代谢综合征患者胰岛素抵抗与游离脂肪酸的变化及非诺贝特的干预

目的观察代谢综合征（MS）患者胰岛素抵抗（IR）和游离脂肪酸（FFA）的变化及非诺贝特对其影响。方法入选30例MS患者，给予非诺贝特治疗12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水平及空腹血糖、血脂，计算IR指数。另选30例正常人作为对照。结果MS患者HOMA—IRI和FFA较正常人明显升高（P分别〈0．01和〈0．05）。经非诺贝特干预后，高密度脂蛋白胆固醇明显升高（P〈0．01），甘油三酯、IR指数、FFA均明显下降（P分别〈0．01，〈0．01及〈0．05）。结论非诺贝特能够明显降低MS患者血清甘油三酯水平，升高高密度脂蛋白胆固醇水平，改善IR，其机制可能与降低血清FFA浓度有关。

Changes of insulin resistance and free fatty acid of pPatients with metabolic syndrome and efficiency of fenofibrate

Objective] To explore the changes of insulin resistance (IR) and free fatty acid (FFA) of patients with metabolic syndrome (MS) and the effect of fenofibrate on them. Methods] 30 patients with MS were treated with fenofibrate for 12 weeks. Fasting serum insulin and FFA were measured by radioimmunity and enzyme-colorimetric method. Homeostasis Model Assessment insulin resistance index (HOMA-IRI) was calculated by using the Homeostasis Model Assessment equation. 30 healthy subjects were selected for comparison. Results] HOMA-IRI and FFA of patients with MS were significantly increased compared to those for comparison (P <0.01, <0.05, respectively). Triglycerides, IR index, and FFA were significantly decreased (P <0.01, <0.01, <0.05, respectively) and high density lipoprotein was significantly increased after treated with fenofibrate (P <0.01). Conclusion] Fenofibrate could significantly decrease triglyceride level and increase high density lipoprotein level of patients with MS, and improve their IR. It may be associated with decrease in serum FFA concentration.