老年代谢综合征患者血清游离脂肪酸与胰岛素抵抗的相关性研究

目的探讨老年代谢综合征（MS）患者中血清游离脂肪酸（FFA）水平与胰岛素抵抗（IR）的相关性。方法选取2009年1月至2010年6月上海交通大学附属第一人民医院老年科住院患者96例，年龄≥65岁。采用2005年国际糖尿病联盟提出的标准，分为MS组38例及非MS组58例，分别检测血清FFA、胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆同醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FBG）、空腹胰岛素（FINS），用稳态模式（HOMAModel）公式计算HOMA—IR评估胰岛素抵抗。分别测各组体重、腰围、身高，计算体质指数（BMI）。结果1、MS组的身高、体重、腰围、BMI、FBG、FINS及HOMA—IR、TC、HDL—C、TG水平均高于非MS组（P〈0．01），MS组的FFA水平高于非MS组（P〈0．01）；2、直线相关分析显示在MS组中FFA水平与FBG、FINS、HOMA-IR呈正相关（P〈0．05）；3、多元逐步回归分析结果显示FFA与HOMA—IR独立相关（P〈0．05）。结论老年MS患者FFA升高，FFA水平与m存在相关性，FFA是老年MS患者IR的独立危险因素。

Study on the relationship between serum free fatty acid levels and insulin resistance in aged patients with metabolic syndrome

Objective To study the relationship between serum free fatty acid （FFA） levels and insulin resistance （IR） in aged patients with metabolic syndrome （MS）. Methods Ninety-six patients （≥65 years old） were divided into MS group （n=38） and non-MS group （n=58） according to the criteria defined by NCEP-ATP III. Height, weight, waistline, body massindex （BMI）, blood pressure （BP）, cholesterol （TC）, triglyceride （TG）, fasting bloodglucose （FBG）, fasting blood insulin （FINS） were measured. Homa-IR indices were calculated by Homa Model. Results Height, weight, waistline, BMI, TC, TG, FBG, FINS and Homa-IR in patients with MS increased significantly, compared with those of non-MS group （P 〈 0.05）. The serum FFA levels of patients with MS were higher than those of non-MS group （P〈0.05）. Correlation analyses indicated that a positive correlation existed among the serum FFA levels and FBG, FINS, HOMA-IR. Multiple regression analysis showed that there was an independent correlation between serum FFA levels and HOMA-IR （P〈0.05）. Conclusion There is a significant increase of serum FFA levels in aged patients with MS. FFA has positive correlation with IR. FFA is the independent dangerous factor of IR in aged MS.