Role of adiponectin and PBEF/visfatin as regulators of inflammation: involvement in obesity-associated diseases

Obesity and obesity-related disorders play an important role in clinical medicine. Adipose tissue, with its soluble mediators called adipocytokines, has emerged as a major endocrine organ. These adipocytokines comprise many mediators such as adiponectin, PBEF (pre-B-cell-enhancing factor)/visfatin, leptin, resistin, retinol-binding protein-4 and others. They play major roles in key aspects of metabolism, such as insulin resistance, fatty acid oxidation, inflammation and immunity. Adiponectin, a prototypic adipocytokine, is of importance in the regulation of insulin resistance, as circulating levels are decreased in obesity and diseases associated with insulin resistance. Besides its major role in regulation of insulin sensitivity, recent evidence suggests potent anti-inflammatory functions for adiponectin. These effects are paralleled by other immune-regulatory properties, such as regulation of endothelial cell function. The in vitro effects of adiponectin have been corroborated by several studies demonstrating potent in vivo anti-inflammatory effects. Many other adipocytokines, such as PBEF/visfatin, leptin, resistin or retinol binding protein-4, are involved in the physiology and pathophysiology of adipocytes, adipose tissue and related diseases. PBEF/visfatin, another recently characterized adipocytokine, has been linked to several inflammatory disease states beyond insulin resistance, such as acute lung injury or inflammatory bowel diseases. It has been recognized for many decades that obesity is accompanied by an increase in cancer and potentially some immune-mediated diseases. Understanding this new exciting world of adipocytokines will be of importance in the development of novel therapies for obesity-associated diseases.     

珠蛋白生成障碍性贫血患者中葡萄糖-6-磷酸脱氢酶活性的调查

目的 研究不同类型珠蛋白生成障碍性贫血(简称地贫)患者中葡萄糖-6-磷酸脱氢酶(G6PD)的活性.方法 采用G6PD活性定量测定,血常规和血清铁蛋白检测对人群进行初筛,同时采用全自动琼脂糖凝胶电泳检测初筛人群的α-地贫以及β-地贫类型,并对其G6PD活性值进行相关统计学分析.结果 健康人群、单纯缺铁性贫血、缺铁性贫血合并地贫、轻型α-地贫、轻型β-地贫、重型β-地贫、血红蛋白H(HbH)病以及α-地贫合并β-地贫各组间G6PD活性差异有统计学意义(P<0.05).结论 各类型地贫患者的G6PD活性有不同程度的升高,对地贫的辅助诊断有一定的价值.     

Relationships between serum adiponectin, leptin, resistin, visfatin levels and bone mineral density, and bone biochemical markers in Chinese men

BACKGROUND: Adiponectin, leptin, resistin, and visfatin, as the main circulating peptides secreted by adipose tissue, are potential contributors to bone metabolism. We investigated whether these serum adipocytokines levels are associated with BMD and bone turnover biochemical markers in 232 Chinese men (20-80 y). METHODS: Serum adiponectin, leptin, resistin, and visfatin levels were determined by ELISA. RESULTS: Leptin had a positively correlation with fat mass, and remained significant after adjustment for age and BMI. There was a significant negative weak correlation between adiponectin and fat mass, and disappear after adjustment for age and BMI. Resistin and visfatin were not significantly correlated with fat mass. In the multiple linear stepwise regression analysis, lean mass and adiponectin, but not leptin, resistin and visfatin, were independent predictors of BMD. The significant positive correlations between adiponectin and bone-specific alkaline phosphatase (BAP), bone cross-linked N-telopeptides of type collagen (NTX) were found, and remained significant after adjustment for age and fat mass. CONCLUSIONS: Adiponectin was an independent predictor of BMD in Chinese men, and positively correlated with bone turnover biochemical markers. It suggested that adiponectin exert a negative effect on bone mass in men.     

Hemoglobinopathies in India--clinical and laboratory aspects

β-thalassemia is the most common autosomal recessive genetic disorder in India with a mean carrier frequency of 3.3%, and 7500 to 12,000 children with β-thalassemia major are born every year. Subjects with thalassemia trait, also known as carriers, have low mean corpuscular volume, low mean corpuscular hemoglobin, and increased hemoglobin A2 (>4%). Patients with β-thalassemia major have severe anemia and require blood transfusions by 1 year of age, whereas β-thalassemia intermedia patients have mild to moderate anemia and in most cases require no or infrequent blood transfusions. Genotype/phenotype correlation is helpful for the prediction of the phenotype, and deciding treatment options for β-thalassemia patients. Genetic analyses include determining the type of β-globin gene mutation, co-inheritance of α-globin gene deletions/duplications, and Xmn1 polymorphism in γ gene. Success of a β-thalassemia control program depends on prospective carrier screening followed by genetic counseling and prenatal diagnosis.     

Serum levels of leptin, adiponectin and resistin are interrelated and related to total antioxidant capacity, free fatty acids and phospholipids in early neonatal life

ObjectivesThe aims of this study were to determine interrelationships between serum leptin, adiponectin and resistin, insulin-like growth factor-1 (IGF-1), total antioxidant capacity (TAC), non-esterified fatty acids (NEFA) and phospholipids concentrations in infants.Design and methodsA cross-sectional study was conducted to assess serum levels of leptin, adiponectin, resistin, IGF-1, TAC, NEFA and phospholipids in 45 breast-fed infants enrolled at 4–30 days after birth.ResultsSerum leptin and adiponectin concentrations were positively correlated. Serum resistin concentrations were inversely correlated to serum leptin and adiponectin concentrations. Serum TAC was positively correlated to serum leptin and adiponectin, and inversely to serum resistin concentrations. Serum adiponectin concentrations were positively related to serum NEFA and phospholipid concentrations. Serum resistin concentrations were inversely related to serum NEFA, and phospholipid concentrations.ConclusionThese data show that circulatory levels of leptin, adiponectin and resistin are interrelated and they apparently interact with the anti-oxidant system of infants.     

Assessment of lung function by spirometry in transfusion-dependent thalassemia patients in a tertiary care center in Sultanate of Oman

Introductionβ-thalassemia’s are hereditary chronic hemolytic diseases, the mainstay of treatment of thalassemia major is regular blood transfusion and iron chelation. They cause many complications, one of the recognized complications related to respiratory system is pulmonary hypertension. Respiratory functions in those patients are not well studied in most of the world. The studies done to assess respiratory function are inconsistent, some found a predominantly restrictive pattern, others found obstructive pattern, and few found normal spirometry. The aim of this study was to assess the spirometric patterns in asymptomatic Omani patients with transfusion-dependent thalassemia using spirometry studies.MethodsTransfusion-dependent thalassemia patients who are registered at Sultan Qaboos University Hospital who are > 15 years old and able to perform spirometry test were selected for the study after they signed the informed consent. All the patients were free of any respiratory disease. Spirometry was performed in all patients in the sitting position and FVC, FEV1, FEV1/FVC were obtained.ResultsTotal number of thalassemia patients enrolled in the study was 37. 32 patients are suffering from thalassemia major and 5 are suffering from thalassemia intermedia. The mean age of our patients was 29.95 years. We found that 37.8 % of the patients showed normal spirometry. Most patients had abnormal spirometry (62.1 %). Of these, 35.1 % showed a restrictive pattern while 27 % showed obstructive pattern.ConclusionSpirometry assessment of the lung function in thalassemia patients who are receiving regular transfusion showed that majority had abnormal spirometry results despite being asymptomatic from a respiratory point of view.     

Genotyping of blood groups in alloimmunized patients with β-thalassemia major by T-ARMS-PCR and multiplex-aso-pcr

IntroductionBeta-thalassemia major is a severe hemolytic anemia requiring life-long blood transfusion. Planned random donor blood transfusion is associated with alloimmunization against incompatible antigens. Determination of the minor blood group systems phenotype or genotype, and administration of the compatible blood components can significantly reduce the rate of alloimmunization.The present study aimed to determine the prevalence of alloimmunization, and genotype/phenotype characteristics of the minor blood groups systems in patients with β-thalassemia major.Material and methodsThis study was conducted on 1147 β-thalassemia major patients. Initially, antibody screening and antibody identification were performed. Then, phenotyping and genotyping for the Rh, Kell, Kidd, and Duffy blood groups were done in alloimmunized patients using monoclonal antibodies and Multiplex-Allele Specific Oligonucleotide-Polymerase Chain Reaction (Multiplex-ASO-PCR) and Tetra-primer amplification refractory mutation system–PCR (T-ARMS-PCR), respectively. Any phenotype/genotype discrepancy was assessed by direct sequencing.ResultsNinety-seven (8.5 %) out of 1147 patients had alloantibodies against the minor blood group antigens (44 males, 45.4 %, and 53 female, 54.6 %). The most common alloantibodies were against the RH (n: 47, 48.5 %), and the Kell (n: 23, 23.7 %) blood groups systems. Twenty-three (2.1 %) genotype/phenotype discrepancies out of 1067 tests, including 9 in the Rh (9.3 %), 8 in Duffy (34.8 %), and 6 in Kidd (26.1 %) blood groups were detected. No discrepancy was found in the Kell blood group system. Direct sequencing revealed that the results of molecular methods were correct.ConclusionMultiplex-ASO-PCR and T-ARMS-PCR molecular methods are fast, reliable and cost-benefit molecular methods for the minor blood group genotyping in multi-transfused β-thalassemia major patients.     

Impact of antiretroviral therapy on visfatin and retinol-binding protein 4 in HIV-infected subjects

Background To determine circulating levels of adipocytokines, especially the recently characterized visfatin, and the fat‐derived factor retinol‐binding protein‐4 (RBP‐4) in HIV‐infected subjects and their respective changes following treatment with highly active antiretroviral therapy (HAART). Materials and methods Fourteen HIV‐positive, HAART‐naïve subjects were compared with 10 HIV‐negative healthy controls and reassessed after a 1‐year treatment with HAART. Plasma visfatin and RBP‐4 were determined by ELISA, whereas leptin and adiponectin by RIA. Body composition was measured with dual X‐ray absorptiometry (DXA). Homeostasis model assessment (HOMA‐IR) was assessed using insulin and glucose levels. Results Visfatin and RBP‐4 levels in HIV‐positive subjects were comparable with those of HIV‐negative controls before treatment with HAART. Treatment with HAART for 12 months resulted in a 6·9‐fold and 7·1‐fold increase of visfatin and RBP‐4 levels (+54·0 ± 9·7 ng mL^?1, P < 0·0001 and +95·3 ± 31·7 ng mL^?1, P < 0·01), respectively. Leptin (?2·7 ± 1·6 ng mL^?1, P = 0·054) was unchanged and adiponectin (?2·8 ± 0·7 µg mL^?1, P < 0·01) decreased. Changes of visfatin concentrations correlated significantly with the increases of RBP‐4 (r = 0·78, P = 0·001), fat‐free mass (FFM, r = 0·75, P < 0·05) and change of HOMA‐IR (r = 0·64, P < 0·05). Parameters of glucose metabolism and body fat mass were unchanged during the observation period. Conclusions Treatment with HAART induced a pronounced increase of plasma visfatin and RBP‐4 as well as a decrease of adiponectin in HIV‐infected patients on HAART. Although body weight, fat mass and parameters of glucose metabolism remained stable, the changes in the adipocytokines might herald subsequent alterations of these parameters.     

Newborn screening for hemoglobinopathies using capillary electrophoresis technology: Testing the Capillarys® Neonat Fast Hb device

ObjectivesTo diagnose hemoglobinopathies in newborns by separating and measuring the Hb fractions on high throughput capillary electrophoresis. To test and validate the Capillarys Neonat Fast Hb device (Sebia) on fresh and dry blood samples.Design and methodsThe Hb fractions in 1.600 cord blood samples from the multi ethnic Dutch population were separated and measured. Further, the sensitivity, specificity and reproducibility of the device in detecting abnormalities and measuring the Hb fractions were estimated.ResultsThe apparatus separated all significant Hb fractions that should be detected during newborn screening (NBS) with 100% sensitivity. The reproducibility of the migrations guaranteed putative specificity for the few relevant frequent variants observed (HbS, C, and E). The estimation of the HbA and F fractions proved reliable using a well-designed integration mode.DiscussionDue to the limited number of samples no cases with sickle cell disease or β-thalassemia major were found in this cohort. However, the heterozygous state for the common variants associated with these diseases was clearly recognizable. The measurements were sufficiently precise to recognize sickle cell disease, β-thalassemia major and intermedia and to identify carriers including possible β-thalassemia. Therefore, Capillarys Neonat Fast Hb (Sebia) can be considered as a valid instrument for NBS of the Hemoglobinopathies on fresh and dry blood samples.     

Prognostic significance of adipocytokines and extracellular matrix activity in heart failure patients with high B-type natriuretic peptide

ObjectivesTo perform risk stratification by serum adipocytokines and serum markers of extracellular matrix in heart failure patients with high b-type natriuretic peptide (BNP).MethodsPatients with heart failure were enrolled in this study. Serum adipocytokines and serum markers of extracellular matrix were analyzed.ResultsIn total, 131 patients were enrolled and followed-up for 240 ± 174 days. Mortality was significantly associated with adiponectin, resistin, type III amioterminal propeptide of procollagen (PIIINP), matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase 1 (TIMP-1), and serum creatinine. Heart failure-related admission was significantly associated with apelin, and PIIINP. Cox regression analysis identified that mortality and heart failure-related admissions were significantly associated with MMP-2 (P = 0.008) and PIIINP (P = 0.011), respectively.ConclusionsSerum markers of extracellular matrix rather than adipocytokines may warrant further risk stratification for impacting the prognosis of patients with heart failure with high BNP.     

Effect of rosiglitazone on visfatin and retinol-binding protein-4 plasma concentrations in HIV-positive patients

Thiazolidinediones (TZD) may improve insulin resistance in patients with diabetes and HIV. The novel adipocytokines visfatin and retinol-binding protein-4 (RBP-4) have been proposed to influence the development of impaired glucose tolerance. The impact of TZD on these cytokines is yet unknown. In this randomized, double-blind, placebo-controlled parallel group study, 37 lean HIV-positive subjects aged 19-50 years were treated with 8 mg/day rosiglitazone (n=20) or placebo (n=17) for 6 months. Insulin sensitivity was estimated from the homeostasis model assessment (HOMA) index. Fasting visfatin, RBP-4, leptin, and adiponectin plasma concentrations were analyzed by immunoassays. Rosiglitazone had no effect on impaired insulin sensitivity, but increased median plasma visfatin from 6.2 ng/ml (95% CI: 5.9; 6.5) to 13.7 ng/ml (12.6; 19.1) (P<0.001) and adiponectin from 3.2 ng/ml (2.2; 4.0) to 4.0 ng/ml (3.3; 8.5; P<0.001). RBP-4 was lowered from 21.0 ng/ml (19.6; 23.1) to 16.3 ng/ml (15.2; 17.0; P<0.001), and leptin concentrations were unchanged. Adipocytokine concentrations were stable in subjects receiving placebo, where a deterioration in insulin sensitivity was detectable (P<0.05). Changes in visfatin and RBP-4 were correlated in subjects receiving rosiglitazone (r=-0.64, P<0.01) but not placebo (r=0.12, P=0.15). TZD treatment affects circulating adipocytokine concentrations in subjects with HIV. Reductions in RBP-4 and increases in visfatin may contribute to the pharmacodynamic action of TZD on glucose homeostasis. Quantification of adipocytokines might be useful to assess TZD treatment effectiveness in insulin-resistant subjects with HIV.     

中间型β地中海贫血家系基因分子生物学特征分析

目的 分析在中国人群中发现的中间型β地中海贫血家系的分子生物学特征.方法 表型检测采用标准的血液学分析技术测量RBC参数,采用高效液相色谱方法检测Hb组分.采用反向斑点杂交技术诊断β地中海贫血基因突变,利用跨越断裂点PCR技术(gap-PCR)扩增断裂点基因序列并进行测序分析.结果 先证者Hb浓度为86 g/L,属中间型地中海贫血表型.先证者父亲呈典型的小细胞低色素改变,平均红细胞容积(MCV)为63.7 fl,平均红细胞血红蛋白量(MCH)为20.4 pg,均降低;血红蛋白A2(HbA2)增加,属地中海贫血杂合子表型.而先证者母亲、外祖母和妹妹的MCV及MCH均正常,但胎儿血红蛋白(HbF)较高,HbF分别为28.3%、21.1%及33.7%,属于胎儿血红蛋白持存综合征(HPFH)杂合子表型.进一步的基因分析表明,先证者为β441-42/HPFH-6基因型的中间型地中海贫血患儿,其父母基因型分别为β41-42/βN和HPFH-6杂合子.其外祖母和妹妹均为HPFH-6杂合子.结论 发现1例β41-42/HPFH-6中间型地中海贫血病例,可为产前诊断提供可借鉴的临床经验.     

Elevated visfatin levels in overweight and obese children and adolescents with metabolic syndrome

Abstract

Objective: Adipokines have been implicated in the pathogenesis of metabolic syndrome (MetS) and insulin resistance. We investigated the association between these conditions and serum levels of visfatin, adiponectin and leptin. Material and methods: 175 overweight and obese boys and girls aged 3–17 years. MetS was defined as presence of at least three of the following: triglycerides ≥ 1.24 mmol/L, high-density lipoprotein cholesterol ≤ 1.03 mmol/L, fasting glucose ≥ 6.1 mmol/L, elevated waist circumference and systolic or diastolic blood pressure ≥ 90th percentile. Results: After adjustment for age and gender visfatin levels were significantly higher (median 19.0 [25th, 75th percentiles 11.9 , 37.1] vs. 15.2 [11.6 , 21.1] ng/ml; p_adjusted = 0.02) in subjects with MetS (n = 41) compared to subjects without (n = 134). There were no significant differences in adiponectin or leptin levels between the two groups after adjustment for age and gender. Visfatin levels increased proportionally with number of MetS components (β = 0.16, 95%CI 0.04, 0.28; p_adjusted = 0.01), and adiponectin levels decreased proportionally with number of components (β = ?0.11, 95%CI ?0.18, ?0.04; p_adjusted = 0.002). Leptin levels were not related to number of components of MetS. Unlike visfatin, both adiponectin (β = ?0.24, 95%CI ?0.33, ?0.15; padjusted < 0.001) and leptin (β = 0.14, 95%CI 0.01, 0.28; padjusted = 0.03) were associated with insulin resistance. Conclusion: The elevation of visfatin observed in children and adolescents with MetS was proportionate to number of components of MetS but was not associated with insulin resistance. The increase in visfatin may contribute to low-grade systemic inflammation associated with MetS.     

Prognostic significance of adipocytokines in systolic heart failure patients

Eur J Clin Invest 2012; 42 (10): 1079-1086 ABSTRACT: Objectives The goal of this study was designed to assess prognostic values of simultaneous measurement of adipocytokines in systolic heart failure (HF) patients. Methods Patients with HF manifestations and left ventricular ejection fraction (LVEF)?≤?50% were selected in this study. Gender, age, medications and serum biochemical data were recorded upon admissions. Adipocytokines including adiponectin, leptin, resistin, visfatin and retinol binding protein-4 were measured. Results A total of 108 (83 males and 25 females) patients were enroled. The age was 62?±?15?years and mean LVEF was 35%. Twenty patients died during 776?±?323?days follow-up. In univariate analysis, mortality was found to be associated with the log-transformed values of serum resistin (β?=?5·616, P?=?0·04), log-transformed values of serum adiponectin (β?=?4·377, P?=?0·038), age (β?=?1·071, P?相似文献   

Plasma adiponectin levels are associated with left ventricular hypertrophy in a random sample of middle-aged subjects

Abstract

Background. A low adiponectin level is associated with high blood pressure which, in turn, often results in left ventricular hypertrophy. We evaluated the association between plasma adiponectin concentrations and echocardiographic measurements, including left ventricular mass index (LVMI), in 933 middle-aged subjects consisting of 453 hypertensives and 480 controls.

Methods. Plasma adiponectin concentrations were measured with an enzyme-linked immunosorbent assay (ELISA) method. One experienced cardiologist performed echocardiographic examinations, and LVMI was calculated according to Devereux’s method.

Results. Low plasma adiponectin levels were independently associated with increased intraventricular septum thickness, posterior ventricular wall thickness, and left ventricular mass index (P<0.001) in the whole cohort. In the subgroup analysis, the association between these echocardiographic parameters and adiponectin concentrations was observed only in the hypertensive cohort although fractional shortening revealed an association with adiponectin levels also in the control cohort (P=0.021). Findings remained significant after adjustment for the major risk factors for LVMI, such as age, sex, smoking, and systolic blood pressure.

Conclusions. This study in a large population sample detected an association between low plasma adiponectin concentration and LVMI, a marker of left ventricular hypertrophy. This association may be one of the factors that could explain the reported increased cardiovascular risk in subjects with low adiponectin levels.     

Peptide hormones and risk for future cardiovascular events among prediabetics: a 20-year follow-up in the OPERA study

Abstract

Background: Prediabetes has proven to have many unfavourable impacts on the cardiovascular system.

Methods: The OPERA (Oulu Project Elucidating Risk of Atherosclerosis) study included 1045 middle-aged subjects followed from the years 1990–1993 to 2014. The focus was on peptide hormones.

Results: Plasma resistin levels were higher among prediabetics (p?=?.001), particularly impaired glucose tolerance (IGT) (p?<?.001), but not impaired fasting glucose (IFG) patients than among normal glucose tolerance (NGT) or diabetes groups. Diabetics showed lower resistin levels than IGT subjects (p?<?.001). IGT or diabetes groups showed lower adiponectin and higher leptin levels compared to the NGT group (p?<?.001). The IFG group had the highest blood pressure and left ventricular mass index, even higher than the diabetic group. Diabetics had the highest, prediabetics (IFG?+?IGT) intermediate and NGT the lowest risk for CVD events during follow-up (p?<?.001). Among prediabetics, high plasma ghrelin was an independent predictor of CVD events (p?<?.05) in the Cox regression analysis although it did not significantly improve either classification or discrimination of the patients.

Conclusions: Among glucose tolerance groups, patients with IGT had the highest resistin, but equally high leptin and low adiponectin levels as diabetics. Among prediabetics, ghrelin seems to predict independently cardiovascular events in the long term.

• KEY MESSAGE

• Among glucose tolerance groups, patients with IGT had the highest resistin, but equally high leptin and low adiponectin levels as diabetics.

• Among prediabetics, ghrelin seems to predict independently cardiovascular events in the long term.

     

Reference intervals for HbA2 and HbF and cut-off value of HbA2 for β-thalassemia carrier screening in a Guizhou population of reproductive age

ObjectiveThe aims of this study were to establish the reference intervals for HbA2 and HbF in a Guizhou population of reproductive age, and to determine the cut-off value of HbA₂ for β-thalassemia carrier screening.MethodsHemoglobin analysis was performed on 832 individuals without hypochromic microcytic anemia to calculate the reference intervals for HbA₂ and HbF. Three hundred and ninety one β-thalassemia carriers and non β-thalassemia individuals were analyzed for their HbA₂ levels followed by detecting β-globin gene mutations, then cut-off value of HbA₂ for β-thalassemia carrier screening was determined using ROC curve analysis.ResultsThe reference interval for HbA₂ in overall normal individuals was 2.3%–3.1%, and reference intervals for HbF in normal males and females (including normal females and pregnant women) were 0–0.5% and 0–1.0% respectively. The cut-off values of HbA₂ for β-thalassemia carrier screening in males, non-pregnant women, pregnant women and the overall set were 4.40%, 3.75%, 3.70% and 3.95% respectively.ConclusionGender and pregnancy status had no obvious influence on reference interval for HbA₂. The HbF level was higher in females than in males, but pregnancy status had no obvious influence on HbF level. Cut-off value of HbA₂ for β-thalassemia carrier screening was obviously affected by gender but not by pregnancy status.     

β-地中海贫血复合α-地中海贫血同时合并葡萄糖6磷酸脱氢酶缺陷症242例血液学分析

目的 分析广东地区β-地中海贫血复合α-地中海贫血同时合并葡萄糖6磷酸脱氢酶（G6PD）缺陷症的检出率及其血液学特点。方法 对2006年11月至2009年5月经金域医学检验中心基因诊断室通过地中海贫血基因确诊的242例β-地中海贫血复合α-地中海贫血[GAP-PCR法检测α-Thal基因;反向点杂交（RDB）法检测β-Thal基因]通过G6PD/6-磷酸葡萄糖酸脱氢酶（6PGD）两个酶的活性直接比值（定量比值法）来正确判断G6PD是否缺乏,并进行血液学分析。结果 242例β-地中海贫血复合α-地中海贫血当中检测出21例G6PD缺陷症,占8.7%（21/242）,β-地中海贫血复合α-地中海贫血同时又合并G6PD缺陷症患者与单纯β-地中海贫血复合α-地中海贫血的各项红细胞参数比较,差异无统计学意义（P＞0.05）。结论 广东是地中海贫血和G6PD缺陷症的高发区,β-地中海贫血复合α-地中海贫血同时又合并G6PD缺陷症与单纯β-地中海贫血复合α-地中海贫血的血液学表现相似。育龄妇女做地中海贫血检查同时应进行G6PD/6PGD比值法测定,可使部分地中海贫血合并G6PD缺陷女性杂合子避免漏诊。     

广东省茂名地区地中海贫血基因型分析

目的研究广东省茂名地区α和β地中海贫血基因型分布特征。方法对2009年4月至2013年6月本院检验科遗传学实验室检测的2198例地中海贫血基因诊断结果进行分析。其中α-地中海贫血采用跨越断裂点PCR（Gap—PCR）基因诊断技术,β-地中海贫血采用PCR结合反向点杂交RDB（PCR-RDB）方法。结果2198例地中海贫血标本中,检测出缺失型α-地贫l083例．最常见的基因类型是-SEA/αα;检验出β-地贫622例,共有11种基因型,最常见的基因型是CD41／42（-TCTT）,其次是IVS—II-654（C〉T）;检出p复合仅地贫基因84例。结论茂名地区α缺失型地贫以-SEA/αα为主;β-地贫突变类型排在前四位的是CD41／42（-TCTT）、IVS-Ⅱ-654（C〉T）、-28（A〉G）和CD17（A〉T）;β复合α地贫基因检出率为13．5％。本研究为茂名地区制定人群筛查地中海贫血预防计划和遗传咨询、产前诊断提供了有价值的基础资料;基因检测对于地中海贫血的临床诊断、治疗和预防有重的意义。     

Association of visceral and subcutaneous fat with glucose intolerance, insulin resistance, adipocytokines and inflammatory markers in Asian Indians (CURES-113)

Objectives:

The aim of the study was to assess the association between visceral and subcutaneous fat with glucose intolerance, adipocytokines, inflammatory markers and carotid IMT in Asian Indians.

Design and methods:

Subjects with NGT (n = 85), IGT (n = 49) and T2DM (n = 93) were randomly selected from CURES. Total abdominal, visceral and subcutaneous fat were measured using Helical CT scan. Adiponectin, hs-CRP, TNF-alpha, oxidized LDL, visfatin and leptin and IMT and insulin resistance were assessed.

Results:

Total abdominal fat (p = 0.041) and the visceral fat (p = 0.039) but not subcutaneous fat progressively increased from NGT, IGT and T2DM subjects. With increasing quartiles of visceral fat, there was a significant increase in insulin resistance (p = 0.040); significant decrease in adiponectin (p = 0.043) and increase in TNF-alpha (p = 0.028), hs-CRP (p = 0.043), OX-LDL (p = 0.034) and visfatin (p = 0.040), and carotid IMT (p = 0.047) was observed.

Conclusion:

Visceral fat levels increased with increasing glucose intolerance and are associated with decreased levels of adiponectin and increased levels of hs-CRP, TNF-alpha, oxidized LDL, visfatin, HOMA-IR and IMT.