成纤维细胞因子21同腹型肥胖者颈动脉内膜中层厚度及胰岛素抵抗关系的研究

目的探讨腹型肥胖者成纤维细胞因子21(FGF21)同颈动脉内膜中层厚度(IMT)及胰岛素抵抗(IR)的关系。方法在体检人员中选择腹型肥胖者90例,并根据颈动脉IMT将其90例分为IMT增厚组(A组)和IMT正常组(B组),并选择90例健康者(C组)进行比较,分别进行FGF21、稳态胰岛素评价指数(HOMA-IR)等参数测定。结果A组的颈动脉IMT、ln(HOMA-IR)和FGF21均分别高于B组和C组,差异有统计学意义(P0.05);颈动脉IMT和ln(HOMA-IR)(r=0.611,P0.01)、FGF21(r=0.464,P0.01)、TC(r=0.370,P0.05)、收缩压(r=0.276,P0.05)呈正相关。FGF21水平同BMI(r=0.454,P0.01)、WHR(r=0.353,P0.01)、TG(r=0.266,P0.05)、ln(HOMA-IR)(r=0.223,P0.05)、空腹胰岛素水平(r=0.220,P0.05)呈正相关。Logistic回归分析结果显示,FGF21、收缩压、ln(HOMA-IR)为动脉粥样硬化的独立危险因素(P0.05)。结论肥胖者颈动脉IMT已有所升高,FGF21可能对预测肥胖者早期的动脉粥样硬化有重要意义。

Correlation of serum fibroblast growth factor-21,carotid arterial intima-media thickness and insulin resistance in patients with abdominal obesity

Objective To investigate the correlation of fibroblast growth factor‐21(FGF21) ,carotid arterial intima‐media thick‐ness (IMT) and insulin resistance (IR) in patients with abdominal obesity .Methods Ninety patients with abdominal obesity in physical examination were divided into two groups according to carotid arterial IMT level :IMT normal group (group B) and IMT increased group (group A) .Ninety healthy people were chosen as control (group C) .All subjects were measured with FGF21 and homeostasis insulin assessment index (HOMA‐IR) .Results The carotid arterial IMT ,FGF21 and ln(HOMA‐IR) levels in group A and B were significantly higher than those in group C(P<0 .05) .There was a positive correlation of the levels of the carotid arte‐rial IMT with ln(HOMA‐IR)(r=0 .611 ,P<0 .01) ,FGF21(r=0 .464 ,P<0 .01) ,TC (r=0 .370 ,P<0 .05) and SBP(r=0 .276 , P<0 .05) .The FGF21 level was positively correlated with BMI (r=0 .454 ,P<0 .01) ,WHR(r=0 .353 ,P<0 .01) ,TG(r=0 .266 , P<0 .05) ,ln(HOMA‐IR)(r=0 .223 ,P<0 .05) and fasting insulin (r=0 .220 ,P<0 .05) .Logistic regression analysis showed that FGF21 ,SBP ,ln(HOMA‐IR) were independent factors for the patients with atherosclerosis(P<0 .05) .Conclusion The carotid ar‐terial IMT of patients with abdominal obesity has increased .And the level of FGF21 may predict the early stage of atherosclerosis in patients with abdominal obesity .