阿昔莫司对老年代谢综合征患者胰岛素抵抗与游离脂肪酸的影响

目的观察老年代谢综合征（MS）患者胰岛素抵抗（IR）和游离脂肪酸（FFA）的变化及阿昔莫司对其影响。方法选取40例老年代谢综合征患者给予阿昔莫司治疗8周，采用放射免疫法和酶比色法测定治疗前后空腹血清胰岛素和FFA水平，并测定空腹血糖、甘油三酯、胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇，应用稳态模型计算胰岛素抵抗指数（Homa-IR），选取40例正常老年人作对照组。测量两组的体重、身高、腰围、臀围，计算体重指数（BMI）、腰臀比（WHI。结果老年MS组Homa-IR和FFA水平较对照组明显升高，（P〈0．01，P〈0．05）。经阿昔莫司干预治疗后，高密度脂蛋白胆固醇明显升高（P〈0．01），甘油三脂、低密度脂蛋白胆固醇、FFA、Homa—IR均明显下降（P〈0．01，〈0．01，0．05，0．01）。结论阿昔莫司能明显降低老年MS患者血清甘油三脂、FFA水平，明显升高高密度脂蛋白胆固醇水平，改善胰岛素抵抗，其机制可能与降低血清FFA水平有关。

Acipimox on the effects of insulin resistance and free fatty acids of metabolic syndrome in elderly patients

Objective To observe the changes of insulin resistance ( IR ) and free fatty acids (FFA) of metabolic syndrome(MS) in elderly patients and its impacts on aeipimoX. Methods 40 cases of metabolic syn-drome in elderly patients that givenaeipimox treatment of 8 weeks, using radioimmunoassay and Enzyme colori- metry methods to detect fasting serum insulin and FFAlevels before and after treatment, and determination of fasting blood glucose, triglyeerides, cholesterol, law-densitylipoprotein cholesterol, high density lipoprotein cho-lesterol. To compute indices of insulin resistance (Homa-IR) by steady-state model, selected 40 cases of normal elderly for control group. To measure weight, Height, waist circumference, hipcircumferenee and calculate body mass index(BMI) ,waist-hip ratio(WHI) of the two groups. Results The Homa-IR and FFAlevels in elderly MS Group were significantly higher than the control group, ( P < 0. 01, P < 0. 05 ). After treatment by intervention of Aeipimox, the high-density lipoprotein cholesterol levels was signifieandy increased ( P < 0. 01 ) , and thetriglyeer-ide,low-density lipoprotein cholesterol, FFA, Homa-IR levels were significantly decreased ( P < 0. 01, < 0. 01, O. 05,0. 01 ). Conclusions Aeipimox can significantly reduce serum triglyeeride,FFA levels and increase high densitylipoprotein cholesterol levels of metabolic syndrome in elderly patients, improving insulin resistance. Itsmechanism mayrelsted to a reduction of serum FFA levels.