脂肪因子和代谢综合征

脂肪组织(脂肪细胞、前脂肪细胞和巨噬细胞)是一种复杂的有活性的内分泌器官,分泌大量的细胞因子,包括:瘦素、脂联素、内肥素、抵抗素、肿瘤坏死因子、血管紧张素原、白介素6、纤溶酶原激活物抑制物1和C-反应蛋白等。这些细胞因子是以自分泌、旁分泌或分泌入全身循环系统,作为信号分子作用于靶细胞发挥作用。细胞因子失凋在肥胖相关的代谢综合征中起重要作用。     

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.     

肥胖者与糖尿病患者胰岛素敏感性的变化

按口服葡萄糖耐量试验将研究对象分成正常年轻组、正常成年组、单纯肥胖组与糖尿病组 ,通过高胰岛素正葡萄糖钳夹试验 ,计算胰岛素敏感性指数并进行比较。结果显示肥胖组及糖尿病组患者的胰岛素敏感性下降     

水飞蓟宾胶囊治疗非酒精性脂肪性肝炎40例近期疗效观察

目的探讨水飞蓟宾胶囊治疗非酒精性脂肪性肝炎（NASH）的疗效及机制。方法将80例NASH患者随机分为观察组与对照组各40例。在基础治疗的基础上,观察组予水飞蓟宾胶囊105 mg,3次/d,对照组予维生素E胶丸100 mg,3次/d,疗程均为90 d。观察治疗过程中不良反应情况,放射免疫分析（RIA）法测定治疗前后IL-18、IL-8、TNF-α、AST、ALT、TG、TC水平,结果两组治疗过程中均未发生明显不良反应,治疗后血清IL-18、IL-8、TNF-α、AST、ALT、TG、TC指标均有不同程度改善,且观察组优于对照组,结论水飞蓟宾胶囊治疗NASH近期疗效确切,且较为安全。     

水飞蓟宾在非酒精性脂肪性肝炎进展过程中对肝纤维化的影响

目的研究水飞蓟宾对NASH大鼠肝纤维化进展的影响。方法30只雄性SD大鼠随机分为正常饮食对照组（n=10）、高脂饮食模型组（n=10）和水飞蓟宾治疗组（n=10），实验时间12周。生化法检测血清AST，ALT，TG，CHO。放免法检测HA，RTPCR法检测TIMP-1、TIMP-2、MMP-2、MMP-13mRNA的表达，紫外分光光度计测量SOD及MDA。结果与模型组比较，水飞蓟宾治疗组大鼠肝功改善，HA及SOD含量下降，TIMP-1、TIMP-2、MMP-2表这降低，MMP-13及MDA升高，肝纤维化程度减轻。结论水飞蓟宾具有一定抗纤维化作用。     

代谢综合征中医证候与血清脂肪因子表达规律研究

目的通过对代谢综合征(MS)常见中医证型的分析和血清脂肪因子水平的检测,研究MS患者中医证候规律及其与血清脂肪因子的相关性。方法对235例代谢综合征患者进行中医辨证分型,分为痰瘀互结组、痰浊阻遏组、气阴两虚组和阴虚热盛组,检测其血清脂肪因子,并对中医证候进行频数分析。结果痰瘀互结组和痰浊阻遏组血清瘦素(LEP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、血清抵抗素(Resistin)、纤溶酶原激活物抑制物-1(PAI-1)水平较高,与气阴两虚组比较差异有统计学意义(P<0.05);痰瘀互结组和痰浊阻遏组血清脂联素(APN)水平较低,与气阴两虚组比较差异有统计学意义(P<0.05);气阴两虚组视黄醇结合蛋白-4(RBP4)较高,与其他3组比较差异有统计学意义(P<0.05)。代谢综合征中医症状、舌脉及病机出现的频次和频率具有一定规律,其病机出现的频次和频率由高到低依次为痰浊阻遏>痰瘀互结>气阴两虚>阴虚热盛。结论痰浊和血瘀可能是脂肪因子分泌及代谢异常并导致代谢综合征的关键病理环节。     

水飞蓟宾胶囊对非酒精性脂肪性肝炎患者血清IL-18、IL-8、TNF-α、肝酶及血脂的影响

随着我国国民生活水平的提高以及人口老龄化的加剧,肥胖、高脂血症和糖尿病发病率的升高,非酒精性脂肪性肝炎(NASH)患者发病率有渐增趋势.部分NASH患者可发展为肝纤维化和NASH相关肝硬化,导致严重后果.胰岛素抵抗、细胞因子的激活、脂质过氧化和炎症反应在NASH发病中起关键作用.     

腹内脂肪与代谢综合征

腹内脂肪堆积与代谢综合征关系密切。腹内脂肪在受体的分布、脂肪细胞分泌性因子、脂肪细胞内酶的活性等方面与皮下脂肪有显著的差异 ,因此有必要进一步研究不同部位脂肪细胞的差异 ,以更好地揭示脂肪细胞在内分泌及代谢中的作用     

水飞蓟宾联合牛磺酸对NASH患者血清IL-18、IL-8、肝酶及血脂水平的影响

目的探讨水飞蓟宾联合牛磺酸治疗非酒精性脂肪性肝炎（NASH）的疗效及机制。方法将80例NASH患者随机分为观察组及对照组各40例。观察组采用水飞蓟宾联合牛磺酸治疗,对照组单用牛磺酸治疗,疗程均为24周。两组治疗期间均禁酒,改善饮食结构,进行中等量有氧运动,控制体质量。治疗前及疗程结束后测定血清IL-18、IL-8、肝酶及血脂变化。结果两组治疗后血清IL-18、IL-8、肝酶及血脂均有不同程度降低;但观察组降低程度大于对照组（P〈0．05）。结论水飞蓟宾联合牛磺酸对NASH患者疗效优于单用牛磺酸;其机制可能为抑制IL-18、IL-8表达。     

核因子κΒ与代谢综合征关系的研究进展

近年来大量研究显示代谢综合征是以胰岛素抵抗为病理生理基础,糖代谢紊乱、脂代谢异常、中心性肥胖和高血压为主要表现的一种病理状态,伴有低度慢性炎症。核因子(NF)-κB是一种重要的介导炎症的转录调节因子,其在细胞信号传递和基因表达调控中起重要作用。本文就NF-κB与代谢综合征的关系做简要综述。     

脂肪细胞产物与肥胖和代谢综合征

脂肪细胞释放多种代谢产物、激素和细胞因子，与肥胖和代谢综合征的发病关系密切，其中瘦素和新近发现的脂联素更引人注目。若能对这些脂肪细胞产物趋利避害，将有可能成为治疗肥胖和代谢综合征的一个突破点。     

An update on metabolic syndrome: Metabolic risk markers and adipokines in the development of metabolic syndrome

BackgroundMetabolic syndrome is a collection of physiological and biochemical abnormalities about 20–25% of adult population in developing countries is suffering from metabolic syndrome. Previous research demonstrated that adipose tissue plays an important role in energy regulation via endocrine, paracrine and autocrine signals as results of obesity due to accumulation of adipose tissue to excess that by time affects negatively both physical and psychological health and well being, it has been found that adipose tissues produces a variety of factors known as “adipokines” which play a key role in the development and progression of the disease and also hypothesized that adipokines are a possible link between obesity and the other risk components of the Metabolic syndrome. Many of the adipokines exert multiple actions in a variety of cellular processes leading to a complex array of abnormal characteristic of Metabolic syndrome. Abnormal production of these adipokines by expanded visceral fat during Adiposity contributes to a pro-inflammatory state. Increasing evidence suggests that aberrant production/release of adipokine from adipocyte i.e. adiponectin, leptin and resistin etc, may contribute to the health problems associated with Adiposity such as dyslipidemia, insulin resistance and atherosclerosis. This study conclusively have shown a significant role of adipokines secreted by adipose tissue and various metabolic risk markers play a important role in the development of Metabolic syndrome.     

A nutraceutical combination improves insulin sensitivity in patients with metabolic syndrome

AIM:To test the efficacy of a proprietary nutraceutical combination in reducing insulin resistance associated with the metabolic syndrome(MetS).METHODS:Sixty-four patients with MetS followed at a tertiary outpatient clinic were randomly assigned to receive either placebo or a proprietary nutraceutical combination(AP)consisting of berberine,policosanol and red yeast rice,in a prospective,double-blind,placebo-controlled study.Evaluations were performed at baseline and after 18 wk of treatment.The homeostasis model assessment of insulin resistance(HOMAIR)index was the primary outcome measure.Secondary endpoints included lipid panel,blood glucose and insulin fasting,after a standard mixed meal and after an oral glucose tolerance test(OGTT),ow-mediated dilation(FMD),and waist circumference.RESULTS:Fifty nine patients completed the study,2 withdrew because of adverse effects.After 18 wk there was a signif icant reduction in the HOMA-IR index in the AP group compared with placebo(ΔHOMA respectively-0.6 ± 1.2 vs 0.4 ± 1.9;P < 0.05).Total and low density lipoprotein cholesterol also significantly decreased in the treatment arm compared with placebo(Δlow density lipoprotein cholesterol-0.82 ± 0.68 vs-0.13 ± 0.55 mmol/L;P < 0.001),while triglycerides,high density lipoprotein cholesterol,and the OGTT were not affected.In addition,there were significant reductions in blood glucose and insulin after the standard mixed meal,as well as an increase in FMD(ΔFMD 1.9 ± 4.2 vs 0 ± 1.9 %;P < 0.05)and a significant reduction in arterial systolic blood pressure in the AP arm.CONCLUSION:This short-term study shows that AP has relevant beneficial effects on insulin resistance and many other components of MetS.     

Chemerin is associated with inflammatory markers and metabolic syndrome phenotypes in hypertension patients

Background: Chemerin is a new adipokine elevated in states of obesity and metabolic syndrome. In order to identify the role of chemerin in hypertension, we conducted a case--control study to evaluate the role of chemerin in hypertension.

Methods: Two hundred and thirty-seven new-diagnosed essential hypertensive (EH) patients and one hundred and ten normotensive healthy subjects (NT) were enrolled. After an overnight fasting, participants underwent an oral glucose-tolerance test (OGTT). Anthropometric measurements and serum analyses were checked, including body mass index (BMI), waist circumference, insulin, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol, glucose, chemerin, hs-CRP, TNF-α and IL-6.

Results: Compared with healthy controls, subjects with hypertension had significantly higher chemerin serum levels (p?p?p?=?0.289).

Conclusions: Chemerin is strongly associated with markers of inflammation and components of the metabolic syndrome in hypertensive subjects and was independently associated with hypertension after adjustment for age, gender and metabolic risk factors.     

Exercise reduces plasma levels of the chemokines MCP-1 and IL-8 in subjects with the metabolic syndrome.

AIMS: Inflammation plays an essential role in the atherosclerotic process, and chemokines such as monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) seem to play a pivotal role in the pathogenesis of atherosclerosis. A possible common inflammatory basis for the pathogenesis of type 2 diabetes, metabolic syndrome and atherosclerosis has been suggested. In this study we investigated the effect of physical exercise and the HMG-CoA reductase inhibitor pravastatin on peripheral markers of inflammation in subjects with the metabolic syndrome. METHODS: The study was an unmasked randomized 2x2 factorial trial of 12 weeks duration. RESULTS: In the combined exercise groups there was a significant reduction in MCP-1 and IL-8 of 48 pg/ml (P=0.04) and 1.0 pg/ml (P=0.007), respectively, as compared to the combined non-exercise groups. There was also a significant reduction vs baseline of 50 pg/ml (33%) (P=0.002) and 0.35 pg/ml (13%) (P=0.03) for MCP-1 and IL-8, respectively. Changes in MCP-1 were significantly correlated to changes in visceral fat (r=0.41, P=0.02). CONCLUSION: The protective effect of exercise might in part be due to suppression of the inflammatory process.     

西洛他唑对OLETF大鼠胰岛素敏感性的影响

目的　探讨西洛他唑对自发 2型糖尿病的动物模型OLETF大鼠胰岛素敏感性的影响。　方法　将雄性OLETF大鼠在 32周龄时根据体重及胰岛素耐量试验中 5 0min血糖下降百分率随机分成三组 :正常喂养组 ,罗格列酮治疗组及西洛他唑治疗组 ,每组 7只鼠。测给药 2 9d后的血脂水平 ;给药 38d后测空腹血糖 ,以正常血糖高胰岛素钳夹技术对以上各组进行胰岛素敏感性评价。　结果　西洛他唑组血甘油三酯水平 ( 1.95± 0 .19mmol/L)较对照组 ( 3.11± 0 .32mmol L)降低 (P <0 .0 1) ;胆固醇 ( 1.32± 0 .17mmol/L)较对照组 ( 2 .2 6± 0 .17mmol/L)降低 (P <0 .0 1) ;游离脂肪酸 ( 0 .46± 0 .11mmol/L)较对照组 ( 1.5 3± 0 .35mmol/L)降低 (P <0 .0 5 ) ;葡萄糖输注速率 ( 11.0 4±1.12mg·kg- 1 ·min- 1 )较对照组 ( 7.33± 1.12mg·kg- 1 ·min- 1 )增加 (P <0 .0 1) ;空腹血糖 ( 6 .1± 0 .7mmol/L)较对照组 ( 7.87± 1.2 3mmol/L)有所下降 ,但差异无显著意义 (P >0 .0 5 )。　结论　西洛他唑能改善OLETF大鼠的胰岛素敏感性。     

代谢综合征患者空腹血清游离脂肪酸水平与胰岛素抵抗的关系

目的　探讨代谢综合征 (MS)患者空腹血清游离脂肪酸 (FFAs)水平与胰岛素抵抗的关系。方法　用发色底物法测定 60例MS患者及 2 0名正常人 (对照组 )的空腹血清FFAs浓度 ,比较两组间空腹血清FFAs水平及胰岛素敏感指数 (ISI)的差异 ;并将空腹血清FFAs水平及MS的其他特征性参数分别与ISI作相关性分析。结果　MS患者空腹血清FFAs水平为 ( 60 7.1± 2 17.8)μmol/L ,显著高于对照组 (P <0 .0 1) ;ISI为 -4 .5 8± 0 .49,显著低于对照组 (P <0 .0 1)。MS患者的ISI与FFAs呈显著负相关 (P <0 .0 5 ,r =-0 .3 2 9) ;ISI亦与BMI呈负相关。结论　代谢综合征患者空腹血清FFAs水平升高 ,并可间接反映胰岛素抵抗程度