内脏脂肪素(visfatin)的研究进展

脂肪组织可分泌众多脂肪细胞因子如瘦素(leptin)、抵抗素(resistin)、脂联素(adiponectin)、网膜素(omentin)以及最近发现的内脏脂肪素(visfatin)。Visfatin具有胰岛素样的降糖作用,并可以改善胰岛素抵抗。本文就Visfatin的研究进展作一综述。     

视黄醇结合蛋白4和内脂素与非酒精性脂肪肝的相关性研究

目的 探讨视黄醇结合蛋白4（retinol - binding protein 4,RBP4）和内脂素与非酒精性脂肪肝（non - alcoholic fatty liver disease,NAFLD）的相关性。方法 采用2011年于某医院进行体格检查的955名年龄＞25岁成年人中身高等一般指标和谷氨酰基转移酶（γ - glutamyl transferase,GGT）等生化指标完整的780名作为研究对象。分析不同组RBP4和内脂素的血压、肝功能等指标趋势,并采用logistic回归模型分析不同RBP4和内脂素水平与NAFLD患病风险的相关性。结果 NAFLD组RBP4（t = 5.892,P＜0.001）、内脂素水平（t = 6.788,P＜0.001）均高于正常组,随着RBP4的增加,内脂素水平呈现上升趋势（P趋势＜0.001）,随着内脂素的增加,RBP4水平呈现上升趋势（P趋势＜0.001）,调整年龄、性别、体质指数（body mass index,BMI）、内脂素及肝功等各生化因素后,RBP4水平对NAFLD患病没有影响（OR = 1.518,95%CI:0.795～2.899）。调整年龄、性别、BMI、RBP4及肝功能等各生化因素后,内脂素仍是NAFLD的危险因子（OR = 2.268,95%CI:1.117～4.606）。结论 RBP4与NAFLD密切相关,但不是独立的危险因素。内脂素是NAFLD的独立影响因素。     

妊娠期糖尿病孕妇血清视黄醇结合蛋白4、内脂素水平的变化及其临床意义

目的探讨妊娠期糖尿病(GDM)患者血清视黄醇结合蛋白4(RBP4)、内脂素水平变化的意义,研究视黄醇结合蛋白4和内脂素与胰岛素抵抗(IR)的相关性。方法采用稳态模型评估法评估正常糖耐量孕妇(NGT)、糖耐量减低孕妇(GIGT)和妊娠期糖尿病孕妇(GDM)的胰岛素抵抗指数,采用酶联免疫吸附法检测所有受试者的空腹血糖(FPG)、空腹胰岛素(FINS)、RBP4和内脂素水平。结果 GDM组和GIGT组血清RBP4、内脂素和胰岛素抵抗指数(HO-MA-IR)均显著高于NGT组(P<0.01)。血清RBP4、内脂素与HOMA-IR均呈显著正相关。结论妊娠期糖尿病患者存在胰岛素抵抗,RBP4、内脂素可影响妊娠期糖尿病患者IR的程度。     

妊娠期糖尿病患者血清内脂素水平的变化

目的    探讨妊娠期糖尿病（GDM）患者血清内脂素（visfatin）的变化及其与年龄、孕周、体质量指数(BMI)、血糖、胰岛素抵抗（HOMA IR）、胰岛B细胞功能（HOMA B）、血脂等的关系。方法    2009年7月至2009年12月在重庆医科大学附属第一医院门诊常规产前检查就诊者80名,按ADA2009年GDM诊断标准分为GDM组35例和非GDM组45例,ELISA法测定空腹血清visfatin水平,葡萄糖氧化酶法分别测定空腹血糖（FPG）及口服75g葡萄糖后0.5、1、2h血糖(0.5hPG、1hPG、2hPG),电化学发光法测定空腹胰岛素（FINS）,酶法测定血脂等。结果    ① GDM患者空腹血清visfatin明显高于非GDM组(P<0.05);②Spearman相关分析显示,visfatin与2hPG（r=0.506、P<0.01）、FINS (r=0.321、P<0.01)、 HOMA-IR (r=0.364、P<0.01)呈显著正相关;③多元线性逐步回归分析表明,2hPG是影响血清visfatin的独立相关因素。结论    GDM患者血清visfatin显著升高,可能是机体针对体内血糖增高、胰岛素抵抗所发生的一种代偿效应。     

Visfatin as a therapeutic target for rheumatoid arthritis

Introduction: The rising prevalence of musculoskeletal pathologies in developed countries has caused a dramatic impact on social welfare. Amidst these musculoskeletal pathologies is Rheumatoid arthritis (RA), a chronic systemic autoimmune disease that mostly affects the synovium. RA metabolic-associated alterations, including distorted adipokine production, enhance RA inflammatory environment. Among the altered adipokines, visfatin is particularly involved in RA inflammation and catabolism and stands out as an essential enzyme linked to critical cell features.

Areas covered: We discuss the potential mechanism supporting the contribution of visfatin to RA and the association between RA and obesity. We discuss the repurposing of cancer-tested drugs to inhibit visfatin in the context of RA. Additionally, we address the possibility of combining these drugs with current RA therapy. Finally, we explore the future of visfatin as an RA biomarker or therapeutic target.

Expert opinion: Inhibition of visfatin has become an interesting therapeutic approach for RA pathology. Such a feat has already been attained in oncology using small molecule inhibitors, which suggest that a similar course of action would be worth pursuing in the RA context. Visfatin will become an important biomarker and therapeutic target for RA.     

新诊断2型糖尿病患者血浆内脂素水平变化研究

目的探讨新诊断2型糖尿病(T2DM)患者血浆内脂素水平变化。方法检测113例新诊断T2DM患者和102例正常对照的空腹血浆内脂素水平和相关临床指标。结果新诊断T2DM患者血浆内脂素水平高于正常对照组(P0.05)。多重线性回归分析显示腰臀比和空腹血糖是影响血浆内脂素水平的独立相关因素。结论血浆内脂素水平变化与糖代谢密切相关,它可能在T2DM的发病机制中起着一定作用。     

血清内脏脂肪素水平与2型糖尿病患者颈动脉内中膜厚度相关性的研究

目的探讨血清内脏脂肪素水平与2型糖尿病患者颈动脉内中膜厚度（IMT）之间的关系。方法应用酶联免疫法测定80例2型糖尿病患者,并根据患者的颈动脉超声结果分为两组：IMT正常组和IMT增厚或斑块组。比较两组及40例正常对照者的血清脂联素水平,分析血清内脏脂肪素水平与IMT之间的关系。结果（1）2型糖尿病组血清内脏脂肪素水平高于对照组（P〈0．01）。（2）IMT正常组与IMT增厚或斑块组相比较,腰臀比、TG、HDL．C、血清内脏脂肪素水平,差异均有统计学意义（P均〈0．05）。（3）Logistic回归分析显示,血清内脏脂肪素含量较高、年龄增长、TG增高、HDL-C降低是2型糖尿病患者IMT增厚的危险因素。结论高血清内脏脂肪素水平可能是2型糖尿病患者动脉粥样硬化的危险因素。     

内脂素与动脉粥样硬化的关系

近年来,研究者发现了一种新的脂肪因子——内脂素,它主要来源于内脏脂肪,具有类胰岛素样作用。最近,国内外许多研究发现,内脂素与易损斑块形成、血管新生、血管炎症发生、内皮功能损伤、血管平滑肌细胞的增生及变性等密切相关,有进一步研究的必要性和重要意义。现就其国内外研究现状进行概述。     

The effect of omentectomy on the blood levels of adipokines in obese patients with endometrial cancer

ObjectiveTo investigate the blood levels of adipokines in obese patients with endometrial cancer who have and have not undergone omentectomy.MethodsBetween September 2017 and September 2019, the study recruited 54 patients with endometrial cancer. Measurements were taken of blood levels of human leptin, perilipin-1, adiponectin, adipolin, resistin, visfatin, and estrone preoperatively and postoperatively before adjuvant therapy or at the end of one month. The serum samples were separated by centrifugation for 10 mins at 3,000 revolutions/min, then stored at ?80 °C until assay.ResultsIn this prospective study, a total of 54 endometrial cancer patients were analyzed in two separate groups according to the omentectomy status. Comprehensive staging surgery with omentectomy and without omentectomy was performed in 26 patients and 28 patients, respectively. The age, body mass index, body fat index, waist circumference, and skin thickness values of the patients with and without omentectomy were found to be similar. No statistically significant difference was determined between the patients with and without omentectomy in respect of the blood level of the adipokines measured preoperatively. A strong statistically significant correlation was determined between the pre and postoperative levels of Human Leptin (p = 0.002), perilipin-1(p = 0.001), adipolin (p < 0.001), adiponectin (p < 0.001), resistin (p = 0.001), visfatin (p < 0.001), and estrone (p = 0.004) (r = ?0.43, ?0.47, 0.75, 0.84, ?0.47, - 0.58, ?0.41, respectively)ConclusionsOmentectomy affected the postoperative blood levels of adipokines in obese patients with endometrial cancer. As omentectomy may have some positive effects on metabolism in these patients, it may be considered during endometrial cancer surgery due to the possible positive metabolic effects.     

饮食对肥胖大鼠骨关节炎的辅助治疗干预作用研究

目的 探讨饮食护理对肥胖大鼠骨关节炎（OA）大鼠行为学、脂代谢、关节形态及软骨中内脂素的作用。方法 90 只雄性SD 大鼠随机分为六组,除正常组及OA 模型组外,其余各组给予高脂高糖饲料,以内侧半月板切除和前交叉韧带切断的Hulth 法建立骨性关节炎模型,将饮食护理组给予脱脂饲料,同时关节腔注射玻璃酸钠进行治疗;无护理组仅进行玻璃酸钠治疗。肥胖模型组及肥胖OA 模型组在OA 模型成功建立的基础上仍给予高脂高糖饲料,连续12 周。饮食干预12 周后,对各组大鼠称重并量取体长,计算身体质量指数（BMI）;检测大鼠自主活动、抓力、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）水平;观察大鼠膝关节软骨组织形态学变化,检测Visfatin 血清含量水平及软骨组织Visfatin 的蛋白表达。结果 饮食护理组大鼠的体重、BMI、血清TC、TG、LDL-C、Visfatin 含量水平及膝关节软骨组织Visfatin 蛋白表达显著低于肥胖OA 模型组;血清HDL-C 含量水平、活动次数、抓力显著高于肥胖OA 模型组。饮食护理组光镜下幼稚软骨细胞形态正常,损伤脱失明显改善。结论 饮食干预对肥胖OA 大鼠骨性关节炎具有保护作用,该作用可能与降低软骨组织visfatin 蛋白表达水平,改善OA 大鼠脂代谢有关。