新疆和田地区维吾尔族瘦素、脂联素及其比值与代谢综合征的关系

目的 研究新疆和田地区维吾尔族居民瘦素(LEP)、脂联素(ADP)及瘦素/脂联素比值(L/A)与代谢综合征(MS)的关系,并探讨其对MS的诊断价值.方法 从新疆和田地区开展的膳食营养与肥胖现况调查资料中随机抽取180例,其中MS患者47例(MS组),非MS者133例(非MS组).调查内容包括一般情况调查、体格测量及生化...     

腹部内脏脂肪沉积的老年非代谢综合征患者脂联素瘦素比值的变化

目的 观察体质指数正常、腹部内脏脂肪沉积的非代谢综合征老年男性患者血清脂联素、瘦素水平及脂联素瘦素比值的变化.方法 将入选的老年非代谢综合征男性患者109例分为2组,内脏无脂肪沉积组67例,内脏脂肪沉积组42例.采用CT方法测定内脏脂肪面积,当腹部内脏脂肪面积≥100cm2,为内脏脂肪沉积;采用LINCO公司提供的放射免疫试剂盒测定空腹血脂联素、瘦素水平;代谢综合征的诊断采用2004年中国糖尿病学会制定的标准.结果 (1)脂肪沉积组与无脂肪沉积组比较,体质指数、内脏脂肪面积均显著升高,体质指数分别为(22.94±1.35)kg/m2对(21.38±2.55)kg/m2(P＜O.001),内脏脂肪面积(135.6±31.7)cm2对(68.6±22.6)cm2(P＜O.001);脂联素瘦素比值降低.分别为2.17±1.77对4.54±7.00(P=0.031);而脂联素、瘦素水平在两者间差异无统计学意义;(2)脂联素瘦素比值与体质指数(r=-0.552,P＜0.001)、腰围(r=-0.390,P＜0.001)、腹部内脏脂肪面积(r=-0.311,P＜0.001)呈负相关.结论 体质指数正常有内脏脂肪沉积与无内脏脂肪沉积的老年男性比较.脂联素瘦素比值明显下降.并与腹部脂肪面积显著负相关.提示血清脂联素瘦素比值可能可用于筛选体质指数正常有腹部内脏脂肪肪沉积的患者.     

2型糖尿病脂联素、瘦素、脂联素与瘦素比值与代谢综合征组分关系的研究

目的观察脂联素、瘦素、脂联素与瘦素的此值（A／L）和代谢综合征的关系。方法初诊2型糖尿病患者260例,放免法检测Fins、脂联素、瘦素水平,计算胰岛素抵抗指数,并以脂联素、瘦素及其比值作为因变量进行多元回归分析。结果肥胖较非肥胖患者有较低的脂联素、A／L,较高的瘦素;胰岛素敏感的患者相对于胰岛素抵抗的患者,有较高的脂联素、A／L和较低的瘦素;A／L与代谢有关变量、胰岛素抵抗及相关变量都有明显的相关性。结论2型糖尿病患者脂联素、瘦素和A／L与肥胖、胰岛素抵抗及代谢综合征的表达有明显的相关性。据此推测脂联素、瘦素、A／L有可能成为进一步研究代谢综合征的发病机制及其诊断标准的指标。     

脂联素/瘦素比值对非瓣膜性心房颤动的预测价值

目的:观察不同类型非瓣膜性心房颤动病人血浆中脂联素/瘦素比值的差异,探讨其对非瓣膜性心房颤动的预测价值。方法:收集2021年9月—2022年1月在新乡医学院第一附属医院心血管内科住院的病人88例,根据临床表现及心电图结果将入组病人分为持续性心房颤动组、阵发性心房颤动组、无心律失常组,测量瘦素、脂联素水平,探讨脂联素/瘦素比值对非瓣膜性心房颤动的预测价值。结果:年龄、高血压病史、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左心房直径(LA)、瘦素、脂联素及脂联素/瘦素比值是心房颤动发生的影响因素(P<0.05)。相关分析结果显示,瘦素水平与体质指数(BMI)呈正相关(P<0.05),脂联素水平、脂联素/瘦素比值与BMI呈负相关(P<0.05)。受试者工作特征(ROC)曲线分析显示,年龄、高血压病史、LVEDD、LA、LVEF及血浆中瘦素、脂联素、脂联素/瘦素比值对心房颤动的发生具有一定预测价值(P<0.05)。年龄、LA、瘦素及脂联素/瘦素比值鉴别诊断心房颤动病人的准确率较高。结论:瘦素、脂联素水平、脂联素/瘦素比值对心房颤动发生的预测价值较高。     

老年代谢综合征患者血清脂联素水平及其影响因素分析

目的研究血清脂联素(APN)水平能否作为老年代谢综合征(MS)的血清标志物。方法应用酶联免疫吸附法(ELISA)对82例MS患者(老年MS组40例,非老年MS组42例)和50例老年对照者进行了血清APN的测定,应用全自动生化分析仪测定了空腹血糖(FPG)、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等项指标,测量研究对象的一般指标,计算体重指数(BMI)和腰臀比(WHR)。系统分析了血清APN水平与MS的关系,分析了与年龄、性别、血脂、血糖、BMI以及WHR等的关系。结果(1)MS组血清APN水平显著低于老年对照组。(2)血清APN水平与BMI、WHR、SBP、TG呈负相关,与HDL-C及载脂蛋白A1(ApoA1)呈正相关。(3)血清APN水平存在性别间差异,男性明显低于女性。结论低APN水平是MS的一个独立危险因素,低APN水平可作为老年MS的血清标记物。     

抵抗素及脂联素与代谢综合征

大量研究表明，脂肪组织不仅是能量储备的终末分化器官，而且是一个具有多种内分泌、自分泌和旁分泌功能的内分泌器官。肥胖是导致胰岛素抵抗和心血管疾病的一个主要危险因素。脂肪细胞释放的细胞因子与胰岛素抵抗和动脉粥样硬化的发生关系密切，其中新近发现的抵抗素、脂联素为研究的热点。以下就有关内容作一综述。     

不同他汀类药物对代谢综合征患者血清脂联素和瘦素的影响研究

目的探讨不同他汀类调脂药物对代谢综合征患者血清脂联素、瘦素的影响。方法选取明确诊断代谢综合征患者100例,随机分为两组,A组口服阿托伐他汀10mg/d,B组口服普伐他汀40mg/d,其他治疗相同。检测治疗前后血脂和脂联素及瘦素水平。结果两组治疗后血脂水平明显下降,两组无显著差异,而血清脂联素水平显著高于治疗前,瘦素水平低于治疗前,A组优于B组。结论两种他汀类调脂药物都可以明显升高代谢综合征患者的血清脂联素水平以及降低瘦素水平,阿托伐他汀优于普伐他汀。     

代谢综合征患者脂联素基因多态性分析

目的探讨脂联素基因单核苷酸多态性（SNP）45T→G和276G→T两个位点与代谢综合征（MS）的关系。方法收集MS患者183例（MS组）和健康对照人群144例（对照组）,采用TaqMan探针技术进行脂联素基因SNP45分析,直接测序法进行脂联素基因SNP276分析。结果SNP45在MS组与对照组比较差异有统计学意义（P〈0．05）,等位基因分布频率提示C等位基因在MS组高于对照组（P〈0.05）,MS组中携带TG＋GG型患者血清脂联素水平低于TT型患者（P〈0．05）;两组SNP276基因型分布及等位基因频率比较均无统计学差异。结论SNP45G／G基因型可能是中国汉族人群MS的易感基因。     

冠心病患者血浆脂联素水平与代谢综合征的相关性研究

目的 检测冠心病病人血浆脂联素水平,并采用多个代谢综合征（metabolic syndrome,MS）诊断标准判断是否合并MS,探讨脂联素与MS的关系,评价MS标准的敏感性.方法 冠心病60例,分别采用美国国家胆固醇教育计划成人治疗指南Ⅲ（national cholesterol education program adult treatment panel Ⅲ,NCEP ATP Ⅲ）和2005年国际糖尿病联盟（international diabetes federation,IDF）的MS诊断标准判断合并MS者,分析冠心病合并MS与单纯冠心病者之间血浆脂联素水平的差异.结果 符合NCEP ATP Ⅲ标准的MS 16例（占25%）,其血浆脂联素水平（4.7±1.2）mg/L;单纯冠心病病人为（5.1±1.1）mg/L,差异无统计学意义（P＞0.05）.符合IDF标准的MS者30例（占50%）,其血浆脂联素水平为（4.3±1.5）mg/L,较单纯冠心病病人（5.4±2.2）mg/L显著降低（P＜0.05）.结论 冠心病合并MS病人的血浆脂联素水平低于单纯冠心病病人,IDF的MS诊断标准对早期发现MS人群更敏感.     

高血压合并代谢综合征患者脂联素检测的意义

脂联素(ADP)是机体内脂肪细胞分泌的一种蛋白激素,在脂肪组织中高度表达。其基因定位于染色体3q27,全长17 kb。研究表明ADP具有抗炎、抗动脉粥样硬化、改善胰岛素抵抗(IR)的作用。本文探讨高血压合并MS患者血清ADP水平与相关指标的相关性。     

Leptin: Adiponectin ratio discriminated the risk of metabolic syndrome better than adiponectin and leptin in Southwest Nigeria

AimTo assess the ability of leptin, adiponectin and leptin: adiponectin ratio (LAR) to discriminate apparently healthy subjects with metabolic syndrome in Southwest Nigeria.MethodsOne hundred and twenty three subjects with metabolic syndrome (cases) were age matched with 123 subjects without metabolic syndrome. The serum adiponectin and leptin levels were measured using standard procedures. The ability of serum adiponectin, leptin and LAR to discriminate metabolic syndrome and its components were determined using the receiver operating curve and linear regression.ResultsThe median age of the cases (49 IQR 42, 56 years) was not significantly different from the controls (48 IQR 39, 56 years) p = 0.252. The adiponectin levels was reduced with increasing number of the components of metabolic syndrome from 11.6 (IQR 9.6, 13.5) among subjects without any component of metabolic syndrome to 6.5 (IQR 5.7, 7.7) in subjects with more than three components of metabolic syndrome. For leptin and LAR, the values increased with increasing components (p < 0.001). LAR (AUC 0.960) discriminated metabolic syndrome better than adiponectin (AUC 0.865) and leptin (AUC = 0.918) in males and females (LAR AUC = 0.966, adiponectin AUC = 0.888, leptin AUC = 0.929).ConclusionLAR had better ability to discriminate the risk of metabolic syndrome than adiponectin and leptin alone in males and females among apparently healthy subjects from Southwest Nigeria.     

Gorham-Stout综合征五例临床分析并文献复习

目的 探讨Gorham-Stout综合征(GSS)患者的临床、骨影像及组织病理特点及其诊断、治疗和预后.方法 回顾性分析1980年1月至2008年1月北京协和医院收治的5例GSS患者的临床资料并进行文献复习.结果 (1)5例患者中男2例,女3例;年龄15～37岁,平均30.2岁.(2)5例患者均有不同部位、不同程度的骨破坏,3 例合并大最胸腔积液,均为血性渗出液;其中2 例为乳糜性胸腔积液.所有患者均无恶性肿瘤的依据.4 例接受骨组织活检,其中2例接受局部穿刺及切开活检,有典型的骨病理表现.(3)采用二膦酸盐、钙剂+活性维生素D3、病变部位的放疗、胸导管结扎等治疗方法.(4)转归:5例患者中,仅有骨病变的2例病情平稳,合并胸腔积液的3例患者中,1例骨病变相对稳定,但需间断放胸腔积液,2例失访.结论 GSS是一以渐进性溶骨性改变为主要表现的罕见病,临床表现取决于受累部位.目前没有确切的治疗方法;合并胸腔积液时预后差.     

代谢综合征与血管性认知障碍

代谢综合征是一组以肥胖、高血压、糖尿病和血脂异常为主要表现的症候群.胰岛紊抵抗是代谢综合征发生的主要病理生理学基础.代谢综合征及其各个组成成分与血管性认知障碍均有密切关系.文章简要回顾了代谢综合征导致血管性认知障碍的机制,概述了控制代谢综合征对预防和治疗血管性认知障碍的意义.     

体重指数在老年代谢综合征人群中诊断价值的初步探讨

目的了解老年人群中体重指数（BMI）与代谢综合征患病及相关代谢异常之间的关系。方法683例65岁以上（平均71．2岁）的老年男性,以中华医学会糖尿病学分会制订的代谢综合征工作定义作为标准,按照BMI进行分层,分析不同BMI人群代谢综合征的患病率及各项代谢指标的异常情况。结果（1）当BMI≥123kg／m^2时,代谢综合征的患病率随BMI的增加显著上升,BMI和代谢异常数量之间呈现一种正相关趋势（r=0．557）;（2）BMI增加与收缩压（SBP）、舒张压（DBP）、血甘油三酯之间正相关（r值分别为0．189、0．198和0．201）,与血高密度脂蛋白胆固醇之间负相关（r=-0．157）;（3）在血压正常人群和在非糖尿病人群,BMI与SBP、DBP、空腹血糖及餐后2h血糖之间显著正相关;（4）冠心病和肾脏损害患者的BMI显著高于无相关疾病人群（P〈0．05）;（5）冠心病、肾脏损害和脑血管病变患者中的代谢综合征患病率显著高于没有这些疾病的人群（P〈0．05）。结论随着BMI的增加,代谢指标异常的数量逐渐增加,代谢综合征的患病率也逐渐升高。BMI的增加与冠心病、肾脏损害和脑血管病变的发病相关。     

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     

The associations of leptin and adiponectin with the metabolic syndrome in an Indonesian and a Dutch population

Background and aimsAt the same BMI, Asian populations develop cardiometabolic complications earlier than Western populations. We hypothesized that a different secretion of the adipocyte-derived hormones leptin and adiponectin plays a role and investigated the associations of the two hormones with the metabolic syndrome (MetS) in an Indonesian and a Dutch population.Methods and resultsWe performed cross-sectional analyses of the Netherlands Epidemiology of Obesity Study (n = 6602) and the SUGAR Scientific Programme Indonesia–Netherlands Study (n = 1461). We examined sex-stratified associations of leptin and adiponectin with MetS, using multivariate logistic regression including adjustment for total body fat. The mean (SD) leptin (mcg/L) were 4.7 (6.0) in Indonesian men, 18.6 (12.0) in Indonesian women, 9.1 (7.7) in Dutch men, and 23.4 (17.4) in Dutch women. The mean (SD) adiponectin (mg/L) were 5.7 (5.4), 7.5 (7.1), 6.6 (3.3), and 11.3 (4.9), respectively. Within the same BMI category, leptin concentrations were similar in the two populations, whereas adiponectin was lower in the Indonesian population. Per SD of leptin, adjusted prevalence odds ratios (ORs, 95%CI) of MetS were 0.9 (0.6–1.2) in Indonesian men, 1.1 (0.9–1.4) in Indonesian women, 2.2 (1.6–2.8) in Dutch men, and 1.2 (1.0–1.5) in Dutch women. Per SD of adiponectin, the ORs were 0.9 (0.7–1.2), 0.8 (0.7–1.0), 0.6 (0.6–0.8), and 0.4 (0.4–0.5), respectively.ConclusionsDespite lower adiponectin levels, adiponectin was not related to the MetS in the Indonesian population and can not explain their increased cardiometabolic risk at the same BMI.     

Low adiponectin levels at baseline and decreasing adiponectin levels over 10 years of follow-up predict risk of the metabolic syndrome

AimAdiponectin is the most abundant adipokine and may play a key role in the interplay between obesity, inflammation, insulin resistance and the metabolic syndrome (MetS). Thus, this large population-based cohort investigated whether adiponectin at baseline and/or a decrease in adiponectin during follow-up is associated prospectively with the risk of incident MetS.MethodsUsing a prospective study design, the development of MetS was examined in 1134 healthy participants from the community. Plasma adiponectin was measured at study entry and again after a median follow-up of 9.4 years (IQR: 9.2–9.7). During follow-up, 187 participants developed MetS, and 439 presented with at least two components of MetS.ResultsDuring follow-up, adiponectin decreased in participants who developed MetS, whereas adiponectin was increased in those who did not develop MetS (P < 0.001). Those with low adiponectin levels (quartile 1) at baseline had an increased risk of developing MetS (OR: 2.92, 2.08–6.97; P < 0.001) compared with those with high levels (quartile 4). After adjusting for confounding variables, low adiponectin levels at baseline remained independently associated with MetS (OR: 2.24, 1.11–4.52; P = 0.017). Similarly, participants with a decrease in adiponectin during follow-up also had an increased risk of MetS (OR: 2.96, 2.09–4.18; P < 0.001). This association persisted after multivariable adjustments, including for baseline adiponectin (OR: 4.37, 2.77–6.97; P < 0.001). Finally, adiponectin levels at follow-up were inversely associated with an increase in the number of components of MetS (P < 0.001); geometric mean adiponectin levels were 9.5 mg/L (95% CI: 9.0–10.0) for participants with no components vs 7.0 mg/L (95% CI: 6.3–7.9) for those with four to five components.Conclusions/interpretationLow plasma adiponectin levels at baseline and decreasing adiponectin levels during follow-up are both associated with an increased risk of MetS.