依那普利叶酸片联合雌二醇片/雌二醇地屈孕酮片治疗围绝经期H型高血压的疗效观察

目的分析围绝经期H型高血压中依那普利叶酸片联合雌二醇片/雌二醇地屈孕酮片的应用效果。方法随机选取平湖市第一人民医院2017年6月-2019年3月诊治的120例围绝经期H型高血压患者,采取随机数字表法分为两组,每组60例。对照组单纯采取依那普利叶酸片治疗,观察组在此基础上采用雌二醇片/雌二醇地屈孕酮片治疗。结果治疗3月后观察组Kupperman评分明显优于对照组,两组比较差异有统计学意义(P<0. 05),但两组血压控制效果经检验,差异无统计学意义(P>0. 05)。治疗后观察组Chemerin蛋白、生长分化因子-15 (GDF-15)及同型半胱氨酸(Hcy)水平显著低于对照组,差异有统计学意义(P<0. 05)。结论应用依那普利叶酸片联合雌二醇片/雌二醇地屈孕酮片治疗围绝经期H型高血压可有效改善血压控制效果,同时还可改善血脂代谢及胰岛素抵抗,值得临床推广。     

体外冲击波对膝骨关节炎患者血清及关节液中Chemerin含量的影响

目的：探讨体外冲击波（ extracorporeal shock wave,ESW）对膝骨关节炎（ knee osteoarthritis,KOA）的疗效及对患者血清及关节液趋化素（ Chemerin）的影响。方法60例KOA患者随机分为ESW组（ n＝30）和对照组（ n＝30）,ESW组以体外冲击波治疗,对照组以常规治疗。在干预前和8周后,采用活动时疼痛视觉模拟评分（ VAS）、膝关节炎病人疼痛指数（ Le?quesne index）评分和美国西部 Ontario 与 McMaster 大学骨关节炎指数（ western Ontario and McMaster osteoarthritis index, WOMAC）评分进行评定,以及血清及关节液中 Chemerin 水平的变化。结果治疗后, ESW 组 VAS、Lequesne 指数评分和WOMAC骨关节炎指数评分均明显好于对照组（ P＜0．05）。治疗后患者血清和关节液中Chemerin含量均比治疗前显著下降（P＜0．05或0．01）;治疗后ESW组血清和关节液中Chemerin含量显著低于对照组（均P＜0．05）。结论膝关节液和血清中Chemerin含量反映了关节炎症的严重程度,ESW治疗有效的降低了血清和关节液中Chemerin含量,ESW对KOA患者治疗有效,Chemerin可作为OA早期诊断及判断严重程度的参考指标。     

芍药甘草汤治疗颈型颈椎病60例

目的研究高血压痛患者血清ehemerin水平与胰岛素抵抗及炎症相关性。方法选择50例无糖尿痛病史的高血压痛患者（高血压组）和40例体检正常者（对照组）,收集一般临床资料,测量血压、腰围、臀围,测定空腹血糖,空腹胰岛素,hsCRP等生化指标,采用ELISA法测定两组血清chemerin水平,并用胰岛素抵抗指数（1RD作为胰岛素敏感性评价指标。结果高血压家族史、腰围、血压、空腹胰岛素IRI、hsCRP及Chemerin在高血压组和对照组之间差异有统计学意义（P〈O．05）,血清chemerin与各指标作相关分析结果显示：高血压组患者血清chemerin与hsCRP、空腹胰岛素、IRI、血肌酐、腰围呈正相关（P均〈O．05）。偏相关分析在校正年龄、性别后,血清Chemerin与hsCRP、IRI仍呈正相关（r值分别为0．264,0．321,P〈0．05）,P均〈O．05）。经Logistic多因素回归分析发现高血压家族史、IRI、hsCRP及Chemerin与高血压密切相关（P〈O．05）。结论高血压病患者血清chemerin水平与胰岛素抵抗及炎症密切相关,这提示chemerin可能通过炎症、胰岛素抵抗在高血压发病过程中起重要作用。     

Elevated serum chemerin concentrations are associated with renal dysfunction in type 2 diabetic patients

Aim

Chemerin, a new adipocytokine, has been suggested to be linked to obesity-induced insulin resistance and type 2 diabetes. The association of plasma chemerin levels with diabetic nephropathy, however, is unknown. Therefore, this study aims to determine whether plasma chemerin levels are associated with renal function in type 2 diabetic patients.

Methods

A total of 116 type 2 diabetic patients and 38 healthy subjects were enrolled in this study. Serum levels of chemerin were measured by enzyme-linked immunosorbent assay.

Results

Serum chemerin was significantly elevated in type 2 diabetic patients with macroalbuminuria compared with control subjects and diabetic patients with normoalbuminuria and microalbuminuria. No differences were found in the level of serum chemerin between diabetic patients with normoalbuminuria and microalbuminuria and control subjects. Serum chemerin was positively correlated with age, body mass index (BMI), systolic blood pressure (SBP), C-reactive protein (CRP), blood urea nitrogen (BUN), serum creatinine and serum triglycerides, and negatively correlated with creatinine clearance Stepwise regression analysis showed that creatinine clearance and serum creatinine remained significantly associated with serum chemerin.

Conclusion

Serum chemerin levels are strongly associated with renal function in diabetic patients.     

黄连解毒汤对糖尿病大鼠血清chemerin水平的影响

目的研究黄连解毒汤干预糖尿病大鼠血清chemerin水平的变化情况,初步探讨黄连解毒汤改善胰岛素抵抗的作用机制。方法实验采用高脂高糖饮食联合链脲佐菌素（STZ）复制大鼠糖尿病模型,连续给黄连解毒汤6周后测定空腹血糖（FBG）、空腹胰岛素（FINS）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）含量,同时以测定脂肪因子chemerin水平的变化。结果给予黄连解毒汤组治疗的糖尿病大鼠,其血清中FBg、TC、Tg、LDL-C水平显著低于模型组（P〈0.01）,HDL-C水平高于模型组（P〈0.01）,血清chemerin水平显著低于模型组（P〈0.01）。结论黄连解毒汤对高脂高糖饮食联合小剂量STZ所致糖尿病大鼠有一定的治疗作用,能改善胰岛素抵抗,其机制可能是通过调节脂肪因子chemerin的表达,从而降低了炎症信号通路,改善了脂肪组织的慢性炎症反应,继而改善胰岛素抵抗。     

普伐他汀对冠心病患者血脂、血浆 Chemerin 水平、超敏C 反应蛋白、血清脂联素的影响

目的 探讨普伐他汀对冠心病患者血脂、血浆脂肪因子趋化素（Chemerin）水平、超敏C反应蛋白（hs—CRP）、血清脂联素的影响。方法 收集2010年1月～2013年12月湖北省荣军医院老年病科收治的118例冠心病患者,并将其随机分为常规治疗组和普伐他汀组,观察治疗前后血浆Chemerin水平、hs—CRP、血清脂联素的变化,分析Chemerin、脂联素、hs—CRP与血脂浓度之间的相关性。结果 疗程结束后,普伐他汀组血浆Chemerin、hs—CRP、总胆固醇（TC）、三酰甘油（TG）及低密度脂蛋白胆固醇（LDL—C）水平均较常规治疗组显著降低（P〈0．01）,血清脂联素及高密度脂蛋白胆固醇（HDL—C）水平均较常规治疗组显著升高（P〈0．01）。血浆Chemerin与TG呈正相关（r=0．48,P〈0．01）;hs—CRP与HDL—C呈负相关（r=-0．21,P〈0．01）;血清脂联素与HDL—C呈正相关（r=0．56,P〈0．01）,与Chemerin、hs—CRP均呈负相关（r=-0．43、-0．36。P〈0．01）。结论 普伐他汀可以显著降低冠心病患者血脂水平,而且能提高血清脂联素水平以降低hs—CRP浓度及血浆Chemerin水平。     

非ST段抬高性心肌梗死危险因素的研究进展

非ST段抬高性心肌梗死临床表现多样,冠状动脉病变程度及血流动力学变化不一,预后差异较大。血清学指标已在临床中运用多年,如血浆肌酸激酶、肌钙蛋白、肌红蛋白、转氨酶等作为心肌梗死患者病理改变中的血清学产物,参与心肌梗死的病理进程。目前,对血清学指标在心血管疾病危险度预测方面又有了新的认识,如C反应蛋白、脑钠肽、趋化素、脂肪酸结合蛋白、基质金属蛋白酶9、热激蛋白70。该文主要对心肌梗死的危险因素——血清学指标进行综述。     

内质网应激介导吡格列酮在趋化素诱导成骨细胞代谢过程中的作用机制

目的 观察吡格列酮（Pioglitazone）对趋化素诱导成骨细胞代谢过程中的影响,探讨吡格列酮改善成骨细胞凋亡的信号转导机制。方法 将成骨细胞随机分组,选取适宜浓度的趋化素（Chemerin）进行诱导后,加入吡格列酮,观察成骨细胞活力变化。ELISA 法检测细胞趋化蛋白1（MCP-1）、E选择素（E-selection）的的影响,采用Western blot法检测成骨细胞黏附分子1（ICAM-1）、需肌醇跨膜激酶/核酸内切酶1(inositol-requiring transmembrane kinase/endonuclease 1,IRE1)、葡萄糖调节蛋白78（Glucose-regulated protein 78,GRP78）的表达变化,探究内质网应激反应在此过程中作用。结果 MTT法检测提示加入Pioglitazone后对成骨细胞活力未见明显影响;与对照组相比,成骨细胞ICAM-1、MCP-1、E-selection、IRE1、GRP78、在Chemerin组的指标较高(P<0.05）,而 Pioglitazone呈浓度依赖性地抑制Chemerin所诱导的上述效应,差异具有统计学意义(P<0.05),当吡格列酮浓度为20μmol/L时效果最显著。结论 内质网应激可能参与趋化素诱导成骨细胞代谢中的细胞凋亡过程,吡格列酮可抑制趋化素的作用,对成骨细胞具有保护功能,其机制可能与抑制内质网应激反应相关。     

Serum Chemerin Levels Are Associated with Abdominal Visceral Fat in Type 2 Diabetes

Chemerin is a recently identified adipokine suggested to play a role in obesity and its metabolic complications. The relationship between visceral obesity and serum chemerin levels in type 2 diabetes (T2DM) is unknown and may differ from that of subjects without diabetes. Therefore, we evaluated whether serum chemerin was associated with visceral abdominal obesity in patients with T2DM. A total of 218 Korean patients with T2DM were enrolled and metabolic parameters, abdominal visceral and subcutaneous fat areas, and serum chemerin levels were measured. Serum chemerin level showed positive correlation with fasting insulin, HOMA-IR, serum triglyceride, serum creatinine, urine albumin/creatinine ratio, high-sensitivity C-reactive protein (hsCRP), fibrinogen, abdominal visceral fat area, visceral to subcutaneous fat area ratio, and negatively correlation with high density lipoprotein cholesterol and creatinine clearance (CCr) after adjusting for age, gender and body mass index. Multiple linear stepwise regression analysis showed that abdominal visceral fat area (β = 0.001, P < 0.001), serum triglyceride (β = 0.001, P < 0.001), CCr (β = -0.003, P = 0.001), hsCRP (β = 0.157, P = 0.001), fibrinogen (β = 0.001, P < 0.001) and BMI (β = 0.02, P = 0.008) independently affected log transformed serum chemerin levels. Higher serum chemerin level was associated with higher level of abdominal visceral fat area, serum triglyceride, hsCRP and fibrinogen and lower level of CCr in patients with T2DM. Serum chemerin may be used as a biomarker of visceral adiposity and chemerin may play a role in inflammation, decreased renal function, and increased cardiovascular risk in T2DM.     

Chemerin alleviates acute pancreatitis in the rat thorough modulation of NF-κB signal

Objective

Chemerin, an adipokine, works as the chemoattractant for the immune cells. The role of chemerin in the inflammatory reaction is controversial. Chemerin has been shown to aggravate the inflammatory response, but other studies demonstrated its anti-inflammatory influence. This study assessed the effects of chemerin on acute pancreatitis (AP) in vivo and in vitro.