甲状腺功能亢进症患者血抵抗素与胰岛素抵抗的关系

目的 探讨甲状腺功能亢进症(甲亢)患者血抵抗素水平与胰岛素抵抗(IR)的关系.方法 分别测定32例甲亢患者及40例健康对照(NC)者空腹血清抵抗素、胰岛素、血脂、血糖等水平,测量身高、体重,计算BMI、IR指数,分析相关因素.结果 与NC组比较,甲亢患者空腹血清抵抗素、胰岛素、FPG及HOMA-IR明显升高(11±6μg/L vs 7±4μg/L,P＜0.01;7.76±2.92mU/L vs 6.37±2.67mU/L,P＜0.05;5.38±0.92mmol/L vs 4.79±0.48mmol/L,P＜0.01;2.20±1.03 vs 1.43±1.12,P＜0.01);甲亢时血抵抗素与游离三碘甲腺氨酸、游离甲状腺素及HOMA-IR正相关(r=0.448,0.405,0.393,P=0.011,0.023,0.036)、与高敏促甲状腺激素负相关(r＝-0.361,P＝0.045),校正年龄和BMI后偏相关分析显示,血抵抗素水平仍与HOMA-IR呈正相关.结论 抵抗素可能是甲状腺功能亢进时发生IR和糖代谢紊乱的重要因素之一.     

Plasma resistin levels and risk of myocardial infarction and ischemic stroke

CONTEXT: Resistin is a hormone that has been linked to insulin resistance, inflammatory processes, and coronary heart disease in case-control studies; however, prospective data on the association between plasma resistin levels and future risk of cardiovascular disease are lacking. OBJECTIVE: The objective of the study was to investigate the association between plasma resistin levels and risk of future myocardial infarction (MI) and ischemic stroke (IS) in a large prospective cohort. METHODS: We investigated the association between plasma resistin levels and risk of MI and IS in a case-cohort design among 26,490 middle-aged subjects from the European Investigation into Cancer and Nutrition-Potsdam Study without history of MI or stroke at time of blood draw. Plasma resistin levels were measured in baseline blood samples of 139 individuals who developed MI, 97 who developed IS, and 817 individuals who remained free of cardiovascular events during a mean follow-up of 6 yr. RESULTS: After multivariable adjustment for established cardiovascular risk factors including C-reactive protein, individuals in the highest compared with the lowest quartile of plasma resistin levels had a significantly increased risk of MI (relative risk 2.09; 95% confidence interval 1.01-4.31; P for trend = 0.01). In contrast, plasma resistin levels were not significantly associated with risk of IS (relative risk 0.94; 95% confidence interval 0.51-1.73; P for trend = 0.88). CONCLUSION: Our data suggest that high plasma resistin levels are associated with an increased risk of MI but not with risk of IS. Further studies are needed to evaluate the predictive value of plasma resistin levels for cardiovascular disease.     

Circulating adiponectin and endometrial cancer risk

Circulating levels of adiponectin, a hormone with insulin-sensitizing properties, are decreased in conditions related to obesity and hyperinsulinemia, which are recognized risk factors for endometrial cancer. Eighty-seven cases with incident, histologically confirmed endometrial cancer and 132 controls admitted for acute, nonneoplastic diseases were interviewed in northeastern Italy between 1999 and 2002, and blood samples were collected. Levels of adiponectin were evaluated in samples by means of a RIA. An inverse association with endometrial cancer risk emerged for plasma adiponectin levels [odds ratio (OR), 0.42; 95% confidence interval, 0.19-0.94] when comparing the highest vs. the lowest tertiles. Similar results emerged for serum adiponectin (OR, 0.30; 95% confidence interval, 0.14-0.68). The association was stronger in pre- than in postmenopausal women, but no significant heterogeneity was observed across strata of body mass index (BMI) or parity. BMI and adiponectin showed independent effects on the risk of endometrial cancer according to a multiplicative model (OR, 6.45 in the highest level of BMI and in the lowest one of adiponectin).     

Adipocytokine levels in gastric cancer patients: resistin and visfatin as biomarkers of gastric cancer

Purpose  Adipocytokines are adipocyte-secreted hormones associated with some malignancies. We investigated the association of adipocytokines with gastric cancer. Methods  The levels of body mass index (BMI) and adiponectin, leptin, resistin, visfatin, and C-peptide in blood at diagnosis were measured in 156 gastric cancer patients and 156 age- and sex-matched controls. Logistic regression models were used to estimate odds ratio, and one-way analysis of variance was performed to examine the prevalence of each variable between 2 or more groups. Results  Adiponectin, C-peptide and BMI levels were significantly lower, and resistin and visfatin levels were significantly higher in the patients on multivariate analysis (P = 0.0004, 0.0006, 0.0051, 0.0006 and 0.0013, respectively). In the controls, the inverse correlation between BMI and adiponectin was comparatively strong, but was weak in the patients. The correlation between BMI and leptin was strong in both the controls and the patients. The correlation between BMI and resistin or visfatin was not clear in either the patients or the controls. The correlation between BMI and C-peptide was not clear in the controls, but might be weak in the patients. Leptin, C-peptide and BMI levels gradually decreased with stage progression, and resistin and visfatin levels gradually increased with stage progression (P < 0.0001 for all). Comparison between 38 patients with Stage I gastric cancer and the controls showed that adiponectin level tended to decrease in the patients (P = 0.0582), and BMI level was not different between two groups (P = 0.2480). Conclusions  Resistin and visfatin may be good biomarkers of gastric cancer.     

抵抗素与炎性反应关系的研究进展

血浆抵抗素主要来源于炎性反应处的单核细胞和巨噬细胞.它与炎性反应及许多炎性反应性疾病的活动性密切相关,与炎性标记物形成网络,通过Ca2+/核因子(NF)-κB依赖途径发挥促炎及促胰岛素抵抗作用.     

Pitavastatin improves serum resistin levels in patients with hypercholesterolemia

AIM: Resistin in serum is associated with high risk in patients with atherosclerosis. This clinical study aimed to investigate whether pitavastatin can regulate the serum level of resistin, together with levels of other inflammatory cytokines and adipocytokines. METHODS: Forty two outpatients (mean age 65.2 +/- 12.6 yr, M/F: 21/21) with hypercholesterolemia were administered 2 mg of pitavastatin and serum levels of resistin, together with serum levels of adiponectin, leptin, TNF-alpha and hsCRP, were measured before, and 12 weeks after enrollment. RESULTS: There was no significant gender-related difference in initial serum resistin levels. Pitavastatin significantly decreased LDL-cholesterol after 12 weeks. Initial levels of resistin showed a significant correlation with those of hsCRP (r=0.38, p=0.013), but not TNF-alpha or HOMA-R. Serum resistin, but not adiponectin and leptin, levels were significantly decreased, dropping from 17.1 +/- 9.9 ng/ dL to 15.2+/-10.0 (p=0.001) after 12 weeks of administration. The patient group with a baseline hsCRP > or = 0.1 at enrollment (n=17) had decreased levels of both resistin and hsCRP (p=0.011 and p=0.022, respectively). CONCLUSION: This study showed the pleiotropic effect of pitavastatin on the serum resistin concentration, suggesting that it may assist in the prevention of atherosclerosis.     

Plasma resistin levels correlate with determinants of the metabolic syndrome

OBJECTIVE: The role of resistin in insulin sensitivity and obesity is controversial. Some authors suggest that increased serum resistin levels are associated with obesity, visceral fat, insulin resistance, type 2 diabetes and inflammation, while others failed to observe such correlations. The aim of the present study was to investigate the relationship of plasma resistin levels with markers of the metabolic syndrome and atherosclerosis in a large population-based study. DESIGN AND PATIENTS: Plasma resistin levels were determined in 1090 subjects free of any medication selected from the PLIC study (designed to verify the presence of atherosclerotic lesions and progression intima-media thickness (IMT) in the common carotid artery in the general population) and related to the presence of obesity, metabolic syndrome, metabolic abnormalities, cardiovascular risk, and progression of IMT. RESULTS: Plasma resistin levels were highly positively correlated with triglycerides, waist circumference, waist/hip ratio, systolic blood pressure, and ApoAI/ApoB ratio, while they were inversely correlated with high density lipoprotein and ApoAI levels. This finding was gender specific (mainly in women). Plasma resistin levels were significantly higher in women with the metabolic syndrome compared with controls (4.90 (0.24) ng/ml vs 3.90 (0.11) ng/ml; P<0.01), while no difference was observed in obese subjects. Finally, plasma resistin levels were significantly correlated with cardiovascular risk calculated according to the Framingham algorithm (P<0.01). CONCLUSION: Plasma resistin levels are increased in presence of the metabolic syndrome and are associated with increased cardiovascular risk.     

Circulating resistin levels in essential hypertension

OBJECTIVE: Resistin, a novel cysteine-rich protein secreted by adipocytes, has been proposed to serve as a link between obesity and insulin resistance in rodents, but this has remained controversial. Most of the data obtained in previous studies are restricted to mRNA levels in tissues. DESIGN AND PATIENTS: We examined the association between insulin resistance and circulating protein levels of resistin in 33 essential hypertensive patients (EHT) and 18 normotensive subjects (NT). Insulin sensitivity (M-value) was evaluated by the euglycaemic hyperinsulinaemic glucose clamp technique. RESULTS: Using a cutoff point of mean - 1 SD of the M-value in the NT, the EHT were divided into two groups: one group of 12 insulin-resistant patients (EHT-R) and one group of 21 noninsulin-resistant patients (EHT-N). There were no intergroup differences in age, gender, body mass index (BMI; range: 20.1-30.4 kg/m2), fasting glucose and total cholesterol. The EHT-R had significantly higher levels of fasting insulin and triglyceride than did the NT and the EHT-N. The EHT-R had higher levels of free fatty acid and lower levels of high-density lipoprotein cholesterol than did the EHT-N. The M-value was negatively correlated with fasting insulin, free fatty acid, and triglyceride. Circulating resistin levels were not significantly different among the three groups and were not correlated with the M-value, BMI, blood pressure, or lipid variables. CONCLUSIONS: Our results suggest that circulating resistin levels are not related to insulin resistance, at least in patients with essential hypertension, although disturbance of lipid metabolism may be associated with insulin resistance.     

Increased serum resistin levels in patients with coronary slow-flow phenomenon

Background

Slow coronary flow (SCF) is an angiographic finding characterized by delayed opacification of the epicardial coronary arteries without obstructive coronary disease. Resistin, an adipocytokine, plays a major role besides low-grade inflammation in atherosclerotic vascular processes and may be of importance in other coronary pathologies such as SCF.

Methods

The present study was cross-sectional and observational, consisting of 70 individuals who underwent coronary angiography and had angiographically normal coronary arteries of varying coronary flow rates. The study included 50 patients with isolated SCF and 20 control participants with normal coronary flow (NCF).

Results

There were no statistically significant differences between the SCF and NCF groups with respect to age, gender, presence of hypertension or diabetes mellitus, and smoking habit, except for increased creatinine levels (p?=?0.014). The serum resistin level was significantly higher in the SCF group than in the NCF group (8.4?±?7.2 vs. 5.4?±?2.6 ng/ml, p?=?0.014). Ln-transformed resistin levels correlated positively with left anterior descending (LAD) coronary artery TIMI frame count (TFC) (r?=?0.408, p?<?0.001) as well as with glucose (r?=?0.340, p?=?0.004), creatinine (r?=?0.248, p?=?0.044), and C-reactive protein (CRP; r?=?0.283, p?=?0.023) levels, and negatively with LAD coronary flow velocity (r?=???0.314, p?=?0.009). When multivariate analyses were performed, in linear regression analysis, ln-resistin was associated with a longer TFC [beta (standardized regression coefficient): 0.404, p?=?0.001] and lower coronary flow velocity (beta: ??0.280, p?=?0.035); in logistic regression analysis, ln-resistin was an independent predictor of the presence of SCF (OR: 6.692, 65?%CI: 1.117–40.1, p?=?0.037).

Conclusion

We demonstrated, for the first time, a significant increase in serum resistin levels in patients with SCF compared to subjects with NCF. We believe that further studies are needed to clarify the role of resistin in patients with SCF.     

Adiponectin and resistin plasma levels in healthy individuals with prehypertension

Prehypertension seems to be related to increased cardiovascular risk in healthy subjects, while hypoadiponectinemia and hyperresistinemia may contribute to insulin resistance and accelerated atherogenesis. This study investigated whether plasma levels of adiponectin (known to increase insulin sensitivity) and resistin (a protein possibly involved in inflammatory activities) are affected in healthy individuals with prehypertension, and to compare the findings to those of healthy normotensives matched for age, gender, and body mass index. Twenty-six (14 men and 12 women) healthy individuals with prehypertension (mean age, 52+/-5 years; mean body mass index, 23+/-1.5 kg/m2) and 24 healthy normotensives (13 men and 11 women; mean age 53+/-6 years; body mass index 23.2+/-1.4 kg/m2) were studied. The adiponectin and resistin plasma levels were determined by the enzyme-linked immunosorbent assay method. Plasma resistin levels were significantly higher, while adiponectin plasma levels were significantly lower, in prehypertensive subjects compared with normotensive subjects (10.62+/-3.17 ng/mL vs. 6.72+/-3.15 ng/mL and 6.26+/-2.18 mg/mL vs. 12.12+/-4.8 mg/mL; p < 0.01, respectively). The findings suggest that healthy individuals with prehypertension have significantly higher resistin plasma levels and significantly lower adiponectin plasma levels compared with healthy normotensives. These findings may represent another possible mechanism that may increase the cardiovascular risk in this special group of patients, needing further investigation.     

Increased levels of resistin in rotating shift workers: A potential mediator of cardiovascular risk associated with circadian misalignment

ObjectiveShift work schedule has been associated with several health problems, including deleterious effects on the cardiovascular system. The present study aimed to evaluate the circulating levels of four biomarkers of atherosclerosis (soluble CD40 ligand [sCD40L], monocyte chemoattractant protein-1 [MCP-1], resistin, and plasminogen activator inhibitor-1 [PAI-1]) in a population-based sample of young adult men exposed to rotating shift work schedule in comparison with day workers.Design and participantsA total of 439 men aged 34.4 ± 8.6 years were included in a cross-sectional study comparing 255 day workers with 184 rotating shift workers. Circulating levels of the biomarkers were measured in duplicate by ELISA using monoclonal specific antibodies.ResultsRotating shift workers had elevated (6440 ± 4510 pg/mL) (mean ± SD) circulating levels of resistin in comparison with day workers (5450 ± 3780 pg/mL), and significance remains after adjusting for age and blood leukocyte count (p < 0.045, ANCOVA). Shift work schedule explains 1% of the proportion of the total variation in the circulating resistin levels. Multiple regression analysis showed that resistin levels significantly correlate with rotating shift work (p < 0.04) and blood leukocyte count (p < 0.00003) independently of age, BMI, waist–hip ratio, HOMA, and cardiovascular risk %. Circulating levels of sCD40L, MCP-1, and PAI-1 did not significantly differ between day workers and shift workers.ConclusionShift work schedule was significantly associated with elevated plasma resistin levels. Resistin, which is probably produced by leukocytes, may play an important role in the pathogenesis of early metabolic syndrome components in young men chronically exposed to circadian misalignment.     

Serum levels of interleukins, growth factors and anglogenin in patients with endometrial cancer

The purpose of this work was to study changes in serum levels of interleukins, growth factors and angiogenin during different stages of endometrial cancer progression. Serum levels were assayed by enzyme-linked immunosorbant assay in 59 women with stages I–IV of endometrial cancer (study subjects: stage I,n=20; stage II,n=8; stage III,n=5; stage IV,n=6) and compared to the serum levels in 20 women without cancer as control subjects. Patients with endometrial cancer had varied serum levels of interleukins and growth factors. There was a significant increase in serum levels of angiogenin in all stages of tumor progression. Levels of interleukin-8 (IL-8), IL-10 and transforming growth factor (TGF) were significantly elevated in patients with stages I and II carcinoma. The serum levels of tumor necrosis factor (TNF), granulocyte/macrophage-colony-stimulating factor, basic fibroblast growth factor (BFGF), IL-7 and IL-2 were significantly elevated in patients with stages II and III carcinoma and the serum level of tumor necrosis factor (TNF) was slightly elevated in patients with stage II carcinoma only. The serum levels of IL-1, IL-1 and IL-6 were not elevated in endometrial cancer patients in any of the clinical stages. The results showed that progression of endometrial cancer is associated with increased serum levels of cytokines, growth factors and angiogenin, which possibly amplify angiogenesis during different clinical stages.This work has been partially supported by a Gustavus and Louise Pfeiffer Research Foundation grant to Vimlarani Chopra     

Serum adipokine levels in chronic liver diseases: Association of resistin levels with fibrosis severity

Objective. Leptin and adiponectin have been implicated in the pathogenesis and progression of non-alcoholic steatohepatitis (NASH) and chronic hepatitis C (CHC), but little is known about the role of resistin in chronic liver diseases. The objective of this study was to investigate serum levels of the above three adipokines in relation to the etiology of liver disease and to determine their associations with histological severity. Material and methods. We prospectively evaluated 146 patients (HBeAg-negative chronic hepatitis B (CHB): 52, CHC: 70, NASH: 24) who consecutively underwent liver biopsy. Detailed epidemiological, anthropometric and laboratory data were recorded. Histological lesions were evaluated blindly according to the Ishak and the Brunt classifications for CHB/CHC and NASH, respectively. Results. Serum adipokine levels were similar between CHB and CHC patients, while CHB/CHC patients had significantly lower leptin levels compared with NASH patients (8.3±7.3 versus 17.6±16.6 ng/ml, p=0.012) and higher adiponectin (10.2±5.1 versus 7.5±4 µg/ml, p=0.018) and resistin levels (7.1±2.5 versus 5.7±2.8 ng/ml, p=0.016). In CHB/CHC, there was no significant association between steatosis or necroinflammation and levels of adipokines, while the presence of moderate/severe fibrosis (stages 4–6) was associated with higher leptin and adiponectin levels in male but not in female patients and with lower resistin levels irrespective of gender or other factors (adjusted odds ratio=0.788, p=0.035). Conclusions. Serum adipokine levels depend on the etiology of liver disease differing between chronic viral hepatitis and NASH, but not between CHB and CHC. In CHB/CHC, resistin levels are independently associated with fibrosis severity, whereas in the association of leptin and adiponectin levels with fibrosis, it seems to be a gender effect.     

Diabetes mellitus and risk of endometrial cancer: a meta-analysis

Aims/hypothesis Diabetes has been associated with a statistically significantly increased risk of endometrial cancer in most, but not all studies. To provide a quantitative assessment of the association between diabetes and risk of endometrial cancer, we conducted a meta-analysis of case-control studies and cohort studies. Subjects and methods We identified studies by a literature search of PubMed and Embase through to January 2007 and by searching the reference lists of relevant articles. Summary relative risks (RRs) with 95% CIs were calculated using random-effects model. Results The analysis of diabetes (largely type 2) and endometrial cancer is based on 16 studies (three cohort and 13 case-control studies), including 96,003 participants and 7,596 cases of endometrial cancer. Twelve of the studies showed a statistically significantly increased risk and four a non-significant increased risk of endometrial cancer. In our meta-analysis we found that diabetes was statistically significantly associated with an increased risk of endometrial cancer (summary RR 2.10, 95% CI 1.75–2.53). The risk estimates were somewhat stronger among case-control (RR 2.22, 95% CI 1.80–2.74) than among cohort studies (RR 1.62, 95% CI 1.21–2.16), stronger among studies adjusting only for age (RR 2.74, 95% CI 1.87–4.00) compared with multivariate adjustment (RR 1.92, 95% CI 1.58–2.33) and slightly lower in studies performed in the USA than in those performed Europe. The analysis of type 1 diabetes and endometrial cancer was based on three studies and found a statistically significant positive association (summary RR 3.15, 95%CI 1.07–9.29). Conclusions/interpretation Results from the meta-analysis support a relationship between diabetes and increased risk of endometrial cancer.     

Serum resistin levels in benign prostate hyperplasia and non-metastatic prostate cancer: possible role in cancer progression

Resistin is a member of adipokine family involved in the regulation of inflammatory reactions and insulin sensitivity. In presented study its possible role in the development of benign prostate hyperplasia and prostate cancer was evaluated. Blood samples and prostate specimens were collected from 26 patients with benign prostate hyperplasia (BPH) and from 42 patients with prostate cancer (PCa) stage pT2 (n=18) and pT3 (n=24). Selected metabolic and biochemical parameters and serum resistin levels were measured and anthropometric measurements were performed as well as tissue immunohistochemistry for resistin. Serum resistin levels did not differ significantly between benign hyperplasia and prostate cancer but in cancer patients there was a trend towards decrease with higher cancer stage. Moreover, serum resistin levels were significantly lower in patients with seminal vesicle invasion in comparison to those without invasion. While in BPH serum resistin levels correlated with insulin resistance, inflammatory status and cortisol, in PCa positive correlation with F/T PSA ratio and cortisol was observed. Tissue immunohistochemistry did not show any differences in staining pattern between benign and neoplastic prostate tissue. We conclude that serum resistin levels do not significantly differ between patients with benign prostate hyperplasia and prostate cancer, but there is a trend towards decrease in resistin serum levels in advanced cancer cases. Key words: Immunohistochemistry, inflammation, insulin resistance, prostate cancer, resistin.     

血清抵抗素水平与高血压的相关性

目的:研究血清抵抗素水平与高血压的相关性.方法:选择50例无糖尿病病史的高血压患者(高血压组)和40例体检正常者(对照组),收集一般临床资料,测量血压、腰围、臀围,测定空腹血糖、空腹胰岛素、高敏C反应蛋白(hsCRP)等生化指标,采用ELISA法测定2组血清抵抗素水平,并用胰岛素抵抗指数(IRI)作为胰岛素敏感性评价指标.结果:高血压组患者其腰围,BMI,血压,IRI,hsCRP和抵抗素水平较正常对照组高(均P<0.05),高血压组患者血清抵抗素与腰围、收缩压、IRI及hsCRP呈正相关(r值分别为0.391,0.425,0.608,0.447,均P<0.05),对照组血清抵抗素与IRI及hsCRP呈正相关(r值分别为0.406,0.452,均P<0.05).经Logistic多因素回归分析发现腰围、IRI、hsCRP及抵抗素与高血压相关(OR值分别是1.042、1.368、1.129、1.082,均P<0.05).结论:血清抵抗素水平与高血压炎症和胰岛素抵抗密切相关,提示抵抗素可能通过炎症,胰岛素抵抗在高血压发病过程中起重要作用.     

冠状动脉支架置入术对冠心病患者术后早期血清抵抗素水平的影响

目的 评价经皮冠状动脉支架置入术(CSI)对血清抵抗素水平的影响.方法 选择2007年7月至2008年5月在我院行CSI的40例患者为研究对象(CSI组),同时选择一组同期进行冠状动脉造影(CAG)的40例患者作为对照(CAG组).采用酶联免疫(ELISA)法检测血清抵抗素和超敏C反应蛋白(HS-CRP)含量,并分别于CSI或CAG术前及术后1 h、6 h、24 h采集静脉血进行血清抵抗素和Hs-CRP含量的测定.结果 CSI组患者血清抵抗素水平术后6 h显著高于术前(30.4±9.2μg/L比23.4±6.4μg/L,t=9.03,P＜0.01),术后24 h Hs-CRP含量显著高于术前(15.2±4.1 mg/L比7.4±3.4 mg/L,P＜0.01),并达到高峰.CAG组患者造影后与造影前比较,血清抵抗素水平差异无统计学意义(P＞0.05).结论 冠状动脉支架置入术后血清抵抗素水平升高,提示术后有炎症刺激反应.