PCOS患者血清脂联素水平与体质量指数、胰岛素抵抗的相关性探讨

目的 探讨多囊卵巢综合征(PCOS)患者血清脂联素水平与体质量指数(BMI)、胰岛素抵抗(IR)的关系.方法 选择206例PCOS患者(PCOS组)和同期收治的74例非PCOS患者(对照组),测定其BMI、血清脂联素水平;PCOS组同时测定血糖、胰岛素,计算胰岛素指数(HOMA-IR,≥1.66为IR).结果 随BMI增加,两组血清脂联素水平呈递减趋势(正常体质量>超重>肥胖);PCOS组合并糖耐量异常(IGT)者和IR者脂联素分别为(3.97±1.27)和(4.90±2.62)mg/L,明显低于无IGT者和无IR者的(6.50±3.11)和(6.82±4.40)mg/L,P<0.01.结论 PCOS患者血清脂联素水平与BMI及IR密切相关,此为更深入了解脂联素在代谢中的作用及影响因素提供了理论依据.     

2型糖尿病家系非糖尿病正常体重一级亲属脂联素水平5年随访

目的探讨2型糖尿病患者非糖尿病正常体重一级亲属脂联素水平变化及脂联素与胰岛素敏感性和颈动脉内膜中层厚度(IMT)之间的关系.方法入选2型糖尿病非糖尿病正常体重一级亲属53名和对照组37名,入组时检测了脂联素、血脂、血糖、血压及空腹胰岛素水平.用高频B超检测IMT及内皮依赖性血管舒张功能(EDVD).采用稳态模式(HOMA)评价胰岛素抵抗(HOMA-IR)和评价胰岛β细胞功能(HOMA-β).一级亲属组29名和对照组20名完成了5年随访.结果基线时一级亲属组血浆脂联素水平明显低于对照组[(10.06±5.79)对(14.43±7.91)mg/L,P<0.05].5年后一级亲属组脂联素水平降低24.0%(P<0.05),对照组脂联素水平降低36.7%(P<0.05).一级亲属组脂联素与腰臀比(r=-0.397)、空腹血糖(r=-0.373)、IMT(r=-0.372)和HOMA-IR(r=-0.40)负相关(均P<0.05).校正相关因素后,多元逐步回归分析显示一级亲属组脂联素与年龄,高密度脂蛋白胆固醇(HDL-C),IMT独立相关.对照组脂联素与低密度脂蛋白胆周醇(LDL-C)和IMT独立相关.结论 5年后一级亲属组和对照组脂联素水平均明显降低,脂联素降低可能与IMT增加相关.     

2型糖尿病合并肥胖患者脂联素水平与胰岛素抵抗的相关性

目的 研究2型糖尿病合并肥胖患者脂联素水平和胰岛素抵抗之间的相关性,探讨脂联素在2型糖尿病合并肥胖患者发生胰岛素抵抗中的作用.方法 选择30例2型糖尿病合并肥胖患者、25例2型糖尿病患者及25例非糖尿病对照人员(其中13例为肥胖者),检测体质指数、腰/臀比值、空腹血糖、糖化血红蛋白、血清空腹胰岛素、血脂、脂联素水平,计算胰岛素抵抗指数和胰岛素敏感指数.分析血清脂联素与胰岛素抵抗的相关性.结果 (1)糖尿病肥胖组的检测体质指数、糖化血红蛋白、空腹血糖、胰岛素抵抗指数、血清空腹胰岛素、腰/臀比值均高于对照肥胖组,脂联素、胰岛素敏感指数低于对照肥胖组(P<0.05).(2)糖尿病非肥胖组甘油三酯、糖化血红蛋白、空腹血糖、胰岛素抵抗指数、血清空腹胰岛素均高于对照非肥胖组,胰岛素敏感指数、脂联素低于对照非肥胖组(P<0.05).(3)糖尿病肥胖组甘油三酯、胆固醇、体质指数、糖化血红蛋白、空腹血糖、胰岛素抵抗指数、血清空腹胰岛素、腰/臀比值均高于糖尿病非肥胖组,胰岛素敏感指数、脂联素低于糖尿病非肥胖组(P<0.05).结论 脂联素与2型糖尿病肥胖患者的胰岛素抵抗发生有关,脂联素降低易导致胰岛素抵抗,脂联素水平可作为2型糖尿病合并肥胖患者发生胰岛素抵抗的监测标准.     

血清脂肪因子与代谢综合征的关系

121例代谢综合征(MS)患者和120名对照者入选本研究以探讨血清脂肪因子与MS的关系.对照组、非腹型肥胖MS组及腹型肥胖MS组的血清抵抗素和脂肪细胞型脂肪酸结合蛋白(A-FABP)依次增高,而脂联素水平依次降低(均P<0.05).MS组抵抗素与体重指数(BMI)、腰围、收缩压、空腹血糖和A-FABP呈正相关(P<0.05或P<0.01);脂联素与高密度脂蛋白胆固醇呈正相关,而与BMI、腰围、空腹胰岛素、甘油三酯、稳态模型评估的胰岛素抵抗指数(HOMA-IR)呈负相关.     

单纯性肥胖青少年血清内脂素水平及其与年龄和高密度脂蛋白胆固醇的关系

目的 检测单纯性肥胖及正常青少年血清内脂素水平,探讨其与年龄、体重指数(BMI)、脂联素、瘦素、血脂、血糖及胰岛素水平的关系.方法 研究对象共148名,其中单纯性肥胖症青少年72例,正常对照76名.采用放射免疫分析法、酶法测定两组青少年的空腹血清内脂素、脂联素、瘦素、睾酮、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇(HDL-C)等.肥胖组青少年均做口服葡萄糖耐量试验(OGTF),计算胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)和早期胰岛素分泌指数(EISI).结果 肥胖组血清内脂素水平显著高于正常对照组[(37.65±18.28 vs 29.35±12.10) μg/L,P<0.01].正常对照组血清内脂素水平与人体测量指数及脂质参数之间无任何相关性,而肥胖组血清内脂素与年龄、EISI和Tanner分期呈负相关,与血清HDL-C水平呈正相关.并且在校正年龄、性别、体重指数后,内脂素水平与年龄及HDL-C水平仍然呈显著相关(g<0.05).结论 在中国青少年人群中,血清内脂素随年龄增长而下降,且可能参与体内HDL-C代谢的调控.     

痛风患者脂联素水平及胰岛素抵抗与动脉粥样硬化的关系

目的通过研究痛风患者颈动脉内膜-中膜厚度(IMT)与脂联素、胰岛素抵抗(IR)的关系,探讨脂联素、IR在痛风患者动脉粥样硬化中的作用。方法测定60例痛风患者、40例尿酸正常的健康志愿者(对照组)空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血尿酸(Ua)及脂联素(APN)水平,测量颈动脉内膜-中膜厚度(IMT),同时计算体重指数(BMI)、胰岛素抵抗指数(HOMA-IR);并以颈动脉IMT为应变量,FPG、FINS、血脂、BMI、HOMA-IR、Ua、脂联素为自变量,进行多元逐步回归分析。结果痛风组TC、LDL-C、FINS、Ua、HOMA-IR高于对照组(P0.05或P0.01),且颈动脉IMT高于对照组(P0.05),而脂联素水平则较对照组明显降低(P0.05)。多元逐步回归分析显示,脂联素、LDL-C和BMI是影响痛风患者动脉粥样硬化的独立危险因素。结论痛风患者较尿酸正常的人群存在明显的代谢紊乱和IR,且血清脂联素水平降低,更容易发生动脉粥样硬化。     

肥胖与代谢综合征血清中性粒细胞明胶酶相关脂笼蛋白2变化及其临床意义研究

目的探讨肥胖及代谢综合征患者血清中性粒细胞明胶酶相关脂笼蛋白2(LCN2)的变化及其临床意义。方法选择2006年6月至12月中南大学湘雅二医院内分泌科104例正常体重者,107例超重者和52例肥胖者,进行体格检查、口服葡萄糖耐量试验、血脂、胰岛素(FINS)、超敏C-反应蛋白(hsCRP)、LCN2检测。计算胰岛素抵抗指数(HOMA-IR)。结果肥胖患者血清LCN2增高,校正年龄和性别后,血清LCN2与BMI、腰围、体脂含量、hsCRP呈正相关(P0.05),与高密度脂蛋白(HDL-C)呈负相关(P=0.001)。校正年龄、性别和BMI后,血清LCN2仍与hsCRP呈正相关(P0.05),与HDL-C呈负相关(P=0.023);多元逐步回归分析显示,hsCRP和HDL-C是血清LCN2的独立决定因素。代谢综合征患者LCN2增高,但LCN2与代谢紊乱数目未见显著相关性。结论肥胖与代谢综合征患者血清LCN2和hsCRP均增高,且LCN2与hsCRP呈正相关。LCN2可作为肥胖及代谢综合征相关低度炎症新的标志物。     

非酒精性脂肪性肝病患者血清瘦素、脂联素的变化

目的:探讨非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)患者血清瘦素、脂联素的变化.方法:选取NAFLD患者60例,与健康组60例相对照.ELISA法测定血清瘦素、脂联素水平,并与体质量指数(BMI)、腰臀比(WHR)、甘油三脂(TG)、总胆固醇(Tchol)、高密度脂蛋白胆固醇(HDL-C)、血糖(FBG)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)相结合,从而判定瘦素、脂联素在NAFLD中的作用.结果:NAFLD组与正常对照组相比,血清瘦素水平升高(12.37±1.99μg/L vs 5.20±41.03 μg/L,P<0.01),脂联素水平降低(12.69±2.83 mg/Lvs 22.83±4.61 mg/L,P<0.01).Logistic多因素回归分析显示瘦素与WHR、HOMA-IR、FBG呈独立正相关(β=8.175,0.974,0.564,P<0.01).脂联素与HOMA-IR、BMI呈独立负相关(β=-0.495,-0.3 14,P<0.01).结论:NAFLD患者血清瘦素水平升高,脂联素水平降低,这两种细胞因子均与胰岛素抵抗相关.     

血清脂联素水平与2型糖尿病患者颈动脉内中膜厚度变化关系的研究

目的 探讨血清脂联素水平与2型糖尿病(T2DM)患者颈动脉内中膜厚度(IMT)变化之间的关系.方法 应用酶联免疫法测定140例IMT≤1 mm的T2DM患者及80例正常对照者的血清脂联素水平,糖尿病组在生活方式干预的基础上,给予抗血小板聚集、强化血糖、血压、血脂治疗,随访12个月后重新测定IMT,按IMT分为两组(DM1组IMT≤1 mm,DM2组IMT＞1 mm),分析血清脂联素水平与IMT变化之间的关系.结果 (1)T2DM组血清脂联素水平低于对照组(6±3 vs 13±7 mg/L, P＜0.01).(2)DM1组与DM2组相比较,腰臀比(0.90±0.07 vs 0.93±0.05,P=0.024)、HDL-C(1.28±0.36 vs 1.11±0.22 mmol/L, P=0.013)、血清脂联素水平(6.07±3.31 vs 4.06±2.71mg/L, P=0.003),差异均有统计学意义.(3)Logistic回归分析显示,血清脂联素含量降低、年龄增长、HDL-C降低是T2DM患者IMT增厚的危险因素.结论 低血清脂联素水平是T2DM患者动脉粥样硬化的独立危险因素.     

老年慢性阻塞性肺疾病患者血浆脂联素的水平

目的 分析老年慢性阻塞性肺疾病(COPD)患者血浆脂联素水平与C反应蛋白(CRP)、空腹血糖(FPG)、胰岛素抵抗(IR)及肥胖指标的关系.方法 选择住院的老年COPD患者60例,按病程分为急性加重期和临床稳定期,在不同时期测定血浆脂联素、CRP、FPG、胰岛素(FINS)、体重指数(BMI)、胰岛素抵抗指数(HOMA-IR).选择同期健康老年人50例作为对照.结果 COPD急性加重期及临床稳定期血浆脂联素均较对照组显著升高(P<0.01),临床稳定期血浆脂联素较急性加重期进一步升高(P<0.01);COPD急性加重期CRP、FPG、FINS、HOMA-IR显著高于临床稳定期及对照组(P<0.01);COPD临床稳定期FINS、HOMA-IR显著高于对照组(P<0.05);急性加重期脂联素与CRP、FPG、FINS、HOMA-IR、BMI均呈显著负相关(P<0.05或P<0.01).结论 老年COPD患者血浆脂联素水平升高并伴一定的胰岛素抵抗,脂联素在COPD稳定期进一步抬高,脂联素与CRP、FPG、IR及肥胖指标存在一定的相关性.     

老年人胰岛素抵抗与动脉粥样硬化的关系

目的:探讨胰岛素抵抗(IR)与动脉粥样硬化(AS)的关系。方法:在60岁以上的人群中筛查,体检,记录病史,进行口服75g葡萄糖耐量试验(75 g OGTT)。抽血检查血脂及胰岛素水平,B型超声检查双侧颈总动脉内中膜厚度(IMT)。采用稳态模型(HOMA Model)计算胰岛素抵抗指数(HOMA-IR),根据HOMA-IR值182例研究对象被分为4组,比较各组的危险因素及颈动脉粥样硬化指标。结果:随着HOMA-IR值升高,高血糖(糖耐量低减及糖尿病)、高血压(HPT)、动脉粥样硬化性血管疾病(ASVD)发病率增高(P<0．05～<0．001),甘油三酯 (TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、服糖后2 h血糖(2 h PG)、空腹胰岛素 (FINS)水平增高(P<0．05-<0．001),高密度脂蛋白胆固醇(HDL-C)水平降低(P<0．05),各项AS指标升高 (P<0．01-<0．001)。多元回归分析结果显示,TG、TC、HDL-C、LDL-C、Ln(HOMA-IR)与IMT独立相关 (P<0.05-<0．001),是IMT增高的危险因素。结论:胰岛素抵抗参与动脉粥样硬化的形成。     

2型糖尿病合并高尿酸血症患者动脉粥样硬化的影响因素

目的研究2型糖尿病合并高尿酸血症(HUADM)患者颈动脉内膜中层厚度(IMT)与脂联素、C反应蛋白(CRP)的关系。方法选择2型糖尿病患者85例,按血尿酸水平分为:HUADM组43例、血尿酸正常糖尿病(NUADM)组42例,分析2组空腹血糖(FPG)、空腹胰岛素(FINS)、脂联素、CRP、糖化血红蛋白(HbA1c)及餐后2h血糖、餐后2h胰岛素,IMT,计算胰岛素抵抗指数(HOMA-IR),并且进行多元逐步回归分析。结果与NUADM组比较,HUADM组患者FPG、餐后2h血糖、FINS、餐后2h胰岛素、HbA1c、IMT、尿酸和lgHOMA-IR均明显升高,脂联素明显降低(P0.05,P0.01)。HUADM组患者IMT与HOMA-IR、TG、LDL-C和CRP呈正相关,与脂联素呈负相关。结论 HUADM患者存在更明显的代谢紊乱和胰岛素抵抗,且血清脂联素水平降低,CRP水平升高,提示更容易发生动脉粥样硬化。     

肥胖儿童的动脉粥样硬化危险因素

目的通过比较肥胖和非肥胖儿童动脉粥样硬化的危险因素,探讨肥胖对儿童发生动脉粥样硬化的影响。方法对51例肥胖儿童和32例非肥胖儿童常规进行24h动态血压测定,检测胰岛素、高敏C反应蛋白、游离脂肪酸、甘油三酯、总胆固醇、空腹血糖、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平,采用B超检测颈动脉内膜中膜厚度、内皮依赖性血管舒张功能、最大的腹膜前脂肪厚度和最小的皮下脂肪厚度,酶联免疫吸附法检验血清抵抗素、脂联素,并计算稳态模型胰岛素抵抗指数。结果肥胖儿童组高敏C反应蛋白、胰岛素抵抗指数高于非肥胖儿童组(分别为1.57±0.06mg/L、4.567±2.621和1.38±0.05mg/L、1.70±0.712),空腹胰岛素、最小皮下脂肪厚度、最大腹膜前脂肪厚度、24h平均收缩压、甘油三酯、低密度脂蛋白胆固醇、游离脂肪酸也明显增高(P<0.05);肥胖组高密度脂蛋白胆固醇、脂联素低于非肥胖组(分别为0.27±0.22mmol/L、1.477±0.609mg/L和1.14±0.25mmol/L、2.795±1.124mg/L;P<0.05)。但两组颈动脉内膜中膜厚度、24h平均舒张压、内皮依赖性血管舒张功能无明显差异。体质指数与24h平均收缩压(r=0.43,P=0.006)、高敏C反应蛋白(r=0.461,P=0.018)、胰岛素抵抗指数(r=0.463,P=0.007)、游离脂肪酸(r=0.358,P=0.029)呈正相关,而与脂联素(r=-0.356,P=0.031)呈负相关。结论肥胖儿童导致动脉粥样硬化的危险因素水平明显增高,肥胖儿童已经存在动脉粥样硬化慢性炎症的早期改变,但是还未出现动脉内膜粥样斑块形态学上的改变。     

Determinants of early atherosclerosis in obese children and adolescents

CONTEXT: Obesity in childhood is associated with an increased mortality due to cardiovascular (CV) diseases in adulthood, independent of adult weight. Recent studies in children indicate that the atherosclerosis process starts at an early age and is linked to obesity. OBJECTIVE: The aim of the study was to investigate determinants of increased carotid intima-media thickness (IMT), an early marker of atherosclerosis, in obese children. DESIGN: A total of 104 obese children [age, 12.7 +/- 0.2 yr; body mass index (BMI)-z-score, 2.8 +/- 0.7] underwent an oral glucose tolerance test. Fasting levels of glucose, insulin, C-reactive protein and adhesion molecules (sICAM, sVCAM, sE-selectin), lipid profile, adiponectin, and resistin were determined. IMT was measured by ultrasound. Insulin resistance was estimated by the homeostatic model assessment index. Baseline measurements of blood parameters were obtained from 93 nonobese children (age, 13.0 +/- 0.2 yr; BMI-z-score, -0.2 +/- 0.9), and IMT was measured in 23 other control children with similar characteristics. RESULTS: Univariate analysis showed a significant positive correlation between IMT and relative BMI, the degree of systolic hypertension, fasting insulin levels, homeostatic model assessment-R index, and resistin concentrations, whereas an inverse correlation with adiponectin levels was found. No correlation was obtained between IMT and classical CV risk factors such as positive familial history of type 2 diabetes or precocious CV disease, visceral obesity, or the lipid profile. C-reactive protein and adhesion molecule levels were not associated with IMT in our obese population. When controlled for sex, Tanner stage, and relative BMI, only adiponectin levels remained an independent determinant of IMT. CONCLUSION: Adiponectin more than conventional CV risk factors and inflammation status may be related to early atherosclerosis in obese children.     

Adiponectin is independently associated with apolipoprotein B to A-1 ratio in Koreans

Apolipoprotein B to A-1 (apo B/A-1) ratio is reportedly a better predictor of atherosclerotic vascular disease than low-density lipoprotein cholesterol (LDL-C). The aim of this study was to assess the association of serum apo B/A-1 ratio with insulin resistance and adiponectin in patients with different grades of glucose intolerance. Patients were divided according to glucose tolerance into 3 groups: normal glucose tolerance without metabolic syndrome (n = 229), impaired fasting glucose (subjects with fasting plasma glucose level between 100 and 125 mg/dL, n = 658), and type 2 diabetes mellitus (n = 381). Serum concentrations of apo B, apo A-1, glucose, total cholesterol (TC), triglycerides, and high-density lipoprotein cholesterol (HDL-C) and adiponectin were measured. Insulin resistance was estimated by the homeostasis model assessment of insulin resistance index (HOMA-IR). There were significant differences in metabolic parameters among the groups, including waist circumference, insulin, HOMA-IR, and apo B/A-1 ratio, which increased sequentially with glucose intolerance, whereas adiponectin level decreased with increasing severity of glucose intolerance. The apo B/A-1 ratio was significantly correlated with TC, triglycerides, LDL-C, HDL-C, adiponectin, and HOMA-IR in normal glucose tolerance, impaired fasting glucose, and type 2 diabetes mellitus. Multiple regression analysis showed that apo B/A-1 ratio was significantly associated with TC, LDL-C, HDL-C, and adiponectin. In conclusion, apo B/A-1 ratio was significantly associated with insulin resistance according to glucose intolerance; and serum adiponectin was an important independent factor associated with apo B/A-1 ratio in Koreans.     

The effects of exercise on C-reactive protein, insulin, leptin and some cardiometabolic risk factors in Egyptian children with or without metabolic syndrome

ABSTRACT: BACKGROUND: The prevalence and magnitude of obesity in the children and the adolescents have increased dramatically in the developing countries over the last 20-30 years. The prevalence of metabolic syndrome (MS) in children is increasing. Aim: This study aimed to investigate the changes of C-reactive protein (CRP), leptin, insulin, and blood lipids before and after the exercise therapy in normal and obese children (with or without metabolic syndrome). METHODS: The study covered 49 normal children (control), 32 obese children without metabolic syndrome and 12 obese children with metabolic syndrome. We examined the influence of exercise (3 times/week) for 12 weeks on the levels of serum CRP, leptin, insulin, homeostatic model assessment insulin resistance (HOMA-IR), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDLC) in all groups. RESULTS: There were significant correlations between HOMA-IR and the individual components of the metabolic syndrome. After 12 weeks of exercise, both of the obese children groups, with and without metabolic syndrome, showed reduced body weight, body mass index (BMI), and CRP level, and increased HDL-C level. The percentage of metabolic syndrome decreased from 12.9 % before the exercise training to 7.5 % after training. Also, there was a significant reduction in BMI (from 47.3 to 32.6 %), in systolic blood pressure (from 18.3 to 15.1 %) and in HDL-C level (from 18.3 to 9.7 %). CONCLUSION: Overweight children have multiple risk factors associated with the metabolic syndrome. 12- week exercise may have a positive effect on reducing risk factors for the metabolic syndrome.     

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.     

Adiponectin inversely correlates with high sensitive C-reactive protein and triglycerides, but not with insulin sensitivity, in apparently healthy Japanese men

Adiponectin, an antiatherogenic peptide, has diverse biological actions on insulin sensitivity, inflammation and lipid metabolism. To explore physiological and pathophysiological significance of adiponectin in the Japanese general population, we systematically analyzed the relationship between adiponectin and high sensitive CRP (hsCRP), lipids, insulin sensitivity, and anthropometric parameters in 166 consecutive adult male health examinees. By univariate analysis, serum adiponectin was positively correlated with age and HDL-cholesterol, and inversely correlated with fasting plasma glucose, fasting insulin, homeostasis model assessment insulin-resistance, waist, body mass index, triglycerides and hsCRP. However, multivariate analysis revealed that adiponectin independently correlated with triglycerides (r = -0.243, P = 0.0033) and hsCRP (r = -0.262, P = 0.0015) but not with all other variables. Adiponectin was lower and hsCRP higher in the subjects with metabolic syndrome (n = 22) than in those without it (n = 144) (adiponectin, 5.4 +/- 2.8 vs 7.5 +/- 4.2 microg/ml, p = 0.002; hsCRP, 832 +/- 605 vs 470 +/- 524 ng/ml, p = 0.0004). Current findings suggest that relative importance of hypertriglyceridemia and enhanced inflammation, rather than insulin resistance, as the downstream events of hypoadiponectinemia leading to atherosclerosis in the Japanese general population.     

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