代谢综合征患者血清色素上皮衍生因子水平变化的研究

目的 探讨代谢综合征(MS)患者血清色素上皮衍生因子(PEDF)水平的变化及其在MS发生、发展中的意义.方法 将93例门诊及住院MS患者按指标异常个数分为3个代谢指标异常组(Ⅲ组,n=30)、4个代谢指标异常组(Ⅳ组,n=42)、5个代谢指标异常组(Ⅴ组,n=20).35名门诊体检正常人群作为正常对照组(NC组).采用酶联免疫吸附试验测定血清PEDF浓度,同时测量身高、体重、腰围、血压,测定血脂、空腹血糖、空腹胰岛素、血清纤维蛋白原含量,计算稳态模型评估-胰岛素抵抗指数(HOMA-IR).采用多元逐步回归法分析PEDF的相关危险因素.结果 4组患者血清PEDF及纤维蛋白原水平逐渐升高(F=23.852、9.671,P均＜0.01).PEDF与体重指数、腰围、收缩压、舒张压、甘油三酯、纤维蛋白原、空腹血糖、空腹胰岛素、HOMA-IR呈正相关(r=0.253 ～0.440,P均＜0.01),与高密度脂蛋白-胆固醇(HDL-C)呈负相关(r=-0.334,P＜O.01).纤维蛋白原、HDL-C、空腹血糖、HOMA-IR是PEDF的相关危险因素(t=-2.977 ～3.793,P均＜0.05).结论 随着MS代谢异常指标个数的增多,PEDF水平升高,且与糖、脂代谢紊乱和胰岛素抵抗相关.PEDF可能是MS发病的预测因子.     

色素上皮衍生因子在心血管疾病中的作用

色素上皮衍生因子(PEDF)生物学功能复杂,既往研究证明其在眼部与神经系统的生理稳态和病理过程中扮演重要角色。近年发现PEDF在心血管系统与脂肪组织表达量高,PEDF与代谢综合征、动脉粥样硬化、高血压、心衰与心肌梗死等心血管疾病关系密切但机制尚未完全阐明,它可能在这些疾病的病理过程中发挥重要作用。PEDF有望成为一个新的有效的治疗心血管疾病的靶点和疾病预测分子。     

色素上皮衍生因子与动脉粥样硬化相关性的研究进展

随着人们生活水平的不断进步,动脉粥样硬化(AS)日益成为危害人类健康的杀手。炎症反应和氧化应激是AS发展的关键步骤,血栓形成和新生血管生成与AS斑块不稳定密切相关,甚至引发AS斑块破裂和急性冠状动脉综合征。目前研究表明,色素上皮衍生因子(PEDF)具有抗炎、抗氧化、抗血管新生和抑制血栓形成等特性,对AS发挥保护作用。本文就PEDF与AS之间关系的研究进展做一综述。     

色素上皮衍生因子与糖尿病肾病

色素上皮衍生因子(PEDF)是丝氨酸蛋白酶抑制剂超家族成员之一,其主要生物学作用是营养神经、神经元保护、抗氧化应激、抗炎性反应、抑制新生血管形成等.越来越多的研究显示,PEDF在糖尿病肾病中可发挥独特的保护作用,如减少肾小球细胞外基质生成、预防肾脏纤维化,并通过抑制肾脏炎性反应和氧化应激反应而抑制肾小球毛细血管内皮细胞增生、调节血管的渗透性,从而减少尿蛋白的生成.因此,PEDF有望成为糖尿病肾病的一个治疗靶点.     

色素上皮衍生因子在胃癌进展中的作用

胃癌(gastric carcinoma,GC)对人类健康来说是一大威胁,是第三大常见的癌症死亡原因.2018年,超过100万人被诊断为GC,约有78.3万人死亡.死亡率高的部分原因是无症状患者在疾病诊断较晚,转移率较高.色素上皮衍生因子(Pigment epithelial-derived factor,PEDF)表...     

代谢综合征概念的发展及防治研究进展

代谢综合征（metabolic syndrome,MS）是心血管病的多种代谢危险因素（与代谢异常相关的心血管病危险因素）在同一个体内集结的状态。伴随着社会进步及人们生活方式的改变,MS对心血管疾病的发生发展产生的危害越来越引起各界的关注。随着时间的推移和对MS研究的深入,人们在不断修正和完善对MS的认识。     

代谢综合征与肾损害研究进展

代谢综合征是由肥胖启动、以胰岛素抵抗为基础,包括肥胖、胰岛素抵抗、糖代谢异常、高血压、脂质代谢紊乱及高尿酸血症等生理异常聚集的临床综合征,这些因素单独或合并存在时均可引起和加重肾脏损害。本文就代谢综合征各因素所致肾脏损害的临床表现、发病机制及干预治疗作一综述。     

色素上皮衍生因子抗炎机制的相关研究进展

动脉粥样硬化(AS)作为心血管疾病(CVD)的主要病理基础,严重危害人类健康。AS实质是一种慢性炎症性疾病,抑制AS过程中的炎症反应或可成为延缓AS的关键。诸多研究已证实色素上皮衍生因子(PEDF)可通过抑制炎症反应进而延缓AS的发展,且作用机制复杂。本文就PEDF抗炎作用的机制做一综述。     

代谢综合征的诊断问题

复习了几种代谢综合征的定义,并对其组分进行了讨论。目前最新的是2005年4月提出的国际糖尿病联盟(IDF)定义。我国于2004年也有一定义。还介绍了最近对代谢综合征诊断的争论。美国糖尿病学会(ADA)及欧洲糖尿病学会(EASD)认为目前此诊断尚不成熟,但IDF定义制定者予以坚决反驳。     

微血管功能在代谢综合征发生机制中的研究进展

随着现代生活水平的不断提高,肥胖、心血管疾病、糖尿病等疾病的发病率逐年增加,构成重大的公共卫生挑战。大量临床资料、实验研究证实,微血管功能障碍不仅与肥胖相关的靶器官损伤的发生发展密切相关,而且是心血管事件（如高血压和胰岛素抵抗）的高危风险因素。现在本文将综述微血管功能障碍与肥胖、高血压与胰岛素抵抗（IR）之间的相互关联及其作用机制。     

Elevated serum levels of pigment epithelium-derived factor in the metabolic syndrome

CONTEXT: Pigment epithelium-derived factor (PEDF), a potent inhibitor of angiogenesis with neuronal differentiating activity, inhibits endothelial cell injury in vitro, thus suggesting the involvement of PEDF in atherosclerosis. Therefore, elucidating the relationship between serum levels of PEDF and coronary risk factors could provide a clue to understanding the pathophysiological role of PEDF in vivo. OBJECTIVE: We examined whether serum levels of PEDF were associated with risk factors for coronary artery disease. DESIGN: The study was designed as a cross-sectional study. Setting: The study was set within the general community. PATIENTS OR OTHER PARTICIPANTS: A total of 196 general Japanese residents (age 65.7 +/- 9.3 yr; 71 males and 125 females) without clinical evidence of coronary or peripheral arterial occlusive diseases were enrolled in this study. RESULTS: PEDF showed a normal distribution, ranging from 8-24 microg/ml, with a mean of 14.6 +/- 3.2 microg/ml. Multivariate analyses revealed that uric acid (P < 0.001), waist circumference (P = 0.009), insulin (P = 0.019), and triglycerides (P = 0.028) were significant independent determinants of serum PEDF levels. Age- and uric acid-adjusted PEDF levels were significantly higher (P = 0.048 for men and P = 0.007 for women) in proportion to the accumulation of the number of the components of the metabolic syndrome. CONCLUSIONS: The present study reveals that serum levels of PEDF are strongly associated with the metabolic syndrome. Our results suggest that serum PEDF levels may be elevated as a counter-system in the metabolic syndrome.     

Visfatin与代谢综合征的研究进展

Visfatin是新近发现的一种脂肪细胞因子,通过与胰岛素受体结合激活胰岛素信号转导通路,具有类胰岛素样作用。它的分泌受体内多种因素的调节,如激素、游离脂肪酸、葡萄糖。在代谢综合征相关疾病的发生发展过程中起重要作用,但目前对visfatin的研究存在很大争议,其作用机制有待于进一步探讨。     

Antiangiogenic property of pigment epithelium-derived factor in hepatocellular carcinoma

Pigment epithelium-derived factor (PEDF) is one of the most powerful endogenous antiangiogenic reagents discovered to date. Its antiangiogenic potential in neoplastic disease remains unclear. In this study, we investigated antiangiogenic property of PEDF in hepatocellular carcinoma (HCC), a typical hypervascular tumor. In HCC cell lines, constitutive messenger RNA and protein expression of PEDF varied. Genomic DNA encoding the PEDF gene was the same in the cell lines examined by Southern blotting. In chemically induced hypoxic conditions, secreted PEDF protein was suppressed in contrast to elevation of vascular endothelial growth factor protein. When PEDF was overexpressed by gene transfer, proliferation and migration of endothelial cells were inhibited in conditioned media derived from all HCC cell lines. However, the serum concentration of PEDF, as measured by enzyme-linked immunosorbent assay, was decreased in patients with cirrhosis or HCC complicated by cirrhosis compared to healthy volunteers and patients with chronic hepatitis. According to the endothelial cell proliferation assay, the serum PEDF of patients with HCC had antiangiogenic activity. Moreover, intratumoral injection of a PEDF-expressing plasmid in athymic mouse models caused significant inhibition of preestablished tumor growth. In conclusion, PEDF plays a role in the angiogenic properties of HCC. Reduction of serum PEDF concentration associated with the development of chronic liver diseases may contribute to the progression of HCC. In addition, gene therapy using PEDF may provide an efficient treatment for HCC.     

色素上皮衍生因子与糖尿病大血管病变

色素上皮衍生因子是一种强有力的新生血管抑制因子,除具有神经营养、神经保护、调节血管通透性的作用,还具有改善胰岛素抵抗、抑制炎性反应、抗氧化应激、抑制血管平滑肌细胞增殖及迁移、抑制新生血管、抑制血栓形成和抑制C反应蛋白生成等效应,因此可以延缓2型糖尿病大血管并发症的发生、发展.     

色素上皮衍生因子与氧化低密度脂蛋白的相关性研究

血管内皮功能障碍是动脉粥样硬化(atherosclerosis,AS)的启动环节,脂代谢紊乱是损伤内皮的重要因素。特别是氧化低密度脂蛋白(oxidized-low density lipoprotein,ox-LDL)沉积于内膜下,导致内皮下胶原暴露,单核细胞黏附,脂质进一步沉积,促进泡沫细胞形成。Ox-LDL在损伤内皮和启动AS过程中发挥重要作用。作为一种多功能糖蛋白,色素上皮衍生因子(pigment epitheliumderived factor,PEDF)的抗炎、抗氧化、抗血栓形成、抗血管新生及抗肿瘤等特性越来越受到关注。大量研究表明PEDF可能缓解内皮损伤,发挥抗AS作用。因此,深入探讨ox-LDL、PEDF在内皮功能障碍和AS发生发展过程中的相互作用,为进一步阐明AS的发病机制及其临床防治提供了新思路。     

Plasma concentration of pigment epithelium-derived factor in patients with diabetic retinopathy

CONTEXT: Pigment epithelium-derived factor (PEDF) is a strong inhibitor of angiogenesis. Eyes with diabetic retinopathy have low levels of ocular PEDF; however, the PEDF levels in the blood of diabetics have still not been determined. OBJECTIVES: Our objective was to determine the plasma levels of PEDF in diabetic patients and to determine the relationship with the stage of the diabetic retinopathy. DESIGN AND SETTING: This study was designed as a cross-sectional, institutional study. PATIENTS OR OTHER PARTICIPANTS: A total of 145 Japanese were studied; 112 had type 2 diabetes mellitus, and 33 were healthy controls. INTERVENTION: There was no intervention. MAIN OUTCOME MEASURES: The plasma level of PEDF was measured by ELISA, and the stage of diabetic retinopathy was determined by ophthalmic examinations. Clinical systemic status of diabetic patients was also examined. RESULTS: The plasma PEDF level in diabetic patients (6.68 +/- 0.54 microg/ml; mean +/- sem) was significantly higher than that in controls (4.38 +/- 0.59 microg/ml, P = 0.03), and the level was especially high in patients with proliferative diabetic retinopathy (7.78 +/- 0.98 microg/ml; n = 45; P = 0.005). The gender (P = 0.03), blood urea nitrogen (P = 0.005), and triglycerides (P = 0.04) were significant and independent determinants of plasma PEDF levels in diabetic patients. CONCLUSIONS: The PEDF level in the plasma was significantly elevated in diabetic patients, especially those with proliferative diabetic retinopathy. High levels of PEDF in the plasma may be related to the progression of diabetic retinopathy.