高尿酸血症与腹型肥胖的关系

研究表明,高尿酸血症和腹型肥胖密切相关,但其机制尚不十分清楚.本文在对比血尿酸与腹型肥胖评估指标关系的基础上,探讨了腹型肥胖引起高尿酸血症的可能成因,对内脏脂肪的蓄积和多种脂肪因子的分泌在参与高尿酸血症形成中的地位和研究进展予以了特别关注,从而为阐明高尿酸血症与腹型肥胖的关系,有效防治高尿酸血症提供了科学依据.     

高尿酸血症与腹型肥胖的关系

研究表明,高尿酸血症和腹型肥胖密切相关,但其机制尚不十分清楚.本文在对比血尿酸与腹型肥胖评估指标关系的基础上,探讨了腹型肥胖引起高尿酸血症的可能成因,对内脏脂肪的蓄积和多种脂肪因子的分泌在参与高尿酸血症形成中的地位和研究进展予以了特别关注,从而为阐明高尿酸血症与腹型肥胖的关系,有效防治高尿酸血症提供了科学依据.     

高尿酸血症与腹型肥胖的关系

研究表明,高尿酸血症和腹型肥胖密切相关,但其机制尚不十分清楚.本文在对比血尿酸与腹型肥胖评估指标关系的基础上,探讨了腹型肥胖引起高尿酸血症的可能成因,对内脏脂肪的蓄积和多种脂肪因子的分泌在参与高尿酸血症形成中的地位和研究进展予以了特别关注,从而为阐明高尿酸血症与腹型肥胖的关系,有效防治高尿酸血症提供了科学依据.     

乙酰辅酶A羧化酶在内分泌代谢性疾病中的作用

乙酰辅酶A羧化酶(ACC)是脂肪酸合成的限速酶,ACC可以催化乙酰辅酶A生成丙二酰辅酶A,而后者作为长链脂肪酸合成的前体,既为脂肪酸合成提供供体,又可变构抑制脂肪酸转运至线粒体氧化,因此ACC在脂肪酸合成和代谢中发挥至关重要的作用.因其特殊的生物学功能,ACC在肥胖、非酒精性脂肪性肝病、糖尿病、高尿酸血症等内分泌代谢性疾病中的作用日趋重要,可成为多种代谢性疾病潜在的治疗靶点.     

姜黄素对脂肪变性HL-7702细胞乙酰辅酶A羧化酶表达的影响

姜黄素为姜科植物姜黄的提取物,是一种多酚类物质.近年来,国内外对姜黄素进行了大量的研究,其在保护肝脏方面的作用备受关注.多种研究提示姜黄素具有防止实验性脂肪肝的作用[1],但其作用机制尚待进一步研究.本实验旨在初步探讨姜黄素对肝细胞脂质变性的影响及其可能机制,为非酒精性脂肪性肝病的防治提供理论依据.     

腹型肥胖对糖尿病人群新发高尿酸血症影响的研究

目的 探讨糖尿病患者腹型肥胖与新发高尿酸血症（HUA）发病风险间的关系. 方法 本研究采用前瞻性队列研究,以参加2006～2007年度开滦集团职工健康体检的糖尿病患者,且既往无HUA病史及相关资料完整者5122例作为观察队列.依据基线WC将观察对象分为肥胖组与非肥胖组,比较两组2010～2011年度健康体检时新发HUA的发病率,并采用多因素Logistic回归分析肥胖与新发HUA发病风险间的关系. 结果 （1）观察队列的平均随访时间为（48.9±5.6）月,HUA发病率为5.6％（285/5122）.肥胖组HUA发病率高于非肥胖组（6.9％ vs3.8％,P＜0.01）;（2）多因素Logistic回归分析显示,肥胖、性别、SBP、基线血清尿酸（SUA）水平是新发HUA的影响因素,其中肥胖是独立危险因素（OR=1.44,95％CI：1.09～1.89）. 结论 腹型肥胖可能是糖尿病患者新发HUA的独立危险因素.     

高脂饮食对老年大鼠骨骼肌脂肪酸含量及乙酰辅酶A羧化酶表达和活性的影响

目的 探讨增龄和高脂饮食对大鼠骨骼肌脂肪酸含量及乙酰辅酶A羧化酶(acetyl-coenzyme A carboxylase,ACC)表达和活性的影响.方法 将22～24月龄雄性Wistar大鼠随机分为老年对照组和高脂组;4～5月龄大鼠作为青年对照组.老年对照组和青年对照组给基础饲料,高脂组给予高脂饲料,喂养8周.用高胰岛素-正葡萄糖钳夹实验评价各组大鼠胰岛素敏感性,用全自动生化分析仪测定骨骼肌三酰甘油,用荧光分光光度计测定骨骼肌总的长链脂酰辅酶A含量,用Western-blot方法测定骨骼肌ACC、和磷酸化ACC(P-ACC)蛋白表达.结果 (1)老年对照组空腹血糖、胰岛索和游离脂肪酸高于青年对照组,高脂组上述几项指标进一步升高,并且出现血清三酰甘油和总胆固醇水平增高;(2)老年对照组葡萄糖输注率(glucose infusion rates,GIR)低于青年对照组,高脂组GIR低于老年对照组,高脂组GIR在8周末低于4周末;(3)老年对照组骨骼肌三酰甘油及长链脂酰辅酶A含量高于青年对照组,高脂组与老年对照组比较进一步升高;(4)老年对照组与青年对照组之间、高脂组与老年对照组之间骨骼肌ACC蛋白表达均无明显变化(P>0.05);骨骼肌P-ACC蛋白水平在老年对照组低于青年对照组,高脂组与老年对照组比较进一步降低(P<0.05或P<0.01).结论 与青年大鼠比较,老年大鼠更易出现脂肪酸代谢异常及胰岛素抵抗;高脂饮食导致老年大鼠骨骼肌脂质积聚更加严重,ACC活性的改变可能在骨骼肌脂质堆积和胰岛素抵抗发生中起了一定作用.     

乙酰辅酶A羧化酶B基因rs2268388多态性与糖尿病慢性肾脏疾病的相关性研究

目的 探讨乙酰辅酶A羧化酶B(ACACB)基因rs2268388多态性与我国昆明地区汉族人群糖尿病慢性肾脏疾病(CKD)的相关性. 方法 选取T2DM患者248例,根据两次UAlb/Cr或24 hUAlb结果分为单纯T2DM组85例、CKD1组99例及CKD2组64例,另选取健康对照(NC)组70名.采用Taqman PCR(Three-star)法对各组ACACB基因rs2268388多态性进行检测,并比较分析各组基因型、等位基因频率、风险因素及相关临床和生化指标. 结果 (1)单纯T2DM、CKD各组C/T基因型频率均低于NC组(Z=-2.391,P=0.017);CKD1组和CKD2组ACACB基因rs2268388T/T基因型频率高于单纯T2DM组(Z=-2.522,P=0.012;Z=-4.981,P=0.001);CK D1组和CKD2组T/T基因型频率及各组等位基因频率比较,差异无统计学意义(P＞0.05).(2) Logistic回归分析表明,糖尿病病程、rs2268388T/T基因型、高TG、高HbA1 c及高SUA是CKD发生的危险因素. 结论 在昆明地区汉族人群中,ACACB基因rs2268388T/T基因型可能与CKD发生相关.     

2型糖尿病伴高尿酸血症的病因与治疗新进展

高尿酸血症是嘌呤代谢障碍性疾病,也是与代谢异常综合征和糖尿病密切相关性疾病之一,其主要原因是尿酸生成过多或肾脏排泄减少.高尿酸血症与肥胖症、高脂血症、高血压病、糖尿病、动脉粥样硬化等疾病呈显著正相关.糖尿病肾病、高血压、高胰岛素血症均可因阻碍肾小管排泌钠与尿酸引起血尿酸增高.血钠增高与高血压相关,高胰岛素血症又与肥胖、脂质代谢异常特别是高甘油三酯血症、肥胖及糖代谢异常共现.高尿酸血症除了引起痛风、肾结石与肾病外,还使糖尿病患者大血管并发症及心脑血管终点事件发生率显著增高.     

腹型肥胖的研究进展

近年来腹型肥胖作为代谢综合征最重要的特征得到了广泛关注."脂质异位沉积"学说提出腹部皮下脂肪与内脏脂肪一样,在促进胰岛素抵抗形成的过程中发挥关键作用,同时也是导致心血管代谢风险的重要因素,而并非仪表现为既往所认为的机体保护作用.提示无论腹部皮下脂肪还是内脏脂肪堆积引起的腰围增加都应当得到足够的重视,也进一步支持将腰围作为代谢综合征工作定义中肥胖的诊断标准.腹型肥胖的治疗基础仍是生活方式干预,而体液因子、胃肠道激素及棕色脂肪研究的开展为腹型肥胖提供了新的治疗方向.     

高强度聚焦超声治疗腹型肥胖子宫肌瘤患者的临床效果及初步经验

目的探讨高强度聚焦超声（HIFU）治疗子宫肌瘤合并腹型肥胖患者的临床效果及初步经验。 方法选择2018年5月至2019年5月于广东省妇幼保健院确诊为子宫肌瘤同时合并腹型肥胖的5名患者的临床资料,分析5例患者的治疗时间、聚焦时间、功率,记录治疗后有无不良反应。比较治疗前,治疗后24 h和治疗后6个月子宫大小,肌瘤大小和消融面积的变化。 结果治疗后24 h,5例患者平均消融率达59.8%,治疗后6个月,子宫体积及肌瘤体积均较治疗前缩小约19.2%、37.6%。5例患者治疗后均出现轻微腹痛伴腰骶部酸胀感,3例患者治疗后出现阴道分泌物增多,1例患者治疗后出现皮下硬结。 结论HIFU治疗子宫肌瘤合并腹型肥胖患者的临床效果和安全性良好,值得进一步推广应用。     

Prevalence of general and abdominal obesity in the adult population of Spain, 2008-2010: the ENRICA study

This is the first study to report the prevalence of general obesity and abdominal obesity (AO) in the adult population of Spain based on measurements of weight, height and waist circumference. The data are taken from the ENRICA study, a cross‐sectional study carried out between June 2008 and October 2010 in 12,883 individuals representative of the non‐institutionalized population on Spain aged 18 years and older. Anthropometry was performed under standardized conditions in the households by trained interviewers. Overweight was considered as body mass index (BMI) 25–29.9 kg m^?2, and obesity as BMI ≥ 30 kg m^?2. AO was defined as waist circumference >102 cm in men and >88 cm in women. The prevalence of obesity was 22.9% (24.4% in men and 21.4% in women). About 36% of adults had AO (32% of men and 39% of women). The frequency of obesity and of AO increased with age and affected, respectively, 35 and 62% of persons aged 65 and over. The frequency of obesity and AO decreased with increasing educational level. For example, 29% of women with primary education or less had obesity vs. only 11% of those with university studies. The prevalence of obesity was very high in the Canary Islands and in the south of Spain.     

Waist-to-height ratio and dynapenic abdominal obesity in users of hemodialysis services

Background and aimsAbdominal obesity and decreased muscle strength are risk factors for individuals on hemodialysis. Thus, the combination of these two factors known as dynapenic abdominal obesity acts as an important marker of the nutritional status of this population. Therefore, the objective of the work was to investigate the association between abdominal obesity, dynapenia, and sociodemographic, clinical, and nutritional factors in individuals with chronic kidney disease undergoing hemodialysis.Methods and ResultsCross-sectional study with 940 individuals undergoing hemodialysis in southeastern Brazil. Dynapenic abdominal obesity was defined by the combination of the presence of abdominal obesity, indicated by the waist-to-height ratio, and the reduction in muscle strength, measured by handgrip strength. Binary logistic regression was performed to calculate the odds ratio (OR) and the respective confidence intervals (95% CI). Dynapenic abdominal obesity was present in 45.42% of the study population. We found that being 18–59 years (OR: 3.17; 95% CI 2.35–4.28; p < 0.001) and being overweight (OR: 2.58; 95% CI 1.92–3.47; p < 0.001) increased the chances for the presence of dynapenic abdominal obesity; however, the habit of consuming meals away from home (OR: 0.63; 95% CI 0.47–0.85; p = 0.003) and having preserved behavioral adductor muscle thickness (OR: 0.52; 95% CI 0.38–0.71; p < 0.001) are considered protective factors.ConclusionDynapenic abdominal obesity, present in individuals on hemodialysis, may represent a valid nutritional tool for assessing cardiovascular risk and mortality in this population, in order to implement the most effective preventive and/or therapeutic intervention possible.     

伴腹型肥胖的2型糖尿病患者的临床特点分析

目的:探讨伴腹型肥胖的2型糖尿病(T2DM)患者的临床特点。方法:选取T2DM住院患者171例,按腰围分为腹型肥胖组(AO组,男性>90 cm,女性>85 cm)和非腹型肥胖组(NAO组,男性≤90 cm,女≤85 cm),比较各组的糖代谢、脂代谢、新稳态模型(HOMA2)胰岛B细胞分泌指数(HOMA2-B)和胰岛素敏感性指数(HOMA2-S)。结果:AO组血压、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、C反应蛋白(CRP)、血糖和C肽(CP0、CP30、CP120)均较NAO组显著升高,而高密度脂蛋白胆固醇(HDL-C)、HOMA2-S则明显降低。结论:伴腹型肥胖的T2DM患者多伴TG水平升高,且血糖失控和胰岛素抵抗程度更重。     

High protein diets decrease total and abdominal fat and improve CVD risk profile in overweight and obese men and women with elevated triacylglycerol

Background and aimsIt is unclear whether high protein weight loss diets have beneficial effects on weight loss, abdominal fat mass, lipids, glucose and insulin compared to conventional low fat diets in subjects at increased risk of cardiovascular disease (CVD) because of elevated glucose and triglyceride concentrations. Our objective was to determine the effects of high protein (HP) compared to standard protein (SP) diets on CVD risk in obese adults.Methods and resultsData from three, 12 week, randomized parallel trials with subjects assigned to either HP or SP diet (5500–6500 kJ/day) were pooled. Weight, body composition (dual energy X-ray absorptiometry), lipids, insulin and glucose were measured before and after weight loss. Data from 215 subjects (49.9 ± 9.8 years, BMI 33.5 ± 3.7 kg/m²), 108 HP, 107 SP were analyzed. Weight loss (HP diet 7.82 ± 0.37 kg; SP diet 7.65 ± 0.39 kg, NS) and total fat loss were not different (HP 6.8 ± 4.3 kg; LP 6.4 ± 4.7 kg, NS on intention to treat analysis). The reduction in triacylglycerol (TAG) was greater on HP than SP 0.48 ± 0.07 mmol/L vs 0.27 ± 0.06 mmol/L, (P < 0.001). Subjects with TAG greater than the median (>1.54 mmol/L at baseline) lost more weight (HP 8.5 ± 0.6; SP 6.9 ± 0.6 kg, P = 0.01, diet by TG group), total (HP 6.17 ± 0.50 kg; SP 4.52 ± 0.52 kg, P = 0.007) and abdominal fat (HP 1.92 ± 0.17 kg; SP 1.23 ± 0.19 kg, P = 0.005) on HP. Total cholesterol (12 vs 6%, HP vs SP) and TAG (39 vs 20%, HP vs SP) decreased to a greater extent in these subjects (both P ≤ 0.05) on HP.ConclusionShort-term high protein weight loss diets had beneficial effects on total cholesterol and triacylglycerol in overweight and obese subjects and achieved greater weight loss and better lipid results in subjects at increased risk of CVD. These observations provide further information regarding the utility of this dietary approach in effectively managing body weight and composition and reducing CVD risk in overweight and obese individuals.     

腹型肥胖脑血栓患者阿司匹林抵抗的初步研究

目的探讨腹型肥胖脑血栓患者是否存在阿司匹林抵抗及其原因。方法选择病情稳定的脑血栓患者125例,根据腰围分为腹型肥胖组和非腹型肥胖组,测定两组的血小板聚集率、TNF-a、IL-6和C反应蛋白。Logistic多元回归分析用于评价阿司匹林抵抗和各种危险因素的联系程度。结果腹型肥胖组阿司匹林抵抗的发生率、TNF-a、IL-6和C反应蛋白均明显高于非腹型肥胖组（P〈0．05）,年龄、TNF—a、IL-6和C反应蛋白是脑血栓患者发生阿司匹林抵抗的独立危险因素。结论腹型肥胖脑血栓患者易发生阿司匹林抵抗,可能与患者体内的炎症介质增加有关,临床工作中要高度重视该类患者。