人类皮下和网膜脂肪组织脂肪细胞因子的表达

目的 探讨脂肪细胞因子在成人皮下和网膜脂肪组织中的表达水平。方法 应用即刻定量PCR方法测定16例成人皮下和网膜脂肪组织中瘦素、脂联素、肿瘤坏死因子α（TNF-α）和抵抗素的表达水平。结果 正常体重组和超重组皮下脂肪组织瘦素mRNA水平均明显高于网膜组织（P〈0．01）;正常组网膜脂肪组织脂联素mRNA水平较皮下组织有升高趋势（P=0．07）;TNF-α和抵抗素mRNA表达水平低下且无显著部位差异。无论皮下或网膜脂肪组织瘦素表达水平均与体重指数（BMI）成正相关（皮下：r=0．68,P〈0．01;网膜：r=0．71,P〈0．01））,而网膜脂肪组织脂联素表达与BMI呈明显负相关（r=-0．60,P〈0．05）。结论 基因编码的一些细胞因子在脂肪组织中的表达呈部位特征,肥胖时皮下和网膜脂肪组织瘦素过度表达,而内脏脂肪组织脂联素表达下调,这可能是肥胖相关的胰岛素抵抗发生的潜在危险因素。     

肥胖高血压病患者瘦素水平与代谢紊乱的关系

目的探讨肥胖高血压病患者血清、脂肪组织中瘦素水平与肥胖、高血压、血脂紊乱、胰岛素抵抗等代谢紊乱的关系。方法选取腹部手术患者48例为研究对象，肥胖高血压痛患者（肥胖高血压组）及单纯肥胖患者（单纯肥胖组）各24例，测定血压、体质指数、腰围臀围、血脂、空腹血糖、空腹胰岛素以及血清和大网膜脂肪组织瘦素水平。结果肥胖高血压组患者的血清瘦素、甘油三酯、空腹胰岛素、空腹血糖均显著高于单纯肥胖组（P〈0．01），血清胰岛素敏感指数、高密度脂蛋白显著低于单纯肥胖组（P〈0．01）。肥胖高血压组患者大网膜脂肪组织瘦素水平与单纯肥胖组无统计学意义（P〉0．05）。血清瘦素与性别、体质指数、腰臀比、收缩压和舒张压、空腹胰岛素、空腹血糖呈显著正相关。脂肪组织瘦素水平与上述指标均无统计学意义（P〉0．05）。结论血清瘦素水平与肥胖程度、血压、胰岛素抵抗存在相关性；脂肪组织瘦素水平与血清瘦素水平、肥胖高血压患者的代谢紊乱无明显关联。     

超重人群皮下和网膜脂肪组织中脂联素基因表达的研究

目的:探讨脂联素(APN)在皮下(SC)和网膜(OM)脂肪组织中的mRNA表达水平与肥胖的关系。方法:实时荧光定量PCR法检测48例超重[体质量指数(BMI)≥25kg/m2)]和40例正常体质量人群(BMI<25kg/m2)腹部SC和OM脂肪组织中APN mRNA的表达,并测定血糖、胆固醇和HOMA-IR等生化指标。结果:在整体人群中,OM脂肪组织APN mRNA表达量均明显高于SC脂肪组织(P<0.05);OM脂肪组织APN mRNA表达量与BMI、腰臀比(WHR)和胆固醇(TC)水平呈负相关(r分别为-0.249、-0.143、-0.148,P<0.05);SC脂肪组织APN mRNA表达量与BMI、WHR、TC和三酰甘油(TG)水平呈负相关(r分别为-0.281、-0.180、-0.247、-0.172,P<0.05),并与同一个体的OM脂肪组织APN mRNA表达量呈正相关(r=0.192,P<0.05)。结论:APN的基因表达量内脏高于外周,提示循环APN可能主要来源于内脏脂肪组织。     

妊娠期糖尿病患者网膜脂肪和肌肉组织GLUT4水平的研究

目的探讨妊娠期糖尿病（GDM）患者网膜脂肪组织与腹直肌葡萄糖转运蛋白4（GLUT4）表达的差异及其与胰岛素抵抗（IR）的关系。方法逆转录-聚合酶链反应（RT-PCR）检测23例GDM（GDM组）、21例正常孕妇（NGT组）网膜脂肪组织与腹直肌GLUT4mRNA的表达水平,测量空腹血糖（FPG）、空腹胰岛素（FINS）等指标,并计算胰岛素抵抗指数（HOMA-IR）值。结果2组腹直肌GLUT4mRNA表达量均高于对应组的网膜脂肪（P〈0.05）;GDM组网膜脂肪GLUT4mRNA表达量低于NGT组（P〈0.05）;2组腹直肌GLUT4mRNA表达量比较差别无统计学意义（P〉0.05）。网膜脂肪GLUT4mRNA表达量与孕前BMI、孕前腰臀比、FPG、FINS、HOMA-IR呈负相关（P〈0.05）;腹直肌GLUT4mRNA表达量与孕前BMI、孕前腰臀比、FPG、FINS、HOMA-IR均无相关性（P〉0.05）。结论在GDM患者网膜脂肪中GLUT4mRNA存在低表达,并且这种低表达可能与IR有关。     

罗格列酮提高胰岛素抵抗大鼠大网膜脂肪细胞PPAR-γmRNA的表达水平

目的观察胰岛素抵抗（IR）大鼠大网膜脂肪细胞过氧化物酶体增生物激活受体γ（PPAR-γ）mRNA的表达水平以及罗格列酮对PPAR-γmRNA表达水平的影响。方法雄性Wism大鼠随机分为空白组、模型组、罗格列酮组。正常组喂以普通饲料。模型组与治疗组注射小剂量STZ并喂以高热量饲料。常规测定各组大鼠治疗前后的空腹血糖（FPG）和治疗后各组大鼠的空腹血清胰岛素水平（FIns）,计算胰岛素敏感性指数（ISI）,测定各组血脂水平。提取大网膜脂肪组织总RNA,采用逆转录PCR技术扩增PPAR-T基因片段,检测其表达水平。结果模型组PPAR-γmRNA表达比正常组明显减少（P〈0．01）。与模型组比较,罗格列酮组PPAR-γmRNA表达显著增加（P〈0．01）。结论R大鼠脂肪细胞PPAR-γmRNA表达减少,而罗格列酮能有效提高PPAR-γmRNA的表达。     

超重人群网膜脂肪组织脂联素mRNA表达水平的性别差异

目的:探讨超重人群网膜(OM)脂肪组织脂联素(APN)mRNA表达水平的性别差异.方法:选取女性超重患者26例(BMI≥25 kg/m2,OBF组)、男性超重患者22例(BMI≥27 kg/m2,OBM组)以及正常体质量者40例(BMI<25kg/m2,女性为NF组,男性为NM组),用TaqMan探针实时荧光定量PCR检测腹部OM脂肪组织中APN mRNA的表达,并测定血糖、血清胆固醇(TC)、血清三酰甘油(TG)、血清胰岛素等指标,计算胰岛素抵抗指数(HOMA-IR).结果:(1)NF组OM脂肪组织APN基因表达量(OAmR)较NM组有升高的趋势,但差异无统计学意义(P>0.05);OBF组OAmR明显高于OBM组(P<0.05),但OBF组APN基因表达量仍低于NF组(P<0.01);(2)OAmR与BMI、腰臀比(WHR)和TC水平负相关(r分别为-0.262、-0.143、-0.149,均P<0.05);超重人群中,OAmR与性别呈正相关(r=0.259,P<0.05).在OBF组中,OAmR与BMI、LDL-C呈负相关(r分别为-0.320、-0.339,P<0.05).结论:女性超重人群OAmR高于超重男性,性别与脂肪组织APN的表达量之间的联系更多的表现在超重人群,体质量适中者则无此关联.     

脂联素在胰岛素抵抗中的作用

目的通过检测脂联素在肥胖及2型糖尿病大鼠腹部脂肪组织中的表达,明确它在胰岛素抵抗中的作用。方法用半定量RT-PCR测定正常、肥胖以及2型糖尿病大鼠内脏脂肪组织中脂联素的表达。结果肥胖及2型糖尿病大鼠脂联素的mRNA表达较对照组显著下降。脂联素与空腹血清胰岛素、血甘油三酯、体重和胰岛素敏感指数负相关。结论脂联素可能在肥胖和2型糖尿病相关的胰岛素抵抗中发挥重要作用。本研究通过对实验性2型糖尿病大鼠以及单纯肥胖大鼠脂肪组织中脂联素表达的分析,探讨它在肥胖及2型糖尿病中所起的作用。     

脂肪细胞雌激素受体的测定及表达水平的研究

目的　研究不同部位的脂肪细胞雌激素受体 (estrogenreceptor ,ER)的表达水平 ,探讨脂肪细胞与雌激素之间的关系。方法　对 64例成人腹部皮下脂肪组织及内脏大网膜脂肪组织 ,应用免疫组织化学法染色并进行图象分析。结果　成人脂肪细胞核内雌激素受体呈阳性反应 ;男性腹部皮下脂肪细胞的ER阳性细胞的光密度高于大网膜脂肪ER阳性细胞的光密度 (P <0 .0 5 ) ;女性的腹部皮下脂肪细胞的ER阳性细胞的光密度与大网膜脂肪组织ER阳性细胞的光密度相比差异无显著性 (P >0 .0 5 )。结论　 ( 1)脂肪细胞的ER免疫阳性反应表达于脂肪细胞的细胞核。 ( 2 )男性的不同部位脂肪细胞的ER表达不同 ,而女性不同部位脂肪细胞ER的表达一致     

中性粒细胞明胶酶相关载脂蛋白与2型糖尿病及肥胖的相关性

目的探讨中性粒细胞明胶酶相关载脂蛋白(Lcn2)与2型糖尿病(T2DM)及肥胖的相关性。方法采用双抗夹心酶联免疫吸附试验检测T2DM正常体重组(A组,42例)、T2DM超重或肥胖组(B组,56例)、正常糖调节正常体重组(C组,40例)、正常糖调节超重或肥胖组(D组,40例)血清Lcn2水平,同时检测空腹胰岛素(FIns)、空腹C肽和血糖、血脂。结果 A组、B组、D组血清Lcn2水平均显著高于C组(P<0.01或P<0.05)。血清Lcn2水平与体重指数、腰臀比、空腹C肽、FIns、胰岛素抵抗指数(HOMA-IR)和甘油三酯呈正相关;与高密度脂蛋白胆固醇呈负相关。HOMA-IR、空腹C肽、甘油三酯是血清Lcn2水平的独立相关因素(P<0.05)。结论超重或肥胖者血清Lcn2水平显著升高,与胰岛素水平、体脂分布、脂代谢相关,提示Lcn2可能参与肥胖及代谢综合征的病理生理过程。     

微RNA-802在肥胖人群脂肪组织中的表达及临床意义

目的 探讨微RNA-802(miR-802)在肥胖人群脂肪组织中的表达情况及临床意义。方法 选择2019年3月至2021年7月在枣庄市三家医院因慢性胆囊结石而需手术治疗的病人102例,其中体质量指数(BMI)≥28 kg/m²有59例作为肥胖组,BMI<24 kg/m²有43例作为非肥胖组。手术过程中取皮下脂肪组织,采用实时荧光定量逆转录PCR(RT-qPCR)检测脂肪组织miR-802相对表达量;比较两组人体学指标、血脂、血糖等临床资料;采用Pearson分析肥胖病人脂肪组织miR-802水平与各指标的相关性。结果 肥胖组、非肥胖组病人性别、年龄及血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平之间比较,差异无统计学意义(P>0.05),肥胖组病人BMI[(31.81±2.43)kg/m²]、腰臀比(WHR)(1.03±0.07)、空腹血糖(FBG)[(10.51±2.71)mmol/L]、空腹胰岛素(FINS)[(16.54±3.26)mU/L]、胰岛素抵抗指数(HOMA-IR)...     

老年肥胖患者血浆抵抗素水平与胰岛素抵抗相关

目的研究抵抗素在老年肥胖患者及健康对照血浆中的平均水平,探讨抵抗素与肥胖及胰岛素抵抗的关系。方法竞争性酶联免疫吸附法检测43例老年肥胖患者及41例对照的空腹血浆抵抗素水平,测量身高、体重、腰围、臀围,计算体重指数（BMI）及腰臀比（WHR）,口服葡萄糖耐量试验（OGTT）测定空腹血浆葡萄糖浓度及胰岛素浓度,计算胰岛素敏感指数（ISI）。结果空腹血浆抵抗素与BMI呈正相关（r=0．23,P〈0．05）,与胰岛素呈负相关（r=-0．34,P〈0．05）,与ISI呈负相关（r=-0．31,P〈0．05）,未发现与血脂、年龄、性别及WHR之间的相关性。结论人类血浆抵抗素与肥胖及胰岛素抵抗相关。     

肥胖症患者脂肪组织中的 SIRT1 mRNA 和蛋白 表达水平及临床意义

目的 探讨肥胖症患者脂肪组织中的沉默信息调节因子 1 （SIRT1）mRNA 和蛋白表达水平及其在肥胖症 治疗中的临床意义。方法 选取接受肥胖治疗的患者 105 例, 以体质量指数 （BMI） 分为肥胖症组 （BMI≥23 kg/m2） 和 对照组 （18.5 kg/m2≤BMI＜23 kg/m2）; 取 2 组患者腹膜脂肪组织。采用实时荧光定量 PCR 法检测 2 组患者脂肪组织 SIRT1 mRNA 表达水平; 采用酶联免疫吸附试验（ELISA）检测脂肪组织 SIRT1 的蛋白表达水平。并分析 2 组 SIRT1 蛋白表达水平与 BMI、 总胆固醇（TC）、 三酰甘油（TG）、 空腹血糖（FPG）、 空腹胰岛素（FINS）以及胰岛素抵抗指数 （HOMA-IR） 的相关性。结果 肥胖症组 SIRT1 mRNA 和蛋白表达水平均低于对照组 （P<0.05）。肥胖症组脂肪组织 中 TC、 TG、 FPG、 FINS 及 HOMA-IR 均高于对照组（P＜0.05）。SIRT1 的蛋白表达水平与总 TC、 TG、 FPG、 FINS 及 HOMA-IR 呈负相关 （r 分别为-0.391、 -0.941、 -0.184、 -0.215 及-0.990, 均 P＜0.05）。结论 肥胖症患者腹膜脂肪组 织中 SIRT1 mRNA 和蛋白表达水平较非肥胖患者均明显下降, 且 SIRT1 蛋白表达水平与肥胖相关指标呈相关性, 对 临床治疗肥胖症具有一定的指导作用。     

Adipose tissue distribution and behaviour of selected gastro-entero-pancreatic hormones, glycaemia, growth hormone and somatomedin C in obese children

Twenty-three boys and 30 girls with simple obesity aged 12-16 years were investigated. The values of insulin, C-peptide, glycaemia, gastrinaemia and pancreatic polipeptide (PP) were measured in a fasting state and 30 and 60 min. after meal--at the beginning and after 3 weeks of reductive diet and physical exercise. The study of growth hormone and somatomedin C was deemed relevant to the issue in hand. Considerably higher insulinaemia and C-peptidemia values accompanied by impaired metabolic clearance of insulin and lowered glucose utilization in children with significant accumulation of adipose tissue in the abdominal area (waist/hip ratio p > 0.95), may constitute a possible predictor for diet-controlled diabetes mellitus and cardiovascular system diseases in adult age. Evaluation of adipose tissue in obese children makes it easier to indicate subjects exposed to complications at a later age. Low-caloric diet and physical exercise bring about a decrease in insulin secretion and an increase in its metabolic clearance. At the same time, glucose assimilation by cells is intensified.     

牛磺酸对胰岛素抵抗大鼠脂肪组织PAI-1mRNA表达的影响

目的 :观察牛磺酸对胰岛素抵抗大鼠的治疗作用。方法 :选择 SD雄性大鼠 ,按体重随机分为正常组和造模组 ,造模组大鼠饲以特殊高脂饲料 30 d,造成胰岛素抵抗动物模型 ;经牛磺酸治疗 30 d后 ,取血检测血糖、胰岛素等指标 ,计算胰岛素抵抗敏感指数。运用 RT- PCR技术测定大网膜脂肪组织 PAI- 1m RNA的表达。结果 :采用特殊高脂饲料可以成功诱导胰岛素抵抗动物模型 ;牛磺酸可提高胰岛素抵抗大鼠胰岛素敏感指数 (P<0 .0 5 ) ,下调脂肪组织PAI- 1m RNA的表达。结论 :牛磺酸具有提高胰岛素敏感性作用 ,以及阻断 PAI- 1m RNA的过度表达的综合效应。     

Effect of weight loss on gelatinase levels in obese mice

1. Gelatinases (matrix metalloproteinase (MMP)-2 and MMP-9) might play a role in the development and structural organization of adipose tissue. Obese mice were subjected to caloric restriction (from 82 to 27 kJ/day) for 6 weeks, in order to investigate the effect of drastic weight loss on gelatinase mRNA, protein and activity levels. 2. Caloric restriction resulted in significantly lower bodyweight, as well as subcutaneous (SC) and gonadal (GON) fat mass (all P < 0.001). 3. The expression of MMP-2 mRNA was significantly upregulated in both SC (3.3-fold) and GON (2.2-fold) adipose tissues; however, without significant effect on total MMP-2 protein levels in fat tissues or in plasma. In contrast, MMP-9 mRNA expression in SC or GON fat was not affected by caloric restriction, whereas protein levels were reduced in SC and GON fat, but not in plasma. Zymography showed significantly elevated levels of active MMP-2 in both SC and GON adipose tissues, whereas active MMP-9 levels were reduced in GON fat. 4. These findings imply that the evaluation of the role of gelatinases in obesity and metabolic disorders requires the determination of both antigen and activity levels in plasma and fat tissues.     

脂肪细胞因子与肥胖和糖尿病的关系

目的 探讨腹脂素等脂肪细胞因子与肥胖和糖尿病的关系.方法 分别测定单纯性肥胖组(30例)、糖尿病组(30例)和正常对照组(20例)的体重指数(BMI)、腰围、臀围、空腹胰岛素(FINS)、空腹血糖(FBS)、血脂、腹脂素、瘦素和脂联素的水平,计算胰岛素抵抗指数(HOMA-IR).结果 (1)单纯性肥胖组和糖尿病组血清腹脂素及瘦素水平高于正常对照组,而脂联素水平明显降低 (P＜0.05);(2)糖尿病组血清腹脂素、瘦素及脂联素水平与单纯肥胖组比较差异无显著性(P=0.450);(3)腹脂素与BMI、腰围、腰臀比、瘦素呈正相关,与脂联素呈负相关;(4)腰围可较好地预测腹脂素水平.结论 腹脂素及瘦素在单纯性肥胖和糖尿病患者中明显升高,而脂联素降低,其表达水平与肥胖程度及肥胖类型(中心性肥胖)密切相关.     

激素替代治疗对绝经后妇女心血管危险因素的影响

目的 探讨不同的激素替代治疗（ＨＲＴ）方案对绝经后妇女心血管危险因素的影响。方法 ９１例绝经后妇女分为：（１）结合雌激素（ＣＥ）Ａ组,（２）ＣＥ Ｂ组;（３）７－甲基异炔诺酮 Ａ组;（４）Ｏｒｇ ＯＤ１４ Ｂ组;（５）炔雌醇（ＥＥ）Ａ组;（６）ＥＥ Ｂ组。     

Differences in the body composition and biochemistry in women grouped as normal-weight, overweight and obese according to body mass index and their relation with cardiometabolic risk

Morbidity of obesity-related diseases tends to increase due to a rise in the body mass index (BMI). We aimed to investigate how the body composition and biochemical parameters change while BMI increases in adult women were categorized as so: as normal weight, overweight and obese. Our objectives are to study the effects of those changes in the development of metabolic disturbances and to find out which parameters are the most sensitive to predict cardiometabolic risks. Three hundred and twenty two records of adult women (mean age: 38.62±12.71 year) who admitted to our unit concerning about losing or preserving their weights, were analyzed in the study. All patients had undergone anthropometric measurements and body composition analyses as well as some biochemical tests. Body composition analyses were performed by means of the Bioelectrical Impedance Analyzer (BIA). Increase in BMI significantly increased the body fat, blood sugar, insulin, triglyceride and uric acid levels. BMI and circumference of the waist were significantly and negatively correlated with the ratio of body water and lean mass/fat mass. However they were positively correlated with the ratio of fat mass and basal metabolism. Furthermore, it was also found that BMI and circumference of the waist were significantly and positively correlated with level of fasting blood sugar, insulin, triglyceride, homeostasis model assessment insulin resistance (HOMA-IR), uric acid and fibrinogen levels, and negatively correlated with high density lipoprotein (HDL) cholesterol level. In multiple regression analyses, circumference of waist measurements was significantly correlated with insulin, triglyseride and HDL, whereas the correlation between BMI and these parameters was not found significant. Total body fat mass (as %) showed significant correlation only with HDL-C level. It could be said that obesity which is a disorder that causes many health complications and affects the quality of life in the short and long term could be prevented or cured by keeping negative environmental conditions under control. According to our results, visceral adipose tissue (VAT) measurement was thought to be more related for metabolic and cardiovascular disorders rather than BMI. We also propose to test fasting blood glucose, insulin, triglyceride, HDL, fibrinogen, homocystein (HOM) levels along with VAT measurements to predict more truly about not only global cardiometabolic risk but also dementia in later life.     

Glycaemic control and hormone replacement therapy: implications of the Postmenopausal Estrogen/Progestogen Intervention (PEPI) study

Despite evidence that supports the beneficial effects of postmenopausal hormone replacement therapy (HRT), concerns remain about its possible adverse effects. However, entry into the postmenopausal state is associated with many characteristics of the insulin resistance syndrome, including increased cardiovascular morbidity and mortality, accretion of generalised and visceral adiposity and insulin resistance. Studies carried out in postmenopausal women have revealed that an increase in visceral obesity is associated with an increase in androgenicity that, in turn, is associated with type 2 (non-insulin-dependent) diabetes mellitus. Short term studies of HRT containing conjugated estrogens (CEE) and medroxyprogesterone (MPA) have shown prevention of the accretion of visceral fat. However, longer term studies using other techniques suggest that these effects may be evanescent. A few trials suggest that oral estrogen therapy reduces postmenopausal insulin resistance, as suggested by reductions in fasting insulin and glucose levels and an increase in glucose metabolism rates, whereas most studies do not show an adverse effect upon carbohydrate metabolism. MPA may decrease these beneficial effects. Transdermal estrogen is essentially neutral with regard to insulin sensitivity and oral estradiol (17beta-estradiol) may also be neutral or enhance sensitivity. Different progestogens vary in their effects upon carbohydrate metabolism. The Postmenopausal Estrogen/Progestogen Intervention (PEPI) Study was a prospective, 3-year, randomised trial in 875 women that compared placebo, unopposed CEE, CEE plus continuous MPA, CEE plus cyclical MPA, and CEE plus cyclical micronised progesterone. Fasting insulin and glucose levels decreased significantly by 16.1% and 0.122 mmol/L, respectively, in all drug treatment groups. However, after a 75g glucose load, glucose levels at 2 hours increased by 0.33 mmol/L in the active treatment groups without a corresponding increase in insulin levels. No beneficial effects on waist/hip ratio could be demonstrated. Data from the PEPI trial also suggested that the maximum benefit regarding carbohydrate metabolism was achieved in patients who were the most hyperglycaemic and hyperinsulinaemic at the start of therapy. It can be concluded, therefore, that HRT has few, if any, harmful effects on carbohydrate metabolism and that it may be of benefit in women in modifying the long term complications of the postmenopausal state.     

2型糖尿病大鼠模型GLUT4 mRNA表达的研究

目的：研究葡萄糖转运体4（GLUT4）mRNA表达在2型糖尿病胰岛素抵抗中的分子机制。方法：采用高脂高糖饲养，一次性腹腔注射链脲佐菌素（STZ）制备2型糖尿病大鼠模型。逆转录聚合酶链反应（RT-PCR）分析大鼠骨骼肌、心肌和脂肪组织中GLUT4 mRNA的表达量变化与差别。结果：正常对照组和2型糖尿病大鼠模型组GLUT4 mRNA在骨骼肌中有相对较高表达，在心肌中表达次之，在脂肪组织中表达相对偏低。2型糖尿病大鼠模型组骨骼肌中GLUT4 mRNA表达量只有对照组骨骼肌的48％、心肌的44％、脂肪组织的38％。结论：GLUT4 mRNA表达量下降导致骨骼肌、心肌和脂肪组织对葡萄糖摄取利用减少是胰岛素抵抗的重要分子基础，是诱发2型糖尿病原因之一。