正常人群Apelin水平与腹型肥胖的关系

目的探讨正常糖调节人群空腹血清Apelin水平与人体脂肪分布之间的关系。方法收集上海地区正常糖调节的20～60岁中国人70名(男40名,女30名),根据1998年世界卫生组织制定的肥胖诊断标准分为正常体重(NW)1组(37名)和超重/肥胖(OW/OB)1组(33名)。采用酶联免疫吸附试验检测空腹血清Apelin水平,测量各体脂参数并检测各项生化指标。另外收集22例正常糖调节行外科择期手术的患者(NW2组,12例;OW/OB2组,10例),术中收集人网膜和腹部皮下脂肪组织,应用实时定量聚合酶链反应检测ApelinmRNA水平。结果 OW/OB1组的血清Apelin水平显著高于NW1组(P<0.05)。偏相关分析校正年龄、性别、血压、血脂后显示,血清Apelin与体质指数(r=0.375)、腰围(r=0.371)、股围(r=0.385)呈正相关(P值均<0.01),与腰臀比(r=0.252)和腹内脂肪面积(r=0.223)呈正相关(P值均<0.05)。进一步以血清Apelin为应变量,以年龄、性别、体质指数、腰围、腰臀比、股围、收缩压、舒张压、胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、腹内脂肪面积、腹部皮下脂肪面积为自变量进行多元逐步回归分析显示,腰围是影响血清Apelin水平的独立相关因素(r2=0.209,P<0.01)。OW/OB2组的大网膜脂肪组织中ApelinmRNA表达为1.25±0.27,显著高于NW2组的0.85±0.20(P<0.05)。结论腹型肥胖可能是引起血清Apelin水平升高的主要因素。

Influence of abdominal obesity on serum Apelin levels in people with normal glucose regulation

Objective To explore the relationship between fasting serum Apelin levels and the distribution of adipose tissues in people with normal glucose regulation. Methods Seventy Chinese with normal glucose regulation in Shanghai (40 men and 30 women) were divided into normal weight (NW)1 group (n=37) and overweight/obesity (OW/OB)1 group (n=33) according to world health organization (WHO) obesity diagnostic criteria in 1998. Enzyme linked immunosorbent assay (ELISA) was used to detect fasting serum Apelin. Biochemical indicators and lipid parameters were also measured. Another 22 patients with normal glucose regulation undergoing elective abdominal surgery were divided into NW2 group (n=12) and OW/OB2 group (n=10). Omental fat and subcutaneous fat were collected during the operation. Real-time quantitative polymerase chain reaction was used to measure the Apelin mRNA level. Results Serum Apelin levels in OW/OB1 group were significantly higher than those in NW1 (P<0.05). After adjustment for age, sex, blood pressure and blood fat, partial correlation analysis showed that serum Apelin level was positively correlated with body mass index (BMI), waist circumference and femoral circumference (r=0.375, 0.371 and 0.385, P<0.01), and positively correlated with waist hip ratio(WHR) and visceral fat area(VFA, r=0.252 and 0.223, P<0.05). Multiple linear regression analysis showed that waist circumference was an independent factor for serum Apelin level (r2=0.209, P<0.01) when age, sex, BMI, waist circumference, WHR, femoral circumference, systolic pressure, diastolic pressure, cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), VFA and abdominal subcutaneous fat were independent variables. The Apelin mRNA expression of omental fat was significantly higher in OW/OB2 group than that in NW2 group (1.25±0.27 vs. 0.85±0.20, P<0.05). Conclusion Abdominal obesity may be the main factor resulting in the increased level of serum Apelin.