综合干预对代谢综合征患者的疗效及血清脂肪细胞因子水平的影响

目的观察饮食、运动及药物综合干预对代谢综合征（metabolic syndrome,MS）患者的疗效及其对患者血清瘦素、抵抗素、脂联素水平影响。方法通过体检,纳入深圳市慢性病防治院＂慢性病管理数据库＂中的56例MS患者,随机分为综合干预组（n=30）及单纯药物干预组（n=26）。综合干预组给予饮食、运动及药物综合干预措施;单纯药物干预组给予药物干预治疗。两组患者分别于干预前、干预3个月、6个月末检测体重指数、血压、血糖、血脂及血清瘦素、抵抗素、脂联素水平,干预3个月、6个月末评价MS患者达标控制率,并对两组指标进行比较分析。结果两组患者干预后BMI、血糖、血脂、血压指标均有改善,但综合干预组改善效果更显著。综合干预组患者干预3个月及6个月后达标控制率分别为83.3%及93.3%,显著高于同时间段单纯药物干预组患者的达标控制率（73.1%及80.8%）,并有统计学意义（P〈0.05）。单纯药物干预组瘦素、抵抗素、脂联素水平在干预前、及干预3个月、6个月均无统计学差异（P〉0.05）;综合干预组干预3个月、6个月后瘦素、抵抗素、脂联素水平与干预前水平比较,及干预3个月与6个月时水平比较,差异均具有统计学意义（P〈0.05）;两组患者在干预6个月后瘦素、抵抗素、脂联素水平比较,也有统计学差异（P〈0.05）。结论饮食、运动及药物综合干预措施能有效改善MS患者血清瘦素、抵抗素、脂联素水平,提高MS患者症状的达标控制率。     

Role of adipocytokines and its correlation with endocrine pancreatic function in patients with pancreatic cancer

IntroductionSome authors suggest that adipocytokines contribute to the induction of pancreatic carcinogenesis as well as the development of endocrine insufficiency.AimsWe evaluate the circulating concentrations of leptin, resistin and visfatin in patients with newly diagnosed pancreatic cancer (PC) and relationship between serum adipocytokines level and clinicopathological features of PC. Moreover the usefulness of those adipocytokines as possible biomarkers of endocrine pancreatic function in PC has been assessed.MethodsThe pilot study group consisted of 45 individuals (mean age 65.6 ± 11.5 years, BMI 21.8 ± 3.4 kg/m²) with newly diagnosed PC (within last 1–3 months) and 13 healthy individuals with age, gender and BMI matched to the study group. Among PC patients 18 (40%) had recently diagnosed diabetes. Fasting plasma leptin, resistin, visfatin concentrations were determined with ELISA (R&D Systems, Phoenix Pharmaceuticals) and insulin by RIA (DakoCytomation).ResultsPatients with PC as compared to controls had significantly lower plasma leptin (40.6 ± 21.3 vs 63.2 ± 16.3 pg/mL; p < 0,0008). In contrast PC patients showed more than six fold higher level of resistin (126.2 ± 143.2 vs 18.9 ± 7.2 ng/mL; p < 0.009) than controls. The median plasma visfatin was 2.8 ± 1.8 ng/mL, which was not significantly different from the controls (3.8 ± 1.1 ng/mL). When PC patients with and without diabetes were considered separately, plasma leptin concentrations among nondiabetic patients were slightly, but not significantly higher (44.6 ± 21.0) as compared to diabetics (34.5 ± 20.7). Moreover there was no difference between visfatin and resistin level in PC, among patients with and without diabetes. No significant differences between serum level of leptin, visfatin and resistin and age, gender, BMI, smoking status, tumor localization, distant metastases and pain has been found.ConclusionThe results of this study confirm previous findings that patients with newly diagnosed pancreatic cancer are characterized with lower level of leptin. This pilot study showed significantly higher resistin concentrations in patients with PC in comparison to healthy controls, which may be helpful in PC early diagnosis. Changes in leptin and resistin level in PC are not likely related to endocrine disorders.     

文迪雅对2型糖尿病患者血浆抵抗素的影响

目的观察2型糖尿病患者用文迪雅治疗后血浆抵抗素的变化.方法新诊断的2型糖尿病患者分组,观察组给予文迪雅治疗3个月;对照组用二甲双胍或加服瑞格列奈治疗3个月;分别在治疗前后用酶免法测定血浆抵抗素的水平.结果治疗前观察组与对照组血浆抵抗素的水平无显著差异(p＞0.05);治疗后观察组血浆抵抗素显著下降(p＜0.05)、胰岛素敏感指数显著升高(p＜0.01);治疗后对照组血浆抵抗素的水平无显著变化(p＞0.05)、胰岛素敏感指数也无显著变化(p＞0.05).结论文迪雅治疗后血浆抵抗素的水平显著下降,胰岛索敏感指数显著上升;血浆抵抗素与胰岛素抵抗有一定的相关性.     

不同分娩方式对新生儿的影响

目的对两种分娩方式对新生儿质量的影响进行比较。方法选取我院2010年8月～2011年8月分娩的92例新生儿为研究对象。依分娩方式不同将其分为两组,每组46例。阴道分娩的新生儿为观察组;剖宫分娩新生儿为对照组。对两组研究对象的生活质量进行比较。结果观察组顺利分娩44例,分娩成功率95.7%,较对照组100%的成功率无显著差异性（P〉0.05）;观察组新生儿质量优于对照组（P〈0.05）。结论在确保母婴健康的前提下,阴道分娩用于产妇的分娩中能够改善新生儿质量,具有重要的临床价值。     

清肝泻心滋阴润燥法对2型糖尿病患者脂肪细胞抵抗素及脂联素的影响

目的探讨清肝泻心滋阴润燥法对2型糖尿病患者血清脂肪细胞抵抗素及脂联素水平变化的影响及其与胰岛素抵抗的关系。方法入选患者随机分为治疗组30例,对照组30例,治疗组采用清肝泻心汤治疗,对照组采用文迪雅治疗2个月。用ELISA法检测并比较治疗前后两组的脂肪细胞抵抗素、脂联素的血清水平及其与血糖、胰岛素抵抗水平的关系。结果两组治疗后均能降低血糖(P<0.01),但两组间差值比较差异无显著性意义(P>0.05)。两组均能降低糖化血红蛋白,且治疗组明显优于对照组(P<0.01)。在改善胰岛素抵抗相关指标方面,两组治疗后均能降低胰岛素、C肽及血清抵抗素水平(P<0.01),升高胰岛素敏感性指数及脂联素水平(P<0.01),但两组间差值比较差异无显著性意义(P>0.05)。结论清肝泻心滋阴润燥法及文迪雅均能降低2型糖尿病患者血清抵抗素水平,升高脂联素水平,这些脂肪细胞因子的改变直接与2型糖尿病患者胰岛素抵抗的改善相关。     

飞行员体重指数与血浆抵抗素水平的关系

目的　对比间隔 12年两组飞行员中体重指数 (BMI)的变化情况 ,探讨BMI与血浆抵抗素水平之间的关系 ,为飞行员心脑血管疾病的一级预防提供客观依据。　方法　对比 1989年调查的 6 36名飞行员和 2 0 0 1年调查的 86 1名飞行员的BMI,用酶标法测定血浆抵抗素水平。　结果　①1989年调查的飞行员BMI≥ 2 4者占 2 6 .7% ,≥ 2 8者占 2 .4 % ,2 0 0 1年调查的飞行员则分别为 4 5 .1%和 5 .8% ,12年上升了 5 0 %以上 ;②在飞行员中 ,BMI≥ 2 4者抵抗素水平明显高于BMI <2 4者 (P <0 .0 5 )。　结论　① 2 0 0 1年调查飞行员中超重者十分普遍 ,已达 4 5 .1% ,与国内经济发达地区 ( 5 0 % )超重的情况十分接近 ,应积极干预 ;②在飞行员中 ,超重者血浆抵抗素水平明显升高 ,是否预示今后发展成为糖尿病的可能性较大 ,还需密切追随观察     

北京市石景山区人群血浆抵抗素浓度变化与同期体重变化的关系

目的:探讨北京市石景山区人群血浆抵抗素浓度变化与同期体重变化的关系。方法:选取我们2005年和2010年两次在北京市石景山区调查的同一人群,心血管病危险因素资料完整的研究对象943例,其中男316例,女627例,男性平均年龄为(58.2±8.5)岁,女性平均年龄为(59.3±7.5)岁。按照两次调查测定血浆抵抗素浓度变化的4分位数将943例研究对象分为:≤-0.66 mmol/L组(n=239)、-0.67~0.25 mmol/L组(n=233)、0.26~1.24 mmol/L组(n=235)和≥1.25 mmol/L组(n=236)。运用Pearson相关及多元线性回归等统计学方法,分析血浆抵抗素浓度变化与同期的体重变化指标之间的关系。结果:单因素相关分析显示,女性血浆抵抗素浓度变化与体重变化百分比、体重指数变化量及其变化百分比、腰围变化量及其变化百分比均显著相关(相关系数分别为0.1173、0.1521、0.1412、0.1228、0.1057,P均0.05),男性均不显著(P均0.05)。多元线性回归分析:在调整基线变量因素后,女性血浆抵抗素浓度变化与体重变化量及其变化百分比、体重指数变化量及其变化百分比、腰围变化量及其变化百分比均显著相关(回归系数分别为0.0261与0.2916、0.2157与0.3072和0.0532与0.2738,P均0.05),男性均不显著(P均0.05)。结论:女性血浆抵抗素浓度的变化与同期体重变化之间存在显著相关,而男性相关不显著。     

Increased level of resistin predicts development of atrial fibrillation

BackgroundResistin is a peptide hormone that is secreted from lipid cells and is linked to type-2 diabetes, obesity, and inflammation. Being an important adipocytokine, resistin was proven to play an important role in cardiovascular disease. We compared resistin levels in patients with and without atrial fibrillation (AF) to demonstrate the relationship between plasma resistin levels and AF.MethodOne hundred patients with AF and 58 control patients who were matched in terms of age, gender, and risk factors were included in the trial. Their clinical risk factors, biometric measurements, echocardiographic work up, biochemical parameters including resistin and high-sensitivity C-reactive protein (hs-CRP) levels were compared.ResultsIn patients with AF, plasma resistin levels (7.34 ± 1.63 ng/mL vs 6.67 ± 1.14 ng/mL; p = 0.003) and hs-CRP levels (3.01 ± 1.54 mg/L vs 2.16 ± 1.28 mg/L; p = 0.001) were higher than control group. In subgroup analysis, resistin levels were significantly higher in patients with paroxysmal (7.59 ± 1.57 ng/mL; p = 0.032) and persistent AF (7.73 ± 1.60 ng/mL; p = 0.006), but not in patients with permanent AF subgroups (6.86 ± 1.61 ng/mL; p = 0.92) compared to controls. However, hs-CRP levels were significantly higher only in permanent AF patients compared to control group (3.26 ± 1.46 mg/L vs 2.16 ± 1.28 mg/L; p = 0.02). In multivariate regression analysis using model adjusted for age, gender, body mas index, hypertension, diabetes mellitus, and creatinine levels, plasma resistin levels [odds ratio (OR): 1.30; 95% confidence interval (CI): 1.01–1.70; p = 0.04] and hs-CRP levels (OR: 1.44; 95% CI: 1.12–1.86; p = 0.004) were the only independent predictors of AF.ConclusionThe elevated levels of plasma resistin were related to paroxysmal AF group and persistent AF group, but not to permanent AF group.