中老年冠心病患者血清瘦素与脂联素水平的关系

目的 探讨中老年冠心病患者血清瘦素和脂联素的表达及相关性.方法 选取88例年龄≥55岁行冠状动脉造影的患者,根据造影结果分为冠心病组52例和对照组36例,采用酶联免疫吸附试验法测定血清瘦素和脂联素水平.结果 冠心病组患者血清瘦素水平高于对照组[(9.38±3.51) μg/L比(7.27±3.25) μg/L,P＜0.05],脂联素水平低于对照组[(11.08±3.87) mg/L比(13.34±4.94) mg/L,P＜0.05],Logistic多元回归分析显示仅有血清瘦素水平是中老年冠心病的独立危险因素.Spearman相关分析显示,血清脂联素与瘦素水平呈负相关(r=-0.320,P=0.002).结论 中老年冠心病患者血清脂联素水平的降低与瘦素水平的升高相关,血清瘦素水平的升高是冠心病的独立危险因素,而血清脂联素水平降低并不是冠心病的独立危险因素.     

中老年人心脑血管危险因素相关物质浓度及与高密度脂蛋白胆固醇的关系

目的 研究中老年人心脑血管危险因素相关物质:血清瘦素、脂联素、白细胞介素-6(IL-6)及纤溶酶原激活物抑制物-1(PAI-1)与高密度脂蛋白胆固醇(HDL-C)的关系,探讨其在传统心脑血管危险因索中的作用.方法 在广州市生物库第3期注册登记的10027名中老年人中随机抽取1 996名中老年人进行问卷调查和健康体检.以酶联免疫吸附双抗夹心法(ELISA)测定瘦素、脂联素、IL-6、PAI-1,以直接法测定血清脂类.其中共1 520名受检者参与血瘦素、脂联素和PAI-1的测定,1 293名参与IL-6的测定.结果 广州市中老年人脂联素随年龄增加而升高,差异有统计学意义(男:P=0.044,女:P＜0.01),随着年龄的增加,瘦素水平在男性中升高(P=0.036).校正年龄和性别因素后,瘦素、脂联素、IL-6、PAI-1和HDL-C之间均呈明显的相关(P＜0.01).结论 瘦素、脂联素、IL-6、PAI-1与HDL-C密切相关.     

急性脑梗死患者血清脂联素、瘦素水平与运动功能恢复的相关性研究

目的 探讨急性脑梗死患者血清脂联素、瘦素水平对运动功能恢复的影响.方法 选取45例急性脑梗死患者作为研究组,选取30例健康体检者作为对照组.出院时采用Fugl-Meyer评分评定急性脑梗死患者的运动功能恢复情况.采用酶联免疫吸附试验法测定受试者血清脂联素、瘦素水平,分析研究组患者血清脂联素、瘦素水平与出院时运动功能恢复程度的相关性.结果 对照组血清脂联素水平为(13.78±4.25) mg/L,明显高于研究组的(6.35±3.18) mg/L,对照组血清瘦素水平为(6.48±1.26) μg/L,明显低于研究组的(20.35±2.59) μg/L,差异有统计学意义(P＜0.05).研究组不同Fugl-Meyer评分患者的血清脂联素、瘦素水平比较差异有统计学意义(P＜0.05).血清脂联素水平与Fugl-Meyer评分呈正相关(r=0.528,P＜ 0.05),血清瘦素水平与Fugl-Meyer评分呈负相关(r=-0.564,P＜ 0.05).血清脂联素水平与血清瘦素水平呈负相关(r=-0.427,P＜0.05).结论 脂联素、瘦素参与了急性脑梗死的发生、发展,且两者水平与患者运动功能恢复程度密切相关.     

2型糖尿病患者血清内脂素、脂联素和瘦素水平的变化

目的研究2型糖尿病(T2DM)患者血清中内脂素、脂联素和瘦素水平,为阐明T2DM的发病机制提供基础。方法将220例新诊T2DM患者和214例年龄、性别与体重指数(BMI)相匹配的健康对照组,按BMI≥25kg/m2或25kg/m2分为肥胖亚组和非肥胖亚组,采用酶联免疫吸附法(ELISA)和放射免疫法(RIA)检测其血清内脂素、脂联素和瘦素水平,并同时采用生化和化学发光法检测空腹血糖(FPG)、甘油三酯(TG)、胆固醇(Chol)以及空腹胰岛素(FINS)等。结果1.T2DM组血清内脂素、FPG、FINS、胰岛素抵抗指数(HOMA-IR)、TG、Chol水平均高于健康对照组(P0.05～0.001),而脂联素水平低于健康对照组(P0.001),瘦素在两组人群中差异无统计学意义(P0.05);2.无论是T2DM组还是健康对照组中,其肥胖亚组中的内脂素、瘦素、FINS、HOMA-IR、TG、Chol水平均高于非肥胖亚组(P0.05～0.001),而脂联素低于非肥胖亚组(P0.01～0.001);3.消除BMI因素影响的偏相关分析显示,T2DM患者血清内脂素水平仅与FPG、FINS、HOMA-IR呈正相关(r=0.267～0.443,P0.05～0.01),与脂联素呈负相关(r=-0.312,P0.05)。结论内脂素和脂联素参与了肥胖、胰岛素抵抗以及T2DM发生过程,而瘦素可能仅与肥胖状况有关,未能以独立因子作用直接参与T2DM的发生。     

2型糖尿病男性患者睾酮与脂联素、瘦素水平的相关性

目的 探讨2型糖尿病男性患者睾酮水平情况及其与脂联素、瘦素水平的相关性.方法 选取2型糖尿病男性患者60例(2型糖尿病组),另选取同期非糖尿病男性患者40例作为对照组.检测受试者的睾酮、脂联素、瘦素水平,对比两组睾酮水平的差异,同时分析睾酮水平和脂联素及瘦素水平的关系.结果 2型糖尿病组睾酮、脂联素及瘦素水平分别为(11.0±4.1) nmol/L、(6.3±1.2) mg/L及(7.2±2.1) μg/L,对照组分别为(12.9±4.6)nmol/L、(7.7±1.3) mg/L及(6.5±2.3) μg/L,2型糖尿病组睾酮及脂联素水平显著低于对照组,瘦素水平显著高于对照组,差异均有统计学意义(P＜0.05).2型糖尿病患者睾酮水平和脂联素、瘦素水平呈负相关(r=-0.38、-0.46,P＜0.05).结论 2型糖尿病男性患者睾酮水平较非糖尿病男性降低.睾酮水平与脂联素及瘦素水平呈负相关.     

2型糖尿病肾病患者血清瘦素和脂联素检测的研究

目的研究2型糖尿病肾病患者(DN)血清瘦素和脂联素水平,为进一步阐明DN的病理过程提供依据。方法选择87例2型糖尿病(DM)患者以及30例健康对照,根据尿白蛋白排泄量将糖尿病患者分为3组:<30mg/d的单纯DM组(32例),30～300mg/d的早期DN组(28例),>300mg/d的临床DN组(26例)。采用放射免疫法检测各组血清瘦素和脂联素水平,并比较各组差异。结果1)4组之间在平均年龄、性别比例、体重指数(BMI)等方面差异无显著性(P>0.05)。2)临床DN组患者血清瘦素和脂联素水平最高,分别为(15.29±4.03)μg/L和(11.32±2.13)mg/L,显著高于单纯DM、早期DN以及健康对照组(单纯DM组:(7.12±3.01)μg/L和(5.81±1.03)mg/L;早期DN组:(11.23±3.31)μg/L和(6.31±1.99)mg/L;健康对照组:(6.12±2.31)μg/L和(4.25±1.62)mg/L,P均<0.001);且早期DN组血清瘦素和脂联素水平显著高于单纯DM和健康对照组(P<0.05～0.001)。3)DN组血清瘦素和脂联素与尿蛋白排泄量呈显著正相关(r=0.515和r=0.453,P<0.05)。结论2型糖尿病肾病患者血清瘦素和脂联素水平升高,并与病程相关。     

肺结核患者血清TNF-α、瘦素、脂联素检测的研究

目的研究肺结核患者血清中肿瘤坏死因子(TNF-α)、瘦素、脂联素水平,为进一步阐明肺结核病的病理过程提供依据。方法按照年龄、性别、体重指数相匹配的原则,选择53例活动性结核患者,49例静止期患者以及50例健康对照进行分组,检测其空腹静脉血清的TNF-α、瘦素、脂联素水平,并进行比较与分析。结果三组之间在平均年龄、性别比例、体重指数(BMI)等方面差异无显著性(P>0.05);活动性肺结核组和静止期组血清中TNF-α水平均高于健康对照组(27.9±5.2ng/L和18.2±5.7ng/Lvs11.7±3.2ng/L,P分别<0.001和<0.01),且活动性肺结核组高于静止期组(P<0.01)。活动性肺结核组和静止期组血清中脂联素水平均低于健康对照组(3.27±1.52mg/L和6.12±1.93mg/Lvs9.93±2.25mg/L,P分别<0.001和<0.01),且活动性肺结核组低于静止期组(P<0.01)。三组间血清瘦素水平差异无显著性(P>0.05);在静止期组和活动性肺结核组中,血清脂联素水平与TNF-α均呈负相关(r分别为-0.602和-0.698,P均<0.001),与体重指数也均呈负相关(r分别为-0.642和-0.671,P均<0.001)。血清瘦素水平与体重指数呈正相关,但与TNF-α以及脂联素水平无相关性(P>0.05)。结论TNF-α和脂联素参与了肺结核病的免疫炎症应答反应,并与疾病的进程相关。而瘦素并非肺结核免疫反应的产物,与疾病的进程无关,体重指数是影响瘦素分泌的重要因素。     

儿童血清ghrelin水平与血脂、瘦素、脂联素及胰岛素关系的分析

目的探讨儿童血清ghrelin水平与血脂、瘦素、脂联素及胰岛素的关系。方法采用多阶段随机抽样的方法,随机抽取879名8～10岁小学生作为调查对象。测量身高、体重、腰围,计算体质指数(BMI)、体脂百分比(%BF),测定血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖、ghrelin、脂联素、胰岛素及瘦素。结果随血清ghrelin水平的升高,体重、腰围、BMI、%BF、血清瘦素水平逐渐降低(P<0.0001),血清HDL-C水平呈现逐渐增高的趋势(P<0.0001),血清TC、胰岛素和脂联素水平变化趋势不明显;与ghrelin密切相关的指标为体成分指标,包括身高、体重、腰围、BMI、%BF以及瘦素,其次是血脂代谢指标,包括TG、HDL-C、TC、LDL-C,第三是血糖代谢指标,包括空腹血糖和胰岛素。结论ghrelin与体成分指标、瘦素、脂联素、胰岛素以及血脂有不同程度的关联,但和身高、体重、腰围、BMI、%BF以及瘦素的相关最为密切。     

代谢紊乱患者血清脂联素水平与冠状动脉病变程度的关系

目的 探讨代谢紊乱患者血清脂联素水平及其与冠状动脉病变程度的关系.方法 100例患者分为代谢综合征组和对照组,分别行冠状动脉造影检查及血清脂联素水平的检测,对比各组血清脂联素水平和冠状动脉病变程度的差异.结果 (1)代谢综合征组空腹血糖(FPG)、三酰甘油(TG)、稳态模型评估法计算的胰岛素抵抗指数(HOMA-IRI)、体重指数、腰围、收缩压、舒张压和Gensini评分均高于对照组,血清脂联素和高密度脂蛋白-胆固醇(HDL-C)水平低于对照组(P＜0.01).(2)随着代谢紊乱数目的 增加,血清脂联素水平逐渐下降,Gensini评分逐渐升高(P＜0.05或＜0.01).1项及以下代谢紊乱者与2项及以上代谢紊乱者之间的冠心病患者比例比较,差异有统计学意义(P＜0.01).(3)脂联素与HDL-C呈正相关,与Gensini评分、TG及代谢紊乱数目呈负相关.结论 代谢紊乱患者随着代谢紊乱数目的 增加,血清脂联素水平降低,冠状动脉粥样硬化程度加重.     

浙江省中年居民体质指数、腰围身高比及膳食脂肪对血清瘦素水平的影响

目的分析浙江省中年居民体质指数(BMI)、腰围身高比(WHtR)及膳食脂肪摄入情况与血清瘦素水平的相关性。方法采用分层随机抽样法,于2014年12月从浙江省抽取4个区县513名30~65岁调查对象,采用3天24小时膳食回顾法进行膳食调查,同时测量其身高、体重、腰围及血清瘦素浓度,分析体格指标及膳食脂肪与瘦素的关系。结果女性血清瘦素水平高于男性(P0.001)。BMI、WHtR与瘦素水平均呈正相关,相关系数男性和女性分别为0.488、0.576和0.453、0.333(P0.0001)。调整WHtR后女性BMI与瘦素水平仍有相关性(r=0.321,P0.0001),调整BMI后男性WHtR与瘦素水平仍有相关性(r=0.354,P0.0001),其余指标相关性消失。偏最小二乘回归结果显示男性WHtR(β=0.27)标准化偏回归系数高于BMI(β=0.21),而女性则为BMI(β=0.26)高于WHtR(β=0.20)。男性总能量、总脂肪、单不饱和脂肪酸(MUFA)与瘦素水平呈负相关(P0.05),而女性多不饱和脂肪酸(PUFA)供能比及(PUFA+MUFA):SFA与瘦素水平呈正相关(P0.05)。对男性调整WHtR、对女性调整BMI,可见男性总脂肪、MUFA仍与瘦素呈负相关(P0.05);女性PUFA供能比与瘦素呈正相关(P0.05),其余指标相关性消失。结论肥胖程度与瘦素水平呈正相关关系,在评价肥胖与瘦素水平关系时,男性WHtR与瘦素水平相关性更强,女性BMI与瘦素水平相关性更强;男性总脂肪摄入量、MUFA与瘦素水平呈负相关,女性PUFA供能比与瘦素水平呈正相关。     

Relationship between adipokines and lipid profile in postmenopausal women with different apolipoprotein E genotypes

The aim of the authors of this study was to clarify the relationships among apolipoprotein E (ApoE) genotype, blood pressure, lipid profile, serum leptin, and adiponectin in healthy postmenopausal women. The study was conducted between March 2011 and December 2012 on 266 participants aged 50–65 years from the Institute of Rural Health in Lublin, Poland. Results showed that women had four combinations of genotypes: ?2/?3, ?3/?3, ?3/?4, and ?4/?4. Carriers of different genotypes did not differ in terms of age, body mass index (BMI), blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, and adiponectin levels. Mean low-density lipoprotein (LDL) cholesterol levels were higher in ε4 carriers compared to non-carriers. Fasting serum leptin concentrations were higher in homozygotes ?4/?4. Leptin correlated positively with BMI in all study groups and with LDL in ?2/?3, ?3/?3, and ?3/?4. Adiponectin correlated negatively with triglycerides in ?2/?3, ?3/?3, and ?3/?4 and positively with HDL in ?2/?3 carriers. Adipokines were not associated with blood pressure. Multiple regression analyses demonstrated associations among leptin, ApoE ?4/?4, BMI, and LDL, and among adiponectin, BMI, and triglycerides. In healthy postmenopausal women ?4/?4 genotype was associated with lower leptin levels. Homozygosity ?4/?4 was associated with a more atherogenic lipid profile and possibly dysregulation of leptin and adiponectin signaling in lipid metabolism.     

血清趋化素、瘦素、脂联素浓度与学龄前单纯性肥胖儿童糖脂代谢的关系

目的 研究血清趋化素、瘦素、脂联素水平与3~6岁学龄前期儿童单纯性肥胖及代谢的关系,为学龄前单纯性肥胖儿童临床监测及治疗效果提供依据。方法 选取2019年1月—2020年5月于大连市妇幼保健院儿童保健门诊体检的3~6岁儿童为研究对象,获取单纯性肥胖儿童41例作为研究组,另获取同年龄、同时期儿童43例作为对照组。测量其身高和体重,并计算身高别体重;测定血清趋化素、瘦素、脂联素、空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c),同时计算胰岛素抵抗指数。结果 单纯性肥胖组的FINS、胰岛素抵抗指数(HOMA-IR),LDL-c,血清趋化素,瘦素明显高于对照组,差异有统计学意义(t=3.288、2.927、4.939、3.078、5.456,P＜0.05),HDL-c,脂联素明显低于对照组,差异有统计学意义(t=-5.179、-3.145,P＜0.05)。而两组FPG、TG、TC差异无统计学意义(t=0.391、0.768、-0.266,P＞0.05); 趋化素与身高别体重、FINS、HOMA-IR、 LDL-c、瘦素呈正相关(r=0.339、0.416、0.227、0.376、0.266,P＜0.05),与HDL-c、脂联素呈负相关(r=-0.410、-0.309,P＜0.05)。瘦素与身高别体重、FINS、HOMA-IR、 LDL-c、趋化素呈正相关(r=0.492、0.375、0.279、0.269、0.266,P＜0.05),与HDL-c、脂联素呈负相关(r=-0.467、-0.326,P＜0.05)。脂联素与身高别体重、FINS、HOMA-IR,LDL-c、趋化素、瘦素呈负相关(r=-0.296、-0.351、-0.278、-0.229、-0.309、-0.326,P＜0.05),与HDL-c呈正相关(r=0.234,P=0.032)。结论 血清趋化素、瘦素、脂联素水平与学龄前单纯性肥胖儿童糖脂代谢密切相关,这些指标对于识别、监测、干预学龄前单纯性肥胖儿童有着重要意义。     

中年人群血清瘦素水平与代谢综合征及其组分的关系

目的 探讨中年人群血清瘦素水平与代谢综合征（MS）及其组分的关系。方法 对345例“宫内发育与成人疾病”研究队列人群（男184例、女161例,年龄46～53岁）的身高、体重、血压、血脂、血糖、胰岛素及血清瘦素进行测定,采用稳态模式评估法计算胰岛素抵抗指数。根据2005年国际糖尿病联盟（IDF）关于MS的定义进行诊断。结果 该群体中心性肥胖、高甘油三酯、低的高密度脂蛋白胆固醇（HDL．C）、高血糖、高血压及MS检出率分别为53．0％、47．5％、34．2％、26．7％、33．9％和31．9％;女性血清瘦素水平几何均数为男性的2．9倍,随着血清瘦素浓度的升高,该人群的MS及组分异常检出率明显上升,除男性组HDL-C指标外,不同血清瘦素水平与MS及组分比较均有显著统计学意义（P〈0．05）,且随着代谢异常组分个数的增多血清瘦素水平呈上升趋势,呈显著正相关（P〈0．001）。结论 该人群的血清瘦素水平与MS及组分密切相关,提示高瘦素血症可能是MS的一个新成分,可作为筛查MS及相关疾病的一个指标。     

Physical activity is associated with risk factors for chronic disease across adult women's life cycle

OBJECTIVE: The purpose of this study was to examine the association of age (young, midlife, and older) and activity level (active and sedentary), determined by a pedometer, with risk factors of chronic disease, including body composition, dietary intake, serum lipids, insulin, leptin, C-reactive protein (CRP), plasma glucose, and resting metabolic rate (RMR) in women across the adult life cycle. METHODS: Young (aged 20 to 30 years) (n=49), midlife (aged 40 to 50 years) (n=62), and older (aged 60 years and older) (n=47) women were recruited for this cross-sectional study. For 7 days, participants completed weighed food records and wore a pedometer. Based on the average number of steps per day, the women were further classified as active (>/=7,500 steps per day) or sedentary (<7,500 steps per day). Height, weight, and waist circumference were determined for each participant. Fasting blood samples were taken to assess serum lipid, CRP, insulin, leptin, thyroid stimulating hormone, and plasma glucose levels. RMR and body composition (via dual-energy x-ray absorptiometry) were assessed. RESULTS: Young and midlife women had lower concentrations compared to older women for serum cholesterol (P<0.01), low-density lipoprotein cholesterol (P<0.01), triglycerides (P<0.01), leptin (P<0.01), and plasma glucose (P<0.01); midlife women had lower serum insulin concentrations vs young and older groups (P=0.01); young women had smaller waist circumference compared to midlife and older groups (P<0.01); percent body fat (P<0.01) and percent fat-free mass (P<0.01) differed between all ages. Lower values were found in active vs sedentary women for serum insulin (P=0.02), serum leptin (P<0.01), waist circumference (P<0.01) and percent body fat (P<0.01). A higher percent fat-free mass (P<0.01) was also found in active compared to sedentary women. No differences were found between activity groups for serum cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, CRP, plasma glucose levels, or RMR. RMR was higher in young and midlife vs the older women (P<0.01). Significant inverse correlations were found between activity (steps per day) and body mass index, insulin level, CRP concentration, leptin level, waist circumference, and body fat. Significant positive correlations were found between age and body mass index, total serum cholesterol level, low-density lipoprotein cholesterol level, serum triglyceride level, leptin level, plasma glucose level, CRP concentration, waist circumference, and body fat. Young and midlife women reported consuming more relative energy (kilocalories per kilogram body weight) and protein (grams per kilogram body weight) than older women (P<0.01). The midlife women reported consuming more dietary cholesterol compared to the young and older women (P<0.01). Active women reported a higher relative energy (kilocalories per kilogram body weight) and protein (grams per kilogram body weight) intake vs the sedentary women (P<0.01). Active women also reported a higher intake of dietary carbohydrates (grams per day, P<0.01; percent of energy, P=0.04). CONCLUSIONS: Overall, these results indicate that younger age and greater physical activity, despite age, are associated with fewer risk factors for chronic disease, such as cardiovascular disease, type 2 diabetes, and obesity.     

The associations between serum leptin, adiponectin and intercellular adhesion molecule-1 in hypercholesterolemic patients

We examined the associations between adiponectin or leptin and serum ICAM-1 levels in seventy-six hypercholesterolemic patients (mean age 59 yrs, 25 males and 51 females, LDL-cholesterol>=130mg/dL at screening). Blood lipid profiles and HOMA-IR derived from fasting glucose and insulin concentrations were determined. Serum levels of adiponectin, leptin and ICAM-1 were analyzed using ELISA. The results showed that serum levels of leptin were positively associated with serum levels of ICAM-1 independent of age, sex and BMI (r =0.392, p<0.001). Serum levels of adiponectin were negatively associated with serum levels of ICAM-1 independent of age, sex and BMI (r =-0.343, p<0.005). Stepwise multiple linear regression analysis showed that serum leptin was an independent factor to be associated with serum ICAM-1 levels after adjusting for age, sex, BMI, alcohol intake, smoking status, blood lipids such as total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol and HOMA-IR (p<0.001). With respect to adiponectin, its association with serum ICAM-1 was attenuated but still significant when further adjustments were made for age, sex, BMI, alcohol intake, smoking status, blood lipids such as total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol and HOMA-IR (p<0.005). In conclusion, this study suggests that adiponectin and leptin are associated with endothelial derived inflammation.     

2型糖尿病患者血清维生素D水平及相关研究

目的 了解2型糖尿病患者血清维生素D水平的变化,并探讨其在2型糖尿病患者代谢紊乱中的作用及与其他代谢指标的关系.方法 按WHO 1999年关于糖尿病诊断标准筛选初发2型糖尿病患者70例,并按2002年国际肥胖特别工作组亚洲成年人标准,根据体质指数(BMI)分为2型糖尿病A组(BMI≥25.00 kg/m2) 32例和2型糖尿病B组(BMI＜ 25.00 kg/m2)38例,另筛选健康人33例作为对照组,检测人体参数和测量生化指标,用酶联免疫吸附试验法测定血清25羟基维生素D3 [25 (OH)D3]水平,对三组进行比较.结果 2型糖尿病A组血清25 (OH)D3水平为(20.59±4.82)μg/L,2型糖尿病B组为(27.07±5.73) μg/L,对照组为(32.27±8.49)μg/L,三组之间比较差异有统计学意义(P＜0.05).2型糖尿病患者血压正常者43例,血清25(OH)D3水平(25.51±6.12)μg/L,高血压者27例,血清25 (OH)D3水平(21.87±5.78)μg/L,两者比较差异有统计学意义(P＜0.05);2型糖尿病患者血脂正常者8例,血清25(OH)D3水平(28.42±5.20)μg/I,血脂异常者62例,血清25 (OH)D3水平(23.55±6.15)μg/L,两者比较差异有统计学意义(P＜0.05).25(OH)D3与体重、腰围、BMI、收缩压、舒张压、空腹血糖、空腹胰岛素、胰岛素抵抗指数、总胆固醇、三酰甘油、低密度脂蛋白胆固醇呈负相关(P＜0.01或＜0.05),与甲状旁腺素、钙、磷、高密度脂蛋白胆固醇、年龄无明显相关性(P＞0.05).结论 2型糖尿病患者血清维生素D水平降低,尤其是伴有肥胖、高血压、血脂异常者血清维生素D水平降低更明显.     

宁夏农村居民血清脂联素和hs-CRP水平与高血压前期关系研究

目的 分析高血压前期人群中血清脂联素和超敏C-反应蛋白（hypersensitive C-reactive protein,hs-CRP）水平与心血管危险因素的关系,探讨血清脂联素和hs-CRP对高血压前期的影响。方法 在宁夏地区2008-2012年开展的横断面研究的基础上,将血压值按诊断标准分为正常组、高血压前期组和高血压组,收集人体测量数据和采集血液进行血清脂联素和hs-CRP水平的测定。结果 血清脂联素水平随着血压的升高呈递减趋势（Z=41.798,P<0.001）,hs-CRP呈递增趋势（Z=31.213,P<0.001）。偏相关分析显示在调整年龄、性别、民族、文化程度、吸烟、饮酒和体育锻炼后,高血压前期人群中血清脂联素分别与体质指数（body mass index,BMI）、腰围、腰臀比、空腹血糖、胰岛素抵抗指数、舒张压、总胆固醇和甘油三酯呈负相关,与高密度脂蛋白胆固醇呈正相关（均有P<0.05）;血清hs-CRP分别与BMI、腰围、腰臀比、空腹血糖、收缩压和甘油三酯呈正相关（均有P<0.05）。Logistics回归分析显示,血清脂联素水平高是高血压前期的保护因素（OR=0.462,95%CI:0.263~0.811,P=0.007）,血清hs-CRP与高血压前期的发生并无统计学关联（均有P>0.05）。结论 高血压前期已出现血清脂联素和hs-CRP水平的变化,并且与心血管危险因素间相互影响,同时血清脂联素是高血压前期的保护因素。     

Association of adiponectin with coronary heart disease and mortality: the Rancho Bernardo study

Hypoadiponectinemia has been implicated in the development of obesity-related conditions, including dyslipidemia and coronary heart disease (CHD). In this study, the authors examined the association of adiponectin with CHD prevalence, incidence, and mortality among 1,513 community-dwelling men and women aged 50-91 years who were followed from 1984-1987 through 2004. In cross-sectional analyses, adiponectin concentrations were positively related to female sex, age, and high density lipoprotein cholesterol level and inversely related to waist girth, triglyceride level, and fasting plasma glucose level (all p's < 0.001). Adiponectin levels in the highest sex-specific quintile, as compared with the lowest, were associated with 44% decreased odds of prevalent CHD (p for trend = 0.03); adjustment for high density lipoprotein cholesterol and/or triglycerides eliminated this association. In 20-year prospective analyses, higher adiponectin concentrations predicted reduced risk of nonfatal myocardial infarction in men only; adiponectin was not associated with fatal incident CHD events or 20-year CHD mortality (n = 215 deaths) in either sex. Adiponectin levels in the highest sex-specific quintile, as compared with lower levels, were associated with almost 40% increased risks of cardiovascular disease death (n = 441) and death from all causes (n = 925), independent of age, sex, waist girth, lipid levels, and glucose level (both p's < 0.001). These results suggest that use of adiponectin for cardiovascular disease risk stratification is premature.     

Increases in serum lipid and lipoprotein levels with movement from the supine to standing position in adult men and women

The effect of movement from the supine to the standing position on the magnitude of change in serum lipid and lipoprotein levels and its impact on the prediction of risk for coronary heart disease was investigated in 23 male and 18 female subjects. The mean age and body weight of the men was 34 years and 93 kg, respectively, while those of women were 36 years and 71 kg. Thirty minutes of standing following thirty minutes in the supine position was associated with hemoconcentration and a significant (P less than 0.05) plasma volume reduction of -13.8% for men and women combined. Posture-related increases in serum lipids and lipoproteins were similar among both men and women and averaged +12% for triglycerides, +9.3% for total cholesterol, +9.0% for low-density lipoprotein + very low-density lipoprotein cholesterol, and +10.4% for high-density lipoprotein cholesterol. Among men, the latter increased from 41.4 to 45.6 mg X dl-1 while among women, the increase was from 58.0 to 64.3 mg X dl-1. The total cholesterol/high-density lipoprotein cholesterol ratio was unaffected by the change in body position, thus strengthening the reliability of this ratio as a coronary heart disease risk measure. Our findings indicate that body position at time of blood withdrawal significantly influences lipid and lipoprotein levels, and, depending on the absolute concentration values of total or high-density lipoprotein cholesterol, can alter the predictive risk for coronary heart disease. Heart disease. Heart disease risk based on the Framingham probability tables and the multiplier for high-density lipoprotein cholesterol is unaffected by the change in body position.     

健康体检人群高尿酸血症的临床特征及血尿酸与代谢综合征的关系

目的 探讨成年人高尿酸血症(HUA)的临床特征及血尿酸(SUA)水平与代谢综合征(MS)的关系.方法 对≥20岁健康体检者共18 862例的资料进行统计分析.结果 HUA检出率为14.8％(2788/18 862),其中男性为18.4％( 1926/10 445),女性为10.2％( 862/8417);HUA患病率随着年龄的增长而升高,不同年龄段之间比较差异有统计学意义(P=0.000);各年龄段检出率男性均高于女性(P＜0.01或＜0.05).与正常SUA患者相比,HUA患者的体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均明显增高(P＜0.01或＜0.05),高密度脂蛋白胆固醇(HDL-C)水平则明显降低(P＜0.05).多元逐步回归分析显示:BMI、SBP、DBP、空腹血糖(FPG)、TG、HDLC均是SUA的独立相关因素.HUA患者中高血压、超重/肥胖、血脂紊乱、高血糖及MS的检出率分别为24.1％ (672/2788)、36.2％ (1009/2788)、31.2％(870/2788)、18.0％(502/2788)、20.8％( 580/2788),均显著高于正常SUA患者的18.2％(2925/16 074)、26.4％(4244/16 074)、22.0％(3536/16 074)、15.0％(2411/16 074)、17.0％(2733/16 074)(P＜ 0.01 );SUA在MS患者为(342.3±64.2)μmol/L,明显高于非MS患者的(319.3±67.1)μmol/L,差异有统计学意义(P=0.000).结论 HUA患病率随着年龄的增长而升高,多种代谢异常在HUA患者中呈现聚集倾向,SUA与MS密切相关.