充血性心力衰竭胰岛素抵抗检测方法的探讨

目的：探讨充血性心力衰竭（ＣＨＦ）胰岛素抵抗（ＩＲ）的检测方法。方法：采用放射免疫法测定４１例ＣＨＦ患者和２６例正常人的空腹胰岛素（ＦＩＮＳ）,检测空腹血（ＦＰＧ）水平。比较空腹血糖、胰岛素乘积的倒数（ＩＡＩ）和空腹血糖胰岛素比值（ＦＰＧ／ＦＩＮＳ）的应用价值。结果：ＣＨＦ组ＩＡＩ低于对照组（Ｐ〈０．０１）,并随心功能恶化进一步降低（Ｐ〈０．０５５）;ＣＨＦ组ＦＰＧ／ＦＩＮＳ也低于对照组（Ｐ〈０．００１）,但在心功能之间的差别无显著性意义。结论：ＩＡＩ在心衰的ＩＲ评价中明显优于ＦＰＧ／ＦＩＮＳ。     

内源性洋地黄因子与原发性高血压胰岛素抵抗

目的：探讨内源性洋地黄因子（ＥＤＬＦ）在胰岛素抵抗（ＩＲ）的原发性高血压（ＥＨ）发病中的作用。方法：对３０例ＥＨ患者（ＥＨ组）行葡萄糖耐量及胰岛素释放试验，测定其血清ＥＤＬＦ，并与１６例正常血压者（ＮＴ组）作对照。结果：ＥＨ组患者血清ＥＤＬＦ〔（１５４．４０±４６．８７）ｎｇ／Ｌ〕显著高于ＮＴ组〔（１２２．２９±２４．０６）ｎｇ／Ｌ，Ｐ＜０．０１〕；ＥＨ组空腹血浆胰岛素与体重、体重指数（ＢＭＩ）、臀围及ＥＤＬＦ呈显著正相关（ｒ值依次为０．５２，０．３５，０．４５和０．４１，Ｐ＜０．００２５、Ｐ＜０．０５、Ｐ＜０．０１和Ｐ＜０．０２５）。结论：ＥＨ患者存在明显的ＩＲ和血清ＥＤＬＦ升高，并由此引起持续的高血压     

高压氧治疗重型闭合性颅脑损伤对血清脂质过氧化物和超氧化物歧化酶的影响

目的观察重型闭合性颅脑损伤高压氧（ＨＢＯ）治疗前中后血清脂质过氧化物（ＬＰＯ）代谢产物丙二醛（ＭＤＡ）和超氧化物歧化酶－１（ＳＯＤ－１）的浓度变化。方法５０名患者分为高压氧＋常规治疗组（ＨＢＯ组）３２例和单纯常规治疗组（对照组）１８例,另有３０名健康志愿者作为正常组：于治疗前中后用硫代巴比妥酸比色法检测ＭＤＡ、用放射免疫法检测ＳＯＤ－１。结果ＨＢＯ组和对照组在治疗前的ＭＤＡ（５．２７±１．５９）μｍｏｌ／Ｌ,（５．７１±１．３４）μｍｏｌ／Ｌ和ＳＯＤ－１（２７１．３±１０２．９）μｇ／Ｌ,（２５６．３±１１２．４）μｇ／Ｌ,差异均无显著性（Ｐ＞０．０５）,但与正常组比较差异均有非常显著性（Ｐ＜０．０１）;ＭＤＡ和ＳＯＤ－１呈负相关;治疗后ＭＤＡ升高和ＳＯＤ－１明显降低者疗效和预后差。ＨＢＯ组ＭＤＡ降低,为（４．１１±０．３５）μｍｏｌ／Ｌ;ＳＯＤ－１升高,为（３８０．５±１１５．３）μｇ／Ｌ及疗效均较对照组显著。结论ＭＤＡ和ＳＯＤ－１与损伤严重程度有关,可用于判断ＨＢＯ的疗效和预后,并有可能作为调整ＨＢＯ治疗方案的依据。     

充血性心力衰竭患者的血浆一氧化氮改变及意义

为探讨充血性心力衰竭（ＣＨＦ）患者的血浆一氧化氮（ＮＯ）含量及其意义，本文采用比色分析法测定了４２例ＣＨＦ患者的血浆ＮＯ浓度，结果发现，ＣＨＦ患者的血浆ＮＯ（６４．４７±２１．４２μｍｏｌ／Ｌ）显著高于对照组（５１．６２±１３．６２μｍｏｌ／Ｌ），Ｐ〈０．０５，其中心功能Ⅲ－Ⅳ级，按（ＮＹＨＡ心功能分级标准）患者的血浆ＮＯ（７８．８±１０．８５μｍｏｌ／Ｌ）显著高于心功能Ⅱ级者（５３．７７±１１．     

急性出血性脑血管病并发多脏器功能失常综合征患者血浆内皮素-1及降钙素基因相关肽水平的观察

目的：探讨血浆内皮素１（ＥＴ１）和降钙素基因相关肽（ＣＧＲＰ）在急性出血性脑血管病（ＡＨＣＶＤ）并发多脏器功能失常综合征（ＭＯＤＳ）发病中的作用。方法：采用放射免疫法分别测定２１例ＡＨＣＶＤ合并ＭＯＤＳ患者（ＭＯＤＳ组）、２０例ＡＨＣＶＤ患者（ＡＨＣＶＤ组）及３０例正常人（正常对照组）血浆中ＥＴ１和ＣＧＲＰ水平。结果：ＭＯＤＳ组及ＡＨＣＶＤ组血浆ＥＴ１水平明显高于正常对照组（Ｐ均＜０．０１），ＭＯＤＳ组ＥＴ１水平又明显高于ＡＨＣＶＤ组（Ｐ＜０．０１）。ＡＨＣＶＤ组血浆ＣＧＲＰ水平高于正常对照组，但无显著性差异（Ｐ＞０．０５）。而ＭＯＤＳ组血浆ＣＧＲＰ水平明显低于正常对照组，ＥＴ１／ＣＧＲＰ（Ｅ／Ｃ）比值明显高于ＡＨＣＶＤ组及正常对照组（Ｐ均＜０．０１）。结论：血浆ＥＴ１水平升高、ＣＧＲＰ水平降低、Ｅ／Ｃ比值严重失衡与ＭＯＤＳ的发生相关；检测血浆ＥＴ１和ＣＧＲＰ水平对评估ＡＨＣＶＤ患者预后有一定意义     

内科急症中多器官衰竭的肾素－血管紧张素系统变化

用放免法测定了２８名内科急症中多器官衰竭（ＭＯＦ）患者的血浆肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡＴ－Ｄ）和醛固酮（ＡＬＤ）水平。结果：ＭＯＦ患者的ＡＴ－Ⅱ及ＡＬＤ均较对照组明显升高（两组分别为１５５．８０±７７．００ｎｇ／Ｌ，１４８．０９±６６．００ｎｇ／Ｌ与６６．５３±１６．２０ｎｇ／Ｌ，１０２．４６±３２．６０ｎｇ／Ｌ），Ｐ＜０．０１；ＰＲＡ及ＡＬＤ随衰竭器官数增多而升高，而ＡＴ－Ⅱ则随衰竭器官数增多而降低；死亡组ＡＴ－Ⅱ水平明显低于存活组（分别为７２．３７±２４．４４ｎｇ／Ｌ与１７４．０１±８２．２８ｎｇ／Ｌ），Ｐ＜０．０１。提示肾素－血管紧张素系统参与了ＭＯＦ的发病过程。作者认为测定内科ＭＯＦ患者的ＰＲＡ、ＡＴ－Ⅱ、ＡＬＤ对病情监测及预后判断有一定价值。     

彩色超声多普勒及OXLDL检查联合诊断颈动脉粥样硬化病变的价值

目的研究彩色超声多普勒（ＣＤＦＩ）及血浆ＯＸＬＤＬ水平在诊断颈动脉粥样硬化（ＣＡＳ）病变中的价值。方法应用ＣＤＦＩ检查１６８例颈动脉（ＣＡ）,以ＣＡ内膜厚度、斑块情况、狭窄程度的超声分级和病理学分型作为评价ＣＡＳ硬化程度的指标。从中筛选出６６例,分为ＣＡＳ组和正常对照组,进行血脂、低密度脂蛋白（ＬＤＬ）及氧化修饰型ＬＤＬ（ＯＸＬＤＬ）水平测定。ＣＡＳ组再分为糖尿病ＤＭ（＋）和ＤＭ（－）组。将所有结果逐一对比分析。结果ＣＤＦＩ检出阳性患者１２５例。ＣＡＳ组ＯＸＬＤＬ水平明显高于对照组（Ｐ＜０００１）,具有显著性差异;ＤＭ（＋）组显著高于ＤＭ（一）组（Ｐ＜００５）。分析表明血浆ＯＸＬＤＬ水平增高是致ＡＳ的危险因素之一。超声检查能发现早期临床无症状的ＣＡＳ,并能够提示ＣＡＳ斑块造成ＣＡ狭窄程度。结论ＣＤＦＩ与ＯＸＬＤＬ检查联合应用可为预防ＣＡＳ的形成,早期发现及治疗提供可靠的依据。     

荧光酶免疫法在先天性甲状腺功能低下症筛查中的应用

目的 探讨荧光酶免疫法（ＦＥＩＡ）在新生儿甲状腺功能低下症筛查中的实用性。方法 对ＦＥＩＡ方法测定滤纸干血片促甲状腺激素（ＴＳＨ）含量进行方法学检测,同时与酶联免疫吸附法（ＥＬＩＳＡ）和免疫放射法（ＩＲＭＡ）相比较,并检测１７９４例新生儿ＴＳＨ正常水平及筛查切值（ｃｕｔ ｏｆｆ）。结果 该方法最低检测限为４．１４ｍＩＵ／Ｌ,批内平均变异系数（ＣＶ）为０．０８,批间平均变异系数（ＣＶ）为０．１１,高     

尿毒症脂质代谢紊乱发生机制的进一步研究

采用口服葡萄糖耐量试验方法（ＯＧＴＴ），检测５０例尿毒症患者胰岛素糖代谢调节作用活性，分析胰岛素拮抗与尿毒症脂质代谢紊乱的关系。结果显示：（１）本组尿毒症者存在明显的脂质代谢紊乱，表现为血浆甘油三酯（ＴＧ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）水平增高，高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）水平低下，ＬＤＬ－Ｃ／ＨＤＬ－Ｃ比值增高；（２）胰岛素拮抗组较非胰岛素拮抗组其ＬＤＬ－Ｃ水平和ＬＤＬ－Ｃ／ＨＤＬ－Ｃ比     

老年脑梗死患者高胰岛素血症的临床研究

目的：探讨高胰岛素血症（ＨＩＳ），胰岛素抵抗（ＩＲ）与老年脑梗死发病的关系。方法：３４例６０岁以上老年脑梗死患者和２０例正常人的葡萄糖耐量试验（ＯＧＴＴ）后血糖，胰岛素及其曲线下面积（ＡＵＣ）和胰岛素／血糖，血脂变化。结果；脑梗死组糖负荷后血糖，胰岛素，胰岛素／血糖，ＡＵＣ以及总胆固醇明显高于对照组，胰岛素敏感性指数及ＨＤＬ－Ｃ明显低于对照组，糖负荷后１小时，２小时胰岛素及其ＡＵＣ与舒张压呈正相关     

血清网膜素1与妊娠期糖尿病的相关性

目的探讨血清网膜素1(omentin 1)与妊娠期糖尿病(GDM)的关系。方法酶联免疫法定量85例孕前肥胖GDM,85例孕前正常GDM及匹配设置的85例糖耐量正常（NGT）孕妇血清网膜素1水平,同时检测3组血清空腹血糖（FPG）、空腹胰岛素（FINS)水平,计算胰岛素抵抗指数（HOMA IR)。结果①GDM组FPG、FINS及HOMA IR均明显高于NGT组,且后二者还表现为：肥胖GDM＞非肥胖GDM＞NGT组(P＜0.05);②GDM组血清网膜素1明显低于NGT组,表现为：肥胖GDM＜非肥胖GDM＜NGT组(P＜0.05);③相关性分析：血清网膜素1与BMI、FPG、FINS 及HOMA IR明显负相关(P＜0.05);④多元回归分析：孕前肥胖GDM组：网膜素 1=484.126 5.015BMI 7.016FPG 13.224FINS;孕前正常GDM组：网膜素 1=497.008 4.092BMI 6.079FPG 11.258FINS。结论血清网膜素1与GDM关系密切,能反映孕妇糖、脂代谢紊乱和胰岛素抵抗程度,可能参与了GDM疾病的发生和发展。     

Metformin plus low-dose glimeperide significantly improves Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)) without hyperinsulinemia in patients with type 2 diabetes mellitus

OBJECTIVE: Type 2 diabetes mellitus is characterized by insulin resistance and defects in insulin secretion from pancreatic beta-cells, which have been studied by using euglycemic/hyperinsulinemic clamps. However, it is difficult to study insulin resistance and beta-cell failure by these techniques in humans. Therefore, the aim of this study was to evaluate the effect of three different antidiabetic therapeutic regimens on insulin resistance and beta-cell activity by using a mathematical model, Homeostasis Model Assessment for insulin resistance (HOMA(IR)) and beta-cell function (HOMA(beta-cell)). RESEARCH DESIGN AND METHODS: Seventy type 2 diabetic patients were randomly assigned to one of three therapeutic regimens: (A) metformin + American Diabetic Association (ADA)-recommended diet + physical activity; (B) metformin + low-dose glimepiride + ADA diet + physical activity; or (C) ADA diet + physical activity (no drugs). Blood samples were obtained before and after the treatment to determine serum levels of fasting and post-prandial blood glucose, fasting insulin, and glycosylated hemoglobin (HbA1c), and HOMA(IR) and HOMA(beta-cell) were calculated. RESULTS: Fasting and post-prandial levels of glucose, HbA1c, and fasting insulin and calculated HOMA(IR) and HOMA(beta-cell) values before treatment were significantly higher than the respective values after treatment for all groups of patients (P < 0.01). Significant differences were also found when comparing the treatment-induced reduction in fasting blood glucose (51.8%; P < 0.01), post-prandial blood glucose (55.0%; P < 0.05), and HOMA(IR) (65.3%; P < 0.01) in patients of Group B with that in patients receiving other therapeutic options (Groups A and C). CONCLUSIONS: Metformin plus low-dose glimepiride (plus ADA diet and physical activity) is a more effective treatment for type 2 diabetes than either metformin plus ADA diet and physical activity or ADA diet and physical activity alone. Determination of HOMA(IR) and HOMA(beta-cell) values is an inexpensive, reliable, less invasive, and less labor-intensive method than other tests to estimate insulin resistance and beta-cell function in patients with type 2 diabetes mellitus.     

2型糖尿病患者血清脂联素水平与胰岛素抵抗的关系

【目的】探讨2型糖尿病（T2DM）患者血清脂联素（APN）水平与肥胖、胰岛素及胰岛素抵抗的关系。【方法】采用病例对照研究,T2DM伴有肥胖组（DO）42例,T2DM不伴肥胖组（NDO）42例,正常对照组（NC）28名。检测三组对象血脂、血糖、空腹胰岛素（Fins）、APN水平。用HOMA模型公式计算胰岛素抵抗指数（HOMAIR）。【结果JDO组和NDO组的血清APN水平均明显低于NC组[DO组（8．02±3．57）mg／L,NDO组（8．35±2．68）mg／L比NC组（14．04±4．75）mg／L,均P〈O．01],DO组与NDO组APN水平差异无显著性。APN与体质指数（BMI）、腰围（w）、腰臀比（WHR）、空腹血糖（FBG）、甘油三脂（TG）、Fins、HO—MAIR呈显著负相关（P〈0．01）,APN与高密度脂蛋白（HDL-C）呈显著正相关（P〈0．01）。多元逐步回归分析显示HOMAIR和WHR是血清APN浓度的主要影响因素。【结论】脂联素参与了胰岛素抵抗的发生,与2型糖尿病的发生相关。     

甲状腺功能正常的非糖尿病人群甲状腺激素水平与胰岛素抵抗的关系

目的 对甲状腺功能正常的非糖尿病人群中甲状腺激素水平与胰岛素抵抗关系进行横断面研究。方法 依托2011年由中华医学会发起的REACTION研究,选取大连地区符合标准的研究对象共5 428例。以促甲状腺激素（TSH）2.5 mU/L为分界,分为低TSH组及高TSH组,测量两组身高、体重、血压,进行口服葡萄糖耐量(OGTT),检验血脂、血肌酐（SCr）、血尿酸（UA）、血糖、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、甲状腺功能,稳态模型评估胰岛素抵抗指数（HOMA IR）。研究甲状腺激素水平与胰岛素抵抗的相关性。结果 与低TSH组比较,高TSH组SCr、UA及游离甲状腺素（FT4）水平降低,低密度脂蛋白胆固醇（LDL C）、胆固醇（TC）、HbA1c、FINS及HOMA IR增高（P＜0.05）。TSH 、游离三碘甲状腺原氨酸（FT3）与HOMA IR呈正相关（r=0.145、0.040,P＜0.05）。而FT4水平与HOMA IR指数呈负相关（r=-0.071,P=0.000）。回归分析显示性别、舒张压（DBP）、BMI、高密度脂蛋白胆固醇（HDL C）、LDL C、TC、HbA1c、UA、TSH、FT4为影响HOMA IR的独立危险因素（P＜0.05）。其中HDL C及FT4为保护性因素（P＜0.05）。结论 在正常范围内的TSH水平与非糖尿病人群的胰岛素抵抗呈正相关,FT4与胰岛素抵抗呈负相关,且TSH、FT4为影响胰岛素抵抗的独立危险因素。     

apo B/apo AⅠ与多囊卵巢综合征患者胰岛素抵抗的相关性研究

目的探讨多囊卵巢综合征(PCOS)患者载脂蛋白B(apo B)/载脂蛋白AⅠ(apo AⅠ)比值与胰岛素抵抗(IR)的关系。方法选择137例PCOS患者和116例健康女性,测量血脂并计算apo B/apo AⅠ比值,行75 g口服葡萄糖耐量试验,计算稳态模型胰岛素抵抗指数(HOMA2-IR);对其中101例PCOS患者及20例健康女性行高胰岛素-正葡萄糖钳夹术,以稳态期葡萄糖代谢率(M值)评估其胰岛素敏感性。根据健康人对照组M值下四分位数(P25)和apo B/apo AⅠ比值的四分位数将PCOS患者进行分组,用logistic回归分析apo B/apo AⅠ比值与IR发生风险的关系。结果 PCOS患者中,与非IR患者相比,IR患者的HOMA2-IR水平及apo B/apo AⅠ比值均显著增高,而M值水平降低(P<0.05);PCOS患者apo B/apo AⅠ比值与BMI、FPG、2 h PG、FINS、HOMA2-IR呈正相关(P均<0.05),与M值呈负相关;随apo B/apo AⅠ比值增高,M值逐渐降低(P<0.05)。apo B/apo AⅠ比值最高组发生IR的风险是最低组的5.42倍(P<0.05)。结论 PCOS患者中,apo B/apo AⅠ比值与IR密切相关,apo B/apo AⅠ比值增高是发生IR的重要标志。     

Comparison of the effects of simvastatin vs. rosuvastatin vs. simvastatin/ezetimibe on parameters of insulin resistance

Background: Statin treatment may be associated with adverse effects on glucose metabolism. Whether this is a class effect is not known. In contrast, ezetimibe monotherapy may beneficially affect insulin sensitivity. Objective: The aim of this study was to compare the effects of three different regimens of equivalent low‐density lipoprotein cholesterol (LDL‐C) lowering capacity on glucose metabolism. Methods: A total of 153 patients (56 men), who had not achieved the LDL‐C goal recommended by the National Cholesterol Education Program Adult Treatment Panel III (NCEP‐ATP III) despite a 3‐month dietary and lifestyle intervention, were randomly allocated to receive open‐label simvastatin 40 mg or rosuvastatin 10 mg or simvastatin/ezetimibe 10/10 mg for 12 weeks. The primary end point was changes in homeostasis model assessment of insulin resistance (HOMA‐IR). Secondary endpoints consisted of changes in fasting insulin levels, fasting plasma glucose (FPG), glycosylated haemoglobin (HbA_1c), the HOMA of β‐cell function (HOMA‐B) (a marker of basal insulin secretion by pancreatic β‐cells), LDL‐C and high sensitivity C reactive protein (hsCRP). Results: At week 12, all three treatment regimens were associated with significant increases in HOMA‐IR and fasting insulin levels (p < 0.05 compared with baseline). No significant difference was observed between groups. No change in FPG, HbA_1c and HOMA‐B levels compared with baseline were noted in any of the three treatment groups. Changes in serum lipids and hsCRP were similar across groups. Conclusion: To the extent that simvastatin 40 mg, rosuvastatin 10 mg and simvastatin/ezetimibe 10/10 mg are associated with adverse effects on insulin resistance, they appear to be of the same magnitude.     

Metabolic characteristics in individuals with impaired glucose homeostasis

We sought to clarify whether impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or both (IFG/IGT) represent the most severe impairment in insulin resistance (IR) and insulin secretion. Among the 159 Chinese subjects, 21 were diagnosed as having IFG, 103 as having IGT and 35 as having both. IR and beta-cell function were assessed using homeostatic model assessment (HOMA) and an insulin-suppression test (IST). No differences were evident between the groups in blood pressure, body mass index, plasma insulin fasting levels and lipid profiles. However, plasma 2-h insulin levels were higher in the IGT and IFG/IGT groups. Beta-cell functions were not different between these groups. But, the result of glucose tolerance was different, in which the IFG/IGT and IFG groups displayed higher insulin sensitivity than IGT via HOMA instead of no difference via IST in the three patient groups.     

代谢综合征患者血清Apelin水平的变化

目的:探讨代谢综合征(MS)患者血清Apelin水平的变化。方法:69例MS患者和63例正常糖调节(NGR)者,采用酶联免疫吸附法测定空腹血清Apelin含量,同时检测空腹血糖和胰岛素水平,以稳态模型评价胰岛素抵抗指数(HOMA-IR)。结果:MS组血清Apelin水平明显升高,确诊2型糖尿病MS组明显高于糖调节受损的MS组(475.8±37.3vs451.5±54.7)ng/L(P<0.05)和超重/肥胖者(475.8±37.3vs430.3±52.1)ng/L(P<0.01),且均高于NC组。多元逐步回归分析结果示:ln(HOMA-IR)、BMI和TC是血清Apelin独立相关因素(r2分别为0.459、0.494、0.293,均P<0.05)。结论:MS中多种代谢成分异常与血清Apelin升高密切相关,其可能是由于胰岛素抵抗加重所致。     

Regional fat mass by DXA: High leg fat mass attenuates the relative risk of insulin resistance and dyslipidaemia in obese but not in overweight postmenopausal women

Objective. To investigate the influence of regional fat mass (FM) on insulin resistance and dyslipidaemia in obese postmenopausal women (BMI >30?kg/m²) compared to overweight women (BMI <30?kg/m²). Leg FM may attenuate the increased risk of cardiovascular disease and diabetes imposed by increased trunk FM in normal and overweight postmenopausal women. Material and methods. Cross‐sectional and consecutively referred patients comprising 63 obese and 36 overweight postmenopausal women. Body composition and regional FM by dual X‐ray absorptiometry (DXA), fasting glucose, fasting insulin and C‐peptide, insulin resistance by homeostasis model assessment (HOMA‐IR), insulin sensitivity by quantitative insulin sensitivity check index (QUICKI) and metabolic clearance rate (MCRestOGTT), insulin secretion (HOMAsecr) and serum lipids were assessed. Results. In obese subjects, leg FM was favourably associated with HOMA‐IR (p<0.05), QUICKI (p<0.05), fasting glucose (p<0.05), fasting insulin (p<0.05), HOMAsecr (p<0.05) and total cholesterol/HDL ratio (p<0.05). Trunk FM was unfavourably associated with MCRestOGTT (p<0.01), QUICKI (p<0.05) and fasting insulin (p<0.05). Compared to leg FM, leg/trunk FM ratio was more strongly associated with fasting insulin (p<0.001), fasting C‐peptide (p<0.001), HOMA‐IR (p<0.001), MCRestOGTT (p<0.001), QUICKI (p<0.001), HOMAsecr (p<0.001), fasting glucose (p<0.01) and triglycerides (p<0.01). Stepwise multiple regression demonstrated that leg/trunk FM ratio was the most important variable with partial R² = 0.26 (p<0.001) for HOMA and R² = 0.37 (p<0.001) when QUICKI was used as the dependent variable. In overweight women, no associations between fat mass and parameters of insulin resistance or dyslipidaemia were found. Conclusions. A high leg/trunk FM ratio as measured by DXA may give relative protection against diabetes and cardiovascular disease in obese postmenopausal women, but not in overweight women.     

Metabolic impact on serum levels of complement component 3 in Japanese patients

The aim of this study was to explore the association between the serum concentration of complement component 3 (C3) and a variety of metabolic parameters. The study involved 125 patients in our outpatient clinic. Anthropometric and clinical laboratory data were collected and statistical associations between the serum concentration of C3 and other parameters were evaluated in a cross‐sectional as well as a prospective manner. A group of male patients with metabolic syndrome (Mets, n=35) were characterized by marked increase in serum concentrations of C3, body mass index (BMI), waist circumference, hemoglobin (Hb) A1c, insulin resistance (HOMA‐IR), triglyceride, uric acid, urinary protein, and Hb. In a one‐way analysis of variance of all subjects, the serum concentration of C3 was significantly elevated as the number of items of complying with the Mets diagnostic criteria increased. In 60 of 125 patients who did not have diabetes and were given anti‐lipogenetic medication, the serum concentration of C3 showed significant positive associations with serum levels of CH50, insulin, HOMA‐IR, total cholesterol, hematocrit, LDL‐c, C4, Hb, triglyceride, BMI, and albumin. In a prospective follow‐up evaluation (n=35), there was a significant positive association between ΔC3 (the second concentration of serum C3 minus the first concentration of serum C3)and ΔHOMA‐IR (the second concentration of HOMA‐IR minus the first concentration of HOMA‐IR). In conclusion, in Japanese patients, there is evidence implicating C3 concentration as a marker of Mets coinciding with insulin resistance. J. Clin. Lab. Anal. 24:113–118, 2010. © 2010 Wiley‐Liss, Inc.