血浆纤溶酶原激活物抑制物1与胰岛素抵抗的相关性研究

目的：探讨血浆纤溶酶原激活物抑制物1（plasminogen activitor inhibitor one,PAI-1)活性及其基因启动子区4G／5G多态性与胰岛素抵抗综合征的关系。方法：应用等位基因特异性PCR扩增技术，对胰岛素抵抗综合征患者（160例）和对照组（90例）PAI－1 4G／5G多态位点的基因型进行检测，用发色底物法测血浆PAI－1活性。结果：（1）胰岛不抵抗综合综合患者PAI－1活性明显升高，空腹胰岛素，空腹血糖，甘油三酯与PAI－1活性升高密切相关（P＜0．01）。（2）对照组和胰岛素抵抗综合征患者，4G／5G基因型频率分别为0．52和0．48，两组比较无明显差异（P＞0．05），但胰岛素抵抗综合征不同基因型者PAI－1活性差异显著（P＜0．01），4G／4G基因型者PAI－1活性高于4G／5G和5G／5G基因型者（P＜0．01）。（3）血糖、甘油三酯对PAI－1活性的调节受基因型的影响。4G／4G基因型者血糖，甘油三酯与PAI－1活性密切相关（P＜0．01），而4G／5G和5G／5G基因型者血糖。甘油三酯与PAI－1活性无明显相关（P＞0．05）。（4）胰岛素对PAI－1活必的影响无基因型依赖性。结论：PAI－1活性升高是胰岛素抵抗综合征患进的特征之一，免疫反应性胰岛素，血糖，甘油三酯与PAI－1活性升高有关，血糖，甘油三酯对PAI－1活性的调节存在明显的基因型依赖性。

The relationship between PAI-1 and insulin resistance syndrome

Objective To investigate the corelationship between PAI 1 activity and PAI 1 promoter 4G/5G polymorphism with insulin resistance syndrome. Methods The 4G/5G allele polymorphism in the PAI 1 gene promoter region were genotyped with an allele specific PCR in patients with insulin resistance syndrome (160)and controls (90).The activity of PAI 1 was assayed by chromogenic substrate method. Results (1)PAI 1 activity was higher in patients with insulin resistance syndrome than in controls.Insulin,blood glucose and triglyceride were responsible for it. (2)Though the frequency of PAI 1 4G/4G genotype was equal in two groups,the plasma PAI 1 activity was significantly different in different genotypes.It was higher in 4G/4G group than in 4G/5G( P <0.01) and 5G/5G group( P <0.01). (3)The level of PAI 1 activity regulated by blood glucose and triglyceride depended on PAI 1 4G/5G genotype. The levels of blood glucose and triglyceride were significantly associated with PAI 1 activity only in 4G/4G group. (4)The plasma PAI 1 activity was regulated by insulin in each group. Conclusion Increased PAI 1 activity caused by insulin ,blood glucose and triglyceride is a character of insulin resistance syndrome. The presence of the 4G allele of PAI 1 gene and higher blood glucose and triglyceride concentrations are associated with higher level of PAI 1 activity and may be involved in the generation of insulin resistance syndrome.