维持性血透患者高抵抗素血症及其意义探讨

目的:观察维持性血透患者血浆抵抗素(Resistin)水平,探讨与微炎症状态的关系.方法:选择我院肾内科病情稳定的维持性血透患者73例,健康志愿者20例,ELISA法测研究对象的空腹IL-6、TNF-α、血抵抗素水平与免疫比浊法测定CRP,并测定血脂、白蛋白、空腹血糖及胰岛素水平,采用空腹血糖×胰岛素/22.5计算胰岛素抵抗(IR)值.结果:维持性血透患者血浆抵抗素水平较正常组明显升高,为(40.15±22.46)ug/L vs(11.78±6.29)ug/L(P＜0.01),同时CRP、IL-6、TNF-α也较正常组明显升高,分别为(4.56±1.46)mg/L vs (2.10±0.67)mg/L (P＜0.01),(90.19±32.04)ng/L vs(49.30±28.12)ng/L(P＜0.01),(115.16±90.35)ng/L vs (48.21±36.54)ng/L(P＜0.01),Spearmen相关分析显示抵抗素与TG、CRP呈正相关(r=0.271,0.246,P＜0.05).结论:维持性血透患者抵抗素水平明显升高且与微炎症状态有关,抵抗素可能在ESRD患者心血管损伤中起作用.     

寻常型银屑病患者血清金属蛋白酶-2和抵抗素含量变化的意义

目的检测寻常型银屑病患者血清中金属蛋白酶-2（MMP-2）和抵抗素含量变化，探讨其在治疗前后的关系。方法采用双抗体夹心酶联免疫技术（ELISA）检测70例寻常型银屑病患者治疗前、中及治疗后血清中MMP-2和抵抗素含量、另检测30例正常人血清中的MMP-2和抵抗素含量作为对照组。结果寻常型银屑病患者血清中MMP-2和抵抗素含量较对照组显著增高（t=9．42，8．76，P值均〈0．01），进行期与静止期MMP-2和抵抗素含量差异有统计学意义（t=3．45，4．38，P值均〈0．05）。治疗前后患者血清中MMP-2和抵抗素含量差异也有统计学意义（t=6．47，8．53，P值均〈0．05），且两者之间存在正相关（r=0．68，P〈0．05）。结论MMP-2和抵抗素可能参与银屑病的发病并起着一定作用。     

Effect of resistin on estradiol and progesterone secretion from human luteinized granulosa cells in culture

ABSTRACT

Information on the role of resistin on steroidogenesis is limited to animal studies. The aim of this study was to investigate the effect of various doses of resistin on estradiol and progesterone secretion from human luteinized granulosa cells in culture. Granulosa cells were obtained from follicular fluid aspirated from 50 women undergoing in vitro fertilization (IVF) treatment. The cells were cultured for 48 h after a 24 h pre-incubation period. The effect of resistin at dosages 1, 10 and 100 ng/ml alone or in combinations with FSH (10 and 100 ng/ml) on steroidogenesis was investigated. Estradiol and progesterone were measured by radioimmunoassays in culture supernatants at 24 h and 48 h. FSH treatment increased both estradiol and progesterone secretion. Resistin suppressed basal estradiol (at 1 ng/ml) and progesterone secretion (at all concentrations tested). When resistin (all concentrations) was combined with FSH (100 ng/ml), it eliminated the stimulatory effect of FSH on the secretion of estradiol and progesterone. This study indicates an inhibitory effect of resistin on the secretion of estradiol and progesterone by human luteinized granulosa cells in vitro. It is likely that this adipokine locally affects ovarian function in women.

Abbreviations: 3β-HSD: 3β-hydroxysteroid dehydrogenase; CAP1: cyclase-associated protein 1; DCN: decorin; FIZZ: Found in Inflammatory Zones; hCG: human chorionic gonadotropin; IGF1: insulin-like growth factor type 1; IVF: in vitro fertilization; PCOS: polycystic ovary syndrome; RIA: radioimmunoassay; ROR1: receptor tyrosine kinase-like orphan receptor-1; TLR4: Toll–like receptor 4     

血浆抵抗素与2型糖尿病及糖尿病微血管病变关系的研究

目的检测糖尿病肾病、糖尿病视网膜病变、糖尿病神经病变患者及2型糖尿病无并发症患者血浆中空腹抵抗素水平及其临床意义。方法应用酶联免疫测定法检测80例2型糖尿病微血管病变患者,20例2型糖尿病无并发症患者及 20例正常对照的空腹血浆抵抗素和真胰岛素的水平,同时观测血糖、血压、身高、体重,计算体重指数、胰岛素抵抗指数、胰岛β细胞功能指数。结果 2型糖尿病微血管病变组的血浆抵抗素水平与正常对照组相比及2型糖尿病无并发症组血浆抵抗素水平与正常对照组相比,差异均有显著意义(P均<0．01),而2型糖尿病微血管病变组与2型糖尿病无并发症组相比,血浆抵抗素水平无显著差异(P>0．05)。2型糖尿病血浆抵抗素水平与空腹血糖、2小时血糖、胰岛素抵抗指数呈显著正相关(P 均<0．01),与胰岛β细胞功能指数呈明显负相关(P<0．05),但与体重指数、血压、空腹真胰岛素无显著相关(P均>0．05)。结论血浆抵抗素参与了2型糖尿病及其微血管并发症的发生,提示抵抗素在2型糖尿病的发病机制中可能起某种作用。     

肥胖性胰岛素抵抗的研究进展

肥胖是胰岛素抵抗和2型糖尿病的主要危险因素。脂肪细胞分泌的多种物质与胰岛素的敏感性可能相关。本文简单介绍了与肥胖性胰岛素抵抗相关的物质leptin、TNF、Acrp30、IL-6。在研究抗糖尿病新药TZDs作用机制时发现的脂肪组织特异性分泌蛋白-Resistin(胰岛素抗性蛋白),在肥胖症中,其含量升高,它具有调节血糖平衡、拮抗胰岛素的作用。Resistin可能是肥胖与糖尿病之间的连接点。Resistin的作用有待于进一步的研究。     

血液透析患者血清抵抗素水平与微炎症状态及脂代谢的关系

目的观察维持性血液透析（maintencehemodialysisMHD）患者血清抵抗素（resistin）水平,探讨其与炎症和脂代谢的关系。方法用酶联免疫吸附试验（ELISA）方法测定30例健康对照者以及30例血液透析患者透析前后血清抵抗素、生化指标及相关炎性因子水平。同时收集这些MHD患者的临床资料。分析抵抗素与上述指标的关系。结果MHD患者较正常组血清抵抗素水平明显增高[（5.88±2.54）ng/ml比（1.94±0.95）ng/ml,P〈0.01],同时三酰甘油（TG）水平升高,高密度酯蛋白（HDL-C）显著降低,胆固醇和低密度酯蛋白（LDL-C）无统计学意义;C反应蛋白（CRP）、白细胞介素6（IL-6）和血管细胞粘附分子（VCAM-1）水平较对照组明显增加。有心血管疾病的MHD患者血清抵抗素水平升高更为显著。患者血清抵抗素与CRP、IL-6、LDL-C和主观综合营养评诂（SGA）成正相关,与HDL-C成负相关。结论MHD患者血清抵抗素水平明显升高,可能与MHD患者的脂代谢紊乱,微炎症状态以及心血管疾病有关。     

代谢综合征患者血清抵抗素与血脂、肥胖和胰岛素抵抗关系的研究

目的:探讨代谢综合征患者血清抵抗素水平与血脂、肥胖和胰岛素抵抗的关系。方法: 60 例代谢综合征患者和28 例年龄相匹配的正常对照者,按体重指数将代谢综合征患者分为肥胖组和非肥胖组。采用ELISA方法测定受试者空腹血清抵抗素和瘦素水平,同时检测其身高、体重、腰围、臀围、血压、血糖、血脂及胰岛素水平,并计算体重指数(BMI)、腰臀比(WHR)和胰岛素抵抗指数(HOMA)。结果:代谢综合征患者肥胖组和正常对照组相比其血清抵抗素水平明显升高(28.28±11.7μg/L与19.44±5.79μg/L,P<0.01);非肥胖组和正常对照组相比其血清抵抗素水平明显升高(26.14±11.9μg/L与19.44±5.79μg/L,P<0.05)。肥胖组和正常对照组相比其血清瘦素水平明显升高(1.47±0.57μg/L与0.31±0.13μg/L,P<0.01);非肥胖组和正常对照组相比其血清瘦素水平明显升高(1.35±0.57μg/L与0.31±0.13μg/L,P<0.01)。肥胖组和非肥胖组相比其血清抵抗素、瘦素水平无显著差异。相关分析显示空腹抵抗素水平与腰臀比、空腹胰岛素、胰岛素抵抗指数呈显著正相关(分别为r=0.22,0.22,0.19;P<0.05);与体重指数、腰围、臀围、瘦素呈显著正相关(分别为r=0.31,0.32,0.36,0.28;P<0.01);而与收缩压、舒张压、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL C)、血     

Adipose tissue as an endocrine organ

Obesity is characterized by increased storage of fatty acids in an expanded adipose tissue mass and is closely associated with the development of insulin resistance in peripheral tissues such as skeletal muscle and the liver. In addition to being the largest source of fuel in the body, adipose tissue and resident macrophages are also the source of a number of secreted proteins. Cloning of the obese gene and the identification of its product, leptin, was one of the first discoveries of an adipocyte-derived signaling molecule and established an important role for adipose tissue as an endocrine organ. Since then, leptin has been found to have a profound role in the regulation of whole-body metabolism by stimulating energy expenditure, inhibiting food intake and restoring euglycemia, however, in most cases of obesity leptin resistance limits its biological efficacy. In contrast to leptin, adiponectin secretion is often diminished in obesity. Adiponectin acts to increase insulin sensitivity, fatty acid oxidation, as well as energy expenditure and reduces the production of glucose by the liver. Resistin and retinol binding protein-4 are less well described. Their expression levels are positively correlated with adiposity and they are both implicated in the development of insulin resistance. More recently it has been acknowledged that macrophages are an important part of the secretory function of adipose tissue and the main source of inflammatory cyokines, such as TNFα and IL-6. An increase in circulating levels of these macrophage-derived factors in obesity leads to a chronic low-grade inflammatory state that has been linked to the development of insulin resistance and diabetes. These proteins commonly known as adipokines are central to the dynamic control of energy metabolism, communicating the nutrient status of the organism with the tissues responsible for controlling both energy intake and expenditure as well as insulin sensitivity.     

儿童哮喘发作期血浆脂联素和抵抗素水平变化及意义

目的：通过观察两组儿童血浆中脂联素（adiponectin,ADP）和抵抗素（resistin,ADSF）水平的变化,初步探讨ADP与ADSF在哮喘发病中的作用及其两者的相关性。方法：采用酶联免疫吸附实验（ElISA）测定40例4-14岁支气管哮喘患儿发作期血浆中ADP和ADSF水平,与40例同年龄段健康小儿血浆水平做统计分析。结果：ADP在实验组与对照组之间无统计学意义（P〉0.05）;实验组ADSF明显高于对照组,有统计学意义（P〈0.05）;ADP与ADSF水平变化两组均无相关性（r值分别为-0.127、-0.227,P值均大于0.05）。结论：ADSF可能参与哮喘发病,其水平增高提示哮喘存在,ADP与儿童哮喘发生无直接关系。     

老年2型糖尿病合并代谢综合征患者血清抵抗素水平与胰岛素抵抗的关系研究

目的探讨老年2型糖尿病合并代谢综合征(MS)患者空腹血清抵抗素水平与胰岛素抵抗的关系。方法选取老年2型糖尿病患者82例,其中46例合并MS(MS组),36例不合并MS(非MS组),另选取同期30例健康体检者作为对照组。检测3组受试者的空腹血清抵抗素水平,分别计算体质指数(BMI)、腰臀比(WHR)和胰岛素抵抗指数(HOMA-IR),并测定相关代谢指标,利用SPSS 13.0软件进行统计学分析。结果 MS组及非MS组糖尿病患者血清抵抗素水平及HOMA-IR均显著高于对照组,MS组患者上述两项指标亦显著高于非MS组,差异均有统计学意义(P<0.05)。多元逐步回归分析显示,抵抗素受HOMA-IR、WHR影响较大。结论老年2型糖尿病合并MS患者血清空腹抵抗素水平显著升高,且抵抗素水平与HOMA-IR及WHR呈正相关;抵抗素可能在胰岛素抵抗、肥胖和糖尿病中发挥重要作用。