联素水平主要受腰围、HOMA-IR、收缩压的影响,回族脂联素水平主要受HOMA-IR、体重、年龄的影响。结论:回族MS患者脂联素水平低于汉族,汉族脂联素与腰围、HOMA-IR、收缩压有关,回族脂联素与HOMA-IR、年龄、体重有关。     

脂联素/瘦素比值用于判断非酒精性脂肪肝严重程度的可行性研究

目的 研究非酒精性脂肪性肝病(NAFLD)患者血清脂联素/瘦素(A/L)与胰岛素抵抗(IR)的关系,探讨血清A/L在NAFLD严重程度分级中的意义.方法 将78例确诊NAFLD患者,依据彩色超声诊断仪显像结果,分为轻度NAFLD组31例,平均年龄为(50±14)岁,男女比例为19∶12;中重度NAFLD组47例,平均年龄为(49±14)岁,男女比例为27∶20.同期观察体检健康志愿者30例作为对照组,平均年龄(48±10)岁,男女比例为18∶12.ELISA法测定血清瘦素(LP)、脂联素(APN)水平,并检测体质量指数(BMI)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、三酰甘油(TG)、总胆固醇(CHO)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、空腹血糖/胰岛素、稳态模型评估的胰岛素抵抗指数(HOMA-IR).采用SPSS17.0软件包进行统计学分析,计量资料差异性比较用方差分析,多因素相关性用Pearson分析.结果 血清LP与HOMA-IR、LDL和BMI均呈正相关(r=0.296,P=0.000;r=0.327,P=0.000;r=0.282,P=0.001),血清APN与HOMA-IR、LDL和BMI均呈负相关(r=-0.375,P=0.000;r=-0.368,P=0.000;r=-0.285,P=0.001).A/L与HOMA-IR、LDL和BMI均呈显著负相关(r=-0.398,P=0.000;r =-0.374,P =0.000;r=-0.307,P=0.000),且NAFLD轻度组的相关系数(r=-0.311)大于中重度组(r=-0.486).结论本研究对NAFLD患者检测发现,A/L与HOMA-IR呈显著负相关.初步提示血清A/L比值可作为一种非侵入性检测指标,有助于NAFLD严重程度的临床分级.     

ApoB/apoA-I ratio is better than LDL-C in detecting cardiovascular risk

Background and aims

Cardiovascular (CV) events occur even when LDL-C are <100 mg/dL. To improve the detection of CV risk we investigated the apoB/apoA-I ratio versus LDL-C in subjects considered normal glucose tolerant (NGT) by oral glucose tolerance test (OGTT).

Methods and results

We enrolled 616 NGT (273 men and 343 women), and we measured insulin resistance, lipid profile, apoB/apoA-I and the factors compounding the metabolic syndrome (MetS). An unfavourable apoB/apoA-I (≥0.9 for males and ≥0.8 for females) was present in 13.9% of 108 patients with LDL-C <100 mg/dL: compared to subjects with lower apoB/apoA-I (<0.9 for males and <0.8 for females), they had more elements of MetS and their lipid profile strongly correlated with high CV risk. Out of 314 patients with lower apoB/apoA-I, 40.12% had LDL-C ≥130 mg/dL: these retained a more favourable lipid profile than corresponding subjects with elevated apoB/apoA-I ratio. Finally, we found a significant correlation between LDL-C and apoB/apoA-I ratio (r = 0.48, p <0.0001).

Conclusions

In NGT with LDL-C <100 mg/dL, a higher apoB/apoA-I exhibited an atherogenic lipid profile, indicating that LDL-C alone is insufficient to define CV risk. Independent from LDL-level, when apoB/apoA-I is lower, the lipid profile is, in fact, less atherogenic. This study demonstrates that apoB/apoA-I is at least complementary to LDL-C in identifying the “effective” CV risk profile of asymptomatic NGT subjects.     

代谢紊乱患者脂联素水平和颈动脉粥样硬化的研究

目的　探讨代谢紊乱患者脂联素水平、颈动脉粥样硬化的变化。方法　入选研究对象共 90例 ,根据代谢紊乱数目 ,分为无代谢紊乱组 (M0 )、1种代谢紊乱组 (M1)、2种代谢紊乱组(M2 )和 2种以上代谢紊乱组 (M3 )。评价了内皮依赖性舒张功能、颈总动脉内膜 中层厚度 (IMT) ,并测定了脂联素 (adiponectin)水平。 结果　M2 组和M3 组颈总动脉IMT分别高于M0 组和M1组(P <0 .0 5 )。M3 组颈总动脉斑块发生率高于M0 组 ,脂联素水平低于M1组 (P <0 .0 5 )。校正了影响因素后 ,M3 组脂联素仍与HOMA IR呈负相关。结论　代谢紊乱患者脂联素水平降低 ,颈总动脉粥样硬化加速     

The ratio of adiponectin to homeostasis model assessment of insulin resistance is a powerful index of each component of metabolic syndrome in an aged Japanese population: results from the KING Study

We evaluated the ratio of adiponectin level to homeostasis model assessment of insulin resistance (A/H ratio) as a risk marker for metabolic syndrome (MetS) and each of its components. The A/H ratio may prove to be a powerful index for evaluation of risk for MetS and each of its components.     

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.     

代谢综合征不同组分患者血清脂联素与游离脂肪酸谱代谢参数的比较

目的研究代谢综合征（MS）患者血清脂联素水平、游离脂肪酸（FFA）谱特征及与其他糖脂代谢参数间的关系。方法用放射免疫分析法测定157例含MS不同组分的患者与43例正常对照（NC）组血清脂联素水平，同时用气相色谱/质谱（GC/MS）联用法测定其血清FFA成分。结果MS组分≥3项组患者血清脂联素水平低于MS组分两项组与NC组（P〈0.05～0.01）。同时，MS组分≥3项组患者平均血压（MBP）、BMI、WC、TG、不饱和脂肪酸（UFA）（C18：2;C20：4;C22：6;C20：3）、多不饱和脂肪酸（PUFA）、n6PUFA等高于MS组分两项组与NC组（P〈0.05～0.01），HDL-C低于MS组分两项组与NC组（P〈0.01）。在研究对象中，脂联素与BMI、WC、TG呈负相关（r=-0.204，-0.203，-0.238，P〈0.01），与HDL-C呈正相关（r=0.238，P〈0.01）。总FFA（TFFA）、PUFA均与BMI、MBP、FPG、TG呈正相关（r=0.163和0.211，0.201和0.288，0.184和0.276，0.274和0.155，P〈0.05～0.01）。结论脂联素与FFA均与MS多种组分相关。脂联素与FFA代谢紊乱、n6系PUFA升高可能在MS发病中起重要作用。     

Imbalance between protective (adiponectin) and prothrombotic (Plasminogen Activator Inhibitor-1) adipokines in metabolic syndrome

AimsThe metabolic syndrome (MS) consists of a constellation of metabolic abnormalities that confer increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Visceral adipose tissue actively produces a variety of adipokines that interact in various obesity related disorders such as metabolic syndrome, diabetes mellitus and heart diseases. Adiponectin has protective role in the vascular physiology while Plasminogen Activator Inhibitor-1 (PAI-1) has a prothrombotic and consequent deleterious effect on the endothelium. We attempted to assess the putative imbalance if any between these two mediators in subjects with metabolic syndrome in the Indian context.Materials and methodsWe enrolled 50 diagnosed case of metabolic syndrome as per International Diabetes Federation (IDF) criteria and 50 healthy volunteers as control. Clinical evaluation included anthropometric, routine biochemical analysis as well as adiponectin and PAI-1 measurement.ResultSubject with MS had significantly lower adiponectin (9.8 ± 1.0 vs 16 ± 1.1 μg/ml) and higher PAI-1 (232 ± 87 vs 185 ± 96 ng/ml). A statistically significant correlation was observed between adiponectin and HDL levels (r = 0.388, p = 0.005).ConclusionSubjects with MS have lower adiponectin and higher PAI-1 levels as compared to controls. The subsequent tilt toward a more prothrombotic and pro inflammatory milieu in the vascular endothelium may be pathognomonic of metabolic syndrome. This understanding of the still undiscovered subtle vascular alterations may help in the better management of obesity and MS.     

综合干预对代谢综合征患者的疗效及血清脂肪细胞因子水平的影响

目的观察饮食、运动及药物综合干预对代谢综合征（metabolic syndrome,MS）患者的疗效及其对患者血清瘦素、抵抗素、脂联素水平影响。方法通过体检,纳入深圳市慢性病防治院＂慢性病管理数据库＂中的56例MS患者,随机分为综合干预组（n=30）及单纯药物干预组（n=26）。综合干预组给予饮食、运动及药物综合干预措施;单纯药物干预组给予药物干预治疗。两组患者分别于干预前、干预3个月、6个月末检测体重指数、血压、血糖、血脂及血清瘦素、抵抗素、脂联素水平,干预3个月、6个月末评价MS患者达标控制率,并对两组指标进行比较分析。结果两组患者干预后BMI、血糖、血脂、血压指标均有改善,但综合干预组改善效果更显著。综合干预组患者干预3个月及6个月后达标控制率分别为83.3%及93.3%,显著高于同时间段单纯药物干预组患者的达标控制率（73.1%及80.8%）,并有统计学意义（P〈0.05）。单纯药物干预组瘦素、抵抗素、脂联素水平在干预前、及干预3个月、6个月均无统计学差异（P〉0.05）;综合干预组干预3个月、6个月后瘦素、抵抗素、脂联素水平与干预前水平比较,及干预3个月与6个月时水平比较,差异均具有统计学意义（P〈0.05）;两组患者在干预6个月后瘦素、抵抗素、脂联素水平比较,也有统计学差异（P〈0.05）。结论饮食、运动及药物综合干预措施能有效改善MS患者血清瘦素、抵抗素、脂联素水平,提高MS患者症状的达标控制率。     

Serum adiponectin and resistin: Correlation with metabolic syndrome and its associated criteria among temiar subtribe in Malaysia

Background and objectivesMetabolic syndrome (MetS) is characterized as a cluster of metabolic disorder including increased blood pressure, elevated blood glucose level, high cholesterol level and visceral fat obesity. Polypeptide hormones such as adiponectin and resistin play a significant role in glucose and lipids metabolism, liver and pancreas function. This study aimed to investigate the relationship between serum adiponectin and resistin with MetS criteria among Temiar subtribe in Kuala Betis.Materials and methodsThis cross sectional study involved 123 subjects from Temiar subtribe in Kuala Betis, Gua Musang, Kelantan. MetS criteria were measured according to standard protocol by modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guideline. Anthropometric and biochemical measurements were performed including serum adiponectin and resistin for every study subjects.ResultsSerum adiponectin was significantly lower in MetS subjects (7.98 ± 5.65 ng/ml) but serum resistin was found to be significantly higher in MetS subjects (11.22 ± 6.34 ng/ml) compared to non-MetS subjects with p < 0.001 and p = 0.002 respectively. Serum adiponectin was negatively correlated with most of the cardio-metabolic risk factors; BMI, waist circumference, systolic and diastolic blood pressure, fasting blood glucose, triglyceride and total cholesterol. Serum resistin was found to be positively correlated with BMI, waist circumference, fasting blood glucose and total cholesterol.ConclusionThe difference in serum adiponectin and resistin level among MetS individuals indicated the potential of serum adiponectin and resistin to be used as a biomarker for the diagnosis of MetS among Temiar subtribe.     

Adiponectin and the cardiovascular system: from risk to disease

Adiponectin is known to play a role in fatty acid and glucose metabolism through a change in insulin sensitivity and activation of fuel oxidation by AMP-activated protein kinase. Adiponectin can be considered an important factor able to modulate the adipovascular axis which, through genomic and environmental influences, affects the cardiovascular risk milieu, from the pre-metabolic syndrome — through the metabolic syndrome — to the overt atherosclerotic process and its clinical manifestations. Hypoadiponectinaemia can be viewed as an early sign of a complex cardiovascular risk factor predisposing to the atherosclerosis process as well as a contributing factor accelerating the progress of the atherosclerotic plaque. In addition, adiponectin per se holds a protective role thanks to its anti-inflammatory and antiatherogenic properties. The early identification of patients “at cardiovascular risk” means in the current practice to search for indexes of metabolic derangements and pro-inflammatory status (adiponectin) from adolescence and childhood.     

2型糖尿病一级亲属血清脂联素、瘦素及其比值与胰岛素抵抗的相关性研究

目的 研究血清瘦素、脂联素与2型糖尿病(T2DM)一级亲属胰岛素抵抗(IR)相关性,探讨二者在T2DM发病中作用.方法 收集既往无糖耐量异常史的T2DM一级亲属, 分为糖耐量正常(NGT)组174例、空腹血糖受损(IFG)或糖耐量低减(IGT)组55例,及新发T2DM组71例;以其无糖尿病家族史的配偶或亲友中OGTT正常者114例作为正常对照组(NC).酶联免疫法测定上述人群的血清真胰岛素(TI)、瘦素和脂联素水平.用HOMA-IR评价胰岛素抵抗(IR)状态.结果 从NC至NGT、IGT/IFG到DM组,IR进行性加重(HOMA-IR分别为1.3±0.7、1.7±1.5、 2.2±1.4 和3.2±2.8,P＜0.01);血清瘦素水平进行性增高(P＜0.01),瘦素水平与HOMA-IR正相关(r=0.35, P＜0.01);血清脂联素水平进行性降低(分别为20±12、17±11、13±8和10±6mg/L,P＜0.01),与HOMA-IR负相关(r=-0.41,P＜0.01);脂联素/瘦素比值进性行降低,与HOMA-IR负相关(r=-0.53, P＜0.01). 结论 T2DM一级亲属在NGT时即存在瘦素水平升高和脂联素水平明显下降.脂联素/瘦素比值下降趋势与IR和糖调节受损的严重程度密切相关,推测该比值的变化可能是糖尿病一级亲属存在的固有遗传缺陷的一种表现,可能在IR和T2DM的发生发展中起重要作用,因而渴望作为预测T2DM发病的早期观察指标.