代谢综合征患者血清抵抗素和瘦素水平关系的探讨

目的探讨代谢综合征(MS)患者血清抵抗素、瘦素水平与血脂、肥胖和胰岛素抵抗的关系。方法按体重指数将60例MS患者分为肥胖组和非肥胖组,采用ELISA方法测定受试者空腹血清抵抗素及瘦素水平,同时检测其身高、体重、腰围、臀围、血压、血糖、血脂及胰岛素,并计算体重指数(BM I)、腰臀比(WHR)和胰岛素抵抗指数(HOMA-IR)并与对照组比较。结果MS患者肥胖组和正常对照组相比其血清抵抗素及廋素水平明显升高(P<0.01)。MS非肥胖组和正常对照组相比其血清抵抗素及廋素水平明显升高(P<0.05,或P<0.01)。肥胖组和非肥胖组相比其血清抵抗素、瘦素水平无统计学意义。显示血清抵抗素水平与腰臀比、空腹胰岛素、胰岛素抵抗指数呈显著正相关(r=0.22,0.22,0.19;P<0.05);与体重指数、腰围、臀围、瘦素呈显著正相关(r=0.31,0.32,0.36,0.28;P<0.01);与高密度脂蛋白胆固醇(HDL-C)呈显著负相关(r=-0.24;P<0.05)。相关分析也显示血清瘦素水平与体重指数、腰围、臀围、腰臀比、收缩压、舒张压、甘油三酯、空腹胰岛素、胰岛素抵抗指数呈显著正相关(r=0.59,0.64,0.53,0.64,0.47,0.53,0.49,0.39,0.32;P<0.01),与血糖呈显著正相关(r=0.23;P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈显著负相关(r=-0.40;P<0.01)。结论MS患者血清抵抗素、瘦素水平均明显升高,并存在一定的瘦素抵抗,且与肥胖、腹型肥胖及胰岛素抵抗程度有明显相关性,因而抵抗素、瘦素、瘦素抵抗可能在肥胖和胰岛素抵抗、MS的发生及发展中具有重要的作用。     

单纯性肥胖儿童血清瘦素水平与血糖及血脂变化的关系

目的 研究单纯性肥胖儿童血清瘦素水平与血糖、胰岛素抵抗及血脂异常的关系。方法 采用放射免疫分析法、酶法对42对7-10岁肥胖及健康对照儿童进行血清瘦素、胰岛素水平及血糖、血脂水平的测定。结果 肥胖及对照儿童瘦素水平分别为2．74-45．125μg/L和0．53-10．18μg/L,经对数转换后肥胖组平均水平非常显著高于体重正常组。血清瘦素水平与体重指数(BMI)、腰臀围比(WHR)及体脂百分比均呈显著正相关关系。83％的肥胖儿童有瘦素抵抗,肥胖瘦素敏感组与体重正常组的血糖、胰岛素及血脂水平均差异无显著性,而肥胖瘦素抵抗组总胆固醇、甘油三酯(TG)、低密度脂蛋白胆固醇及胰岛素水平均显著高于体重正常组,肥胖瘦素敏感与瘦素抵抗儿童年龄、性别分布及BMI、WHR的差异无显著性,但瘦素抵抗组TG显著高于瘦素敏感组,高密度脂蛋白胆固醇显著低于瘦素敏感组。结论 肥胖儿童即存在瘦素抵抗,瘦素抵抗与代谢综合征及心血管疾病的危险因素密切相关,可作为筛查高危肥胖儿童的有用指标。     

2型糖尿病患者瘦素与胰岛素抵抗的相关性研究

目的探讨2型糖尿病患者血清瘦素水平与性别、体重指数及胰岛素抵抗的相关性。方法随机选108例2型糖尿病患者根据体重指数BMI(身高/体重2)分为糖尿病肥胖组和糖尿病正常BMI组,均测量身高、体重、空腹血糖(FPG)、空腹真胰岛素(FTI)、空腹瘦素(LP)及馒头餐后2h真胰岛素(PTI),以ISI=1/(FBG×FTI)作为胰岛素敏感指数,对瘦素与性别、BMI、空腹和餐后胰岛素及胰岛素敏感指数做相关性分析。结果⑴糖尿病肥胖组的瘦素、体重指数和胰岛素水平高于糖尿病正常BMI组,胰岛素敏感性指数糖尿病肥胖组低于糖尿病正常BMI组。⑵糖尿病肥胖组和糖尿病正常BMI组女性瘦素均明显高于男性。⑶直线相关性分析表明瘦素与性别显著相关,瘦素与体重指数和空腹胰岛素呈明显正相关,与ISI呈明显负相关。结论2型糖尿病患者血清瘦素与性别、体重指数、胰岛素抵抗密切相关。     

蒙古族人群高血压与相关因素研究

目的　探讨超重或肥胖及血脂水平与蒙古族人群高血压的关系。方法　将在现场内居住的 30岁及以上成年人经知情同意后作为调查对象并采血 ,并进行血压、身高、体重、腰臀围的测量 ,对血清标本进行血脂各项指标的检测。结果　高血压组的体重指数和腰臀围比显著高于血压正常组。高血压组的总胆固醇 (TC)、甘油三酯 (TG)、载脂蛋白AI(ApoAI)和ApoB水平均显著高于血压正常组。按体重指数分层后 ,在体脂指数 (BMI) <2 4组 ,高血压组TC、TG、ApoAI水平显著高于血压正常组 (P <0 0 5 )。按腰臀围比分层后 ,在腰臀比 (WHR) <0 9组 ,高血压组TC、TG、ApoAI、ApoB水平显著高于血压正常组 (P <0 0 5 )。结论　超重或肥胖、高血脂与蒙古族人群高血压密切相关。     

单纯性肥胖儿童瘦素、胰岛素及其相关性研究

目的 研究单纯性肥胖儿童瘦素、胰岛素及其相关关系。方法 对筛选出来的54名肥胖儿童和60名正常体重儿童进行瘦素、胰岛素、C-肽、血糖水平的测定，并进行相关关系的研究。结果 肥胖组儿童瘦素、胰岛素、C-肽、血糖水平高于非肥胖组儿童，胰岛素敏感性指数肥胖组儿童低于非肥胖组儿童，差异有显性意义(P＜0．05)。瘦素与体质指数、体脂百分比、体脂肪、臀围、胰岛素、C-肽浓度均呈显正相关(P＜0．05)，与血糖、瘦体重、腰臀围比没有相关性。结论 肥胖儿童存在瘦素抵抗、高胰岛素血症和胰岛素抵抗，瘦素与体质指数、胰岛素浓度呈显正相关。     

绝经女性血清瘦素水平与代谢综合征关系

目的 探讨绝经女性血清瘦素与代谢综合征(MS)关系.方法 对沈阳市某社区106名绝经女性进行人体测量、血清瘦素及MS指标测定.结果 因子分析抽出2个公因子,累计方差贡献率为60.7%;核心因子为瘦素-体脂肪,包括瘦素、体脂肪含量、体质指数、腰围;另一因子为MS因子,包括腰围、血压、空腹血糖、甘油三酯、高密度脂蛋白胆固醇.体脂肪含量和收缩压是预测瘦素的独立变量(R2=0.607,P＜0.01);瘦素浓度随MS成分数的增多而升高,MS≥3项组瘦素浓度为(11.33±4.51)ng/mL、2项组为(9.21±4.70)ng/mL,均高于≤1项组的(5.54±3.46)ng/mL(均P＜0.05);高瘦素水平组(＞9.2 ng/mL)MS的危险度是低瘦素水平组(≤9.2 ng/mL)的4倍(OR=4.00,95%CI=1.34～11.97,P＜0.05).结论 绝经女性瘦素与体脂肪含量、收缩压呈正相关,高瘦素水平可增大MS的危险度.     

代谢综合征患者血浆内脂素水平的变化

目的 探讨代谢综合征(MS)患者血浆内脂素(visfatin)水平及与胰岛素抵抗(IR)的关系.方法 筛选MS患者45例、年龄、性别相匹配的健康成年人40例为对照组.ELISA法测定各组空腹血浆visfatin水平,同时检测空腹血糖(FPG)、胰岛素(FINS)、血脂、血压,测量身高、体重、腰围、臀围计算体重指数(BYI)、腰臀比(WHR),采用HOMA-IK模型公式计算胰岛素抵抗指数.结果 MS组visfatin水平明显高于对照组,差异有统计学意义.在MS组,visfatin与BMI、WC、FPG、2 hPG、FINS、TG、HOMA-IR呈正相关,r值分别为0.378,0.231,0.419,0.363,0.448,0.423,P圴<0.05;与HDL-C无明显相关关系.多元逐步回归分析表明,BMI和visfatin是HOMA-IR的独立影响因素.结论 MS患者血浆visfitin水平增高,visfatin与机体糖、脂代谢紊乱密切联系.     

代谢综合征患者血浆内脂素水平的变化

目的探讨代谢综合征(MS)患者血浆内脂素(visfatin)水平及与胰岛素抵抗(IR)的关系。方法筛选MS患者45例、年龄、性别相匹配的健康成年人40例为对照组。ELISA法测定各组空腹血浆visfatin水平,同时检测空腹血糖(FPG)、胰岛素(FINS)、血脂、血压,测量身高、体重、腰围、臀围计算体重指数(BNI)、腰臀比(WHR),采用HOMA-IR模型公式计算胰岛素抵抗指数。结果MS组visfatin水平明显高于对照组,差异有统计学意义。在MS组,visfatin与BMI、WC、FPG、2hPG、FINS、TG、HOMA-IR呈正相关,r值分别为0.378,0.231,0.419,0.363,0.448,0.423,P均<0.05;与HDL-C无明显相关关系。多元逐步回归分析表明,BMI和visfatin是HOMA-IR的独立影响因素。结论MS患者血浆visfatin水平增高,visfatin与机体糖、脂代谢紊乱密切联系。     

蒙古族人群2型糖尿病瘦素水平与胰岛素抵抗

目的 在蒙古族人群中探讨血清瘦素水平与2型糖尿病胰岛素抵抗的关系.方法 在蒙古族人群中选择2型糖尿病患者54例及健康对照36人,检测其血清瘦素(Leptin)水平、空腹血糖(FPG)、空腹胰岛素(FINS)、体质指数(BMI)、血压、血脂等指标,并计算胰岛素敏感指数(ISI).结果 病例组与对照组比较,瘦素、FPG、FINS、BMI、甘油三酯(TG)、明显高于对照组,而ISI、高密度脂蛋白(HDL-C)明显低于对照组(P<0.05);糖尿病组瘦素与BMI、FINS、TG、总胆固醇(TC)呈正相关,而与ISI呈负相关(P<0.05);多元逐步回归分析显示,影响胰岛素敏感指数(ISI)的独立预测因素是瘦素、BMI、FINS(P<0.05).结论 2型糖尿病患者血清瘦素水平明显升高,肥胖、瘦素抵抗与胰岛素抵抗(IR)密切相关.     

青少年代谢综合征因子分析

【目的】 通过青少年代谢综合征(metabolic syndrome, MS)相关组分的因子分析,探索青少年MS病理生理机制。 【方法】 以哈尔滨市某校130名高一学生为研究对象。测量身高、体重、腰围、臀围、收缩压、舒张压,计算体质指数、腰臀比和腰围身高比;测定空腹血糖、血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及血清超敏C反应蛋白(high sensitivity C reactive protein, hs-CRP)含量。 【结果】 未引入hs-CRP变量时,提取三个公因子:肥胖因子、脂代谢因子和血压血糖因子,分别解释10个原始变量的31.730%、22.287%和16.767%,累计方差贡献率为70.784%。引入hs-CRP变量后,青少年MS相关组分共提取3个因子,分别为肥胖因子、脂代谢因子和血压血糖因子,分别解释10个原始变量的32.697%、20.275%、15.454%,累计方差贡献率为68.427%。 【结论】 肥胖因子在青少年MS发病机制中起主要作用;腰围身高比较腰围更适于评价青春期MS的中心性肥胖;hs-CRP可能参与青春期MS的发病。     

城市居民血清瘦素水平与体质指数、血脂和胰岛素关系的研究

目的　测量城市居民血清瘦素 (leptin)水平并探讨其与体质指数 (BMI)、血脂、胰岛素的关系。方法　选取 15 8例 17～ 72岁济南市社区居民作为研究对象 ,测量其身高、体重、腰围 (W)、臀围 (H) ,检测其血清胰岛素、血脂、血清leptin水平。结果　 15 8名城市居民血清leptin水平为 (17. 4 7± 13. 5 2 )ng ml,男性血清leptin水平为 (8.38± 6 . 31)ng ml,女性血清leptin水平为 (2 4. 98± 13. 2 9)ng ml。Leptin与BMI、腰围、臀围呈显著正相关 ,与腰臀比 (WHR)没有相关性 ;女性leptin与WHR相关 ;男性和女性血清leptin水平和胰岛素水平均无相关性 ;男性载脂蛋白B(ApoB)和leptin呈正相关 ,女性的总胆固醇 (TC)、低密度脂蛋白 (LDL- c)与leptin呈正相关。结论　BMI是影响血清leptin水平的重要因素。男性ApoB和leptin有相关性 ,女性的TC、LDL- c与leptin呈正相关。胰岛素、血脂、与leptin的关系均受性别的影响。     

The quantitative relationship between "the metabolic syndrome" and abdominal obesity in women

Abdominal obesity is closely associated with the presence of metabolic risk factors and elevated blood pressure in selected materials. This has, however, never been analyzed quantitatively in a non-selected cohort. Therefore, in a population-based study of 1462 Swedish women, four selected risk factors for non-insulin dependent diabetes mellitus (NIDDM) and cardiovascular disease (CVD), serum triglycerides, blood glucose and systolic blood pressure and also serum insulin in a subsample, were examined in relation to regional and overall obesity. This was performed by subdividing the age adjusted sample into quintiles of waist to hip circumference ratio (WHR) or body mass index (BMI) as indicators of abdominal distribution of body fat and overall obesity, respectively. The risk factors serum triglycerides, blood glucose, blood pressure and serum insulin were defined as being elevated when the value of the risk factor was higher than the mean plus one or two standard deviations of the total age-adjusted cohort. The percentage of women with elevated risk factors according to this definition was then calculated in each of these quintiles. Having a risk factor which was elevated according to the definition was significantly correlated to WHR and BMI (p<0.0001) independent of age. The presence of one or several of these elevated risk factors was clearly higher than expected in the fifth quintile of WHR, and to a lesser extent in the fifth quintile of BMI while this was not the case in the lower quintiles of WHR and BMI. When studying the combination of the WHR and BMI, the presence of risk factors higher than the mean plus two standard deviations increased gradually with WHR in all five quintiles of BMI. A significant association was observed between WHR and presence of risk factors independent of BMI (p<0.0001) but BMI did not remain significantly correlated to presence of risk factors when controlling for WHR (p=0.09). These results indicate that abdominal distribution of body fat in women independently of general obesity is closely associated with metabolic risk factors including elevated blood pressure, a metabolic syndrome with increased risk for cardiovascular disease and non-insulin dependent diabetes mellitus.     

营养干预结合有氧运动对非酒精性单纯性脂肪肝患者血清瘦素水平的影响

摘要:目的　探讨营养干预结合有氧运动对非酒精性单纯性脂肪肝（NAFL）患者血清瘦素水平和胰岛素抵抗（IR）的影响。方法　以2010年8月-2013年8月聊城市人民医院查体中心和肝病门诊确诊的NAFL患者42例为NAFL组,同期健康查体人员40例为对照组。对NAFL组进行营养干预并实施有氧运动方案,检测两组干预前后体重、体重指数（BMI）、腰臀比（WHR）、血清瘦素、空腹血糖（FBG）、空腹胰岛素（FINS）及血脂水平变化,计算胰岛素抵抗指数（HOMA-IR）,比较干预前组间差异、NAFL组干预前后差异以及血清瘦素与各指标的相关性。结果　NAFL组干预后体重、BMI、WHR、FBG、FINS和瘦素水平低于干预前,差异有统计学意义（P＜0.01）;HOMA-IR较干预前有所降低,差异无统计学意义（P＞0.05）。瘦素与BMI、FBG、FINS、HOMA-IR、TC和TG呈显著正相关（P＜0.01）,与HDL-C无相关性（P＝0.238）。结论　营养干预结合有氧运动可提高NAFL患者的血清瘦素水平,调节血糖血脂水平,改善IR.。     

Measures of adiposity in the identification of metabolic abnormalities in elderly men

BACKGROUND: Body mass index (BMI; in kg/m(2)) is considered a poor indicator of overall and abdominal obesity in the elderly. OBJECTIVES: Our goal was to determine which simple anthropometric measurements [BMI, waist-to-hip ratio (WHR), waist circumference (WC), percentage body fat (%BF), or fat mass (FM)] are most closely associated with metabolic risk factors and insulin resistance in elderly men. DESIGN: This was a cross-sectional study of 2924 men aged 60-79 y with no history of coronary heart disease, stroke, or diabetes who were drawn from general practices in 24 British towns. RESULTS: BMI and WC were the measures most strongly associated with the metabolic syndrome (>/=3 of the following: hypertension, low HDL cholesterol, high triacylglycerols, or high blood glucose) and insulin resistance. For a 1-SD increase in BMI, WC, WHR, %BF, and FM, the odds ratios (95% CIs) of having the metabolic syndrome after adjustment for age, socioeconomic status, smoking status, and physical activity were as follows: BMI, 1.61 (1.44, 1.79); WC, 1.65 (1.48, 1.81); WHR, 1.49 (1.34, 1.66); %BF, 1.41 (1.25, 1.59); and FM, 1.53 (1.38, 1.70). For insulin resistance, the odds ratios (95% CIs) were as follows: 2.48 (2.22, 2.77), 2.46 (2.19, 2.65), 1.75 (1.59, 1.93), 1.79 (1.60, 2.00), and 2.10 (1.88, 2.34), respectively. In normal-weight (BMI < 25) and overweight (BMI 25-29.9) men, the presence of the metabolic syndrome and insulin resistance increased with increasing WC; this did not occur in obese men. CONCLUSIONS: BMI and WC are the simple measures of adiposity most strongly associated with metabolic abnormalities in elderly men. Our findings suggest that WC can be used as a complementary measurement to identify health risks in normal-weight and overweight elderly persons.     

Body fat distribution, serum lipoproteins and blood pressure in middle-aged Finnish men and women

The association of body fat distribution as measured by the ratio of waist to hip girth (WHR) to age, to serum total cholesterol and HDL-cholesterol and to blood pressure was studied in a population-based sample of 2461 men and 2768 women aged 25 to 64 years not treated with cardiovascular drugs. In men, the relationships of age with WHR and age with body mass index (BMI) were similar, an increase levelling at the age of about 50 years. In women, BMI increased linearly, but WHR exponentially with age. In both sexes, age-adjusted WHR and BMI associated positively with non-HDL cholesterol, and with systolic and diastolic blood pressure, and inversely with HDL-cholesterol and the HDL/non-HDL cholesterol ratio. WHR and BMI were independently related to several cardiovascular risk factors. HDL-cholesterol concentration was 19% lower in men, and 17% lower in women who belonged to the upper tertile of both WHR and BMI, than in the subjects in the lower tertiles of WHR and BMI. Age-adjusted WHR and BMI also predicted fasting and 2-hour post-challenge blood glucose values in women aged 45 to 64 years, but not in men. The WHR provides additional information on elevated cardiovascular risk factors in cross-sectional analysis among middle-aged men and women independently of BMI. The measurement of WHR in large-scale risk factor surveys should be recommended, in order to assess the independent contribution of WHR to the risk of cardiovascular disease, and to find out the importance of WHR for the prevention of chronic diseases.     

糖尿病患者血清瘦素水平及相关因素分析

目的测定初次确诊为糖尿病患者的血清瘦素水平,探讨瘦素与体重指数,血糖、甘油三脂、胆固醇和空腹胰岛素的关系.方法受试者精确测量身高、体重、计算体重指数(BMI),同步检测空腹血糖(FPG),胰岛素(Fins),胆固醇(CH)、甘油三酯(TG),放射免疫法(RIA)测定血清瘦素(Leptin)水平.结果糖尿病组与对照组比较瘦素水平无显著性差异(P＞0.05);无论是糖尿病组还是对照组,肥胖者的瘦素水平与非肥胖者的瘦素水平相比均有显著性差异(P＜0.01);女性的瘦素水平明显高于男性(P＜0.01);相关分析显示,瘦素与体重指数(r=0.4406 P＜0.01)显著相关;瘦紊与胰岛索(t=0.2644 P＜0.05)显著相关;瘦素与FPG(r=0.1112 P＞0.05)、TG(r=0.0008 P＞0.05)、CH(r=0.0194 P＞0.05)无相关性.结论血清瘦素水平与BMI显著相关,显示存在瘦素抵抗;瘦素与胰岛素有相关性,提示两种激素间存在一定的内在联系.     

Relationship between plasma adiponectin levels and metabolic risk profiles in Taiwanese children

OBJECTIVE: Adiponectin, a novel adipokine with antiinflammatory and insulin-sensitizing properties, has an important role in glucose metabolism and is negatively correlated with body fat amount in adults. The purpose of this study was to evaluate the association of plasma adiponectin level with metabolic risk profiles and insulin resistance status among Taiwanese children. RESEARCH METHODS AND PROCEDURES: We enrolled 1,248 children (608 boys and 640 girls) to ascertain their demographic, anthropometric, and cardiovascular risk factors distribution in Taipei. We measured plasma insulin, adiponectin, and leptin levels by radioimmunoassay (Linco Research Inc, St. Charles, MO). We calculated an insulin resistance index (IRI) using the Homeostasis Model Assessment model and also calculated an insulin resistance syndrome (IRS) summary score for each individual by adding the quartile ranks from the distribution of systolic blood pressure, serum triglyceride, high-density lipoprotein-cholesterol (HDL-C) (inverse), and insulin levels. RESULTS: In general, the boys had larger BMI, higher systolic blood pressure, serum total cholesterol, and triglyceride, and lower plasma leptin and adiponectin levels than girls. Plasma adiponectin levels were correlated negatively with BMI, leptin, insulin, IRI, and IRS summary score but positively correlated with HDL-C in both boys and girls. In multivariate regression analyses, adiponectin was negatively associated with insulin (girls only), IRI (girls only), and IRS score, and positively associated with HDL-C in both genders even after adjusting for age, BMI, plasma leptin level, and other potential confounders. DISCUSSION: These data suggest that plasma adiponectin levels were negatively associated with metabolic risk profiles that may have played a protective role in the development of insulin resistance among Taiwanese school children.