血浆内脂素在代谢综合征各组分的表达及相关因素分析

目的观察代谢综合征(MS)患者与健康人群血浆内脂素水平的变化。方法采用病例—对照研究,共入选118例。健康对照组48例为健康体检者;病例组70例根据MS定义中组分的累加评分(1个组分为1分,以此类推,计为1～4分)分为:1分组(10例)、2分组(18例)、3分组(24例)、4分组(18例),其中符合MS诊断者(即3分组和4分组之和)为MS组(42例)。用酶联免疫吸附方法(ELISA)测定空腹血浆内脂素浓度,化学发光法测定空腹血清胰岛素浓度(FINS),同时常规测量身高、体质量、腰围(WC)、臀围、BP,计算BMI、WHR、WHtR,检测空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、血尿酸(UA)等指标,并用稳态模型法计算胰岛素抵抗指数(HOMA-IR)。比较各组血浆内脂素水平,并将内脂素与其他指标进行直线相关分析及多元线性回归分析,观察血浆内脂素与各检测指标间的关系。观察随着MS组分的聚集,血浆内脂素水平的变化。结果 (1)MS组的血浆内脂素水平(547±67)μg/L明显高于健康对照组(498±46)μg/L,差异有统计学意义(P<0.01)。(2)MS患者1～4分组血浆内脂素水平分别为(469±59)μg/L、(530±54)μg/L、(538±70)μg/L、(559±66)μg/L。内脂素水平随着MS组分的增加呈升高趋势,其中3、4分组血浆内脂素水平高于1分组,差异均有统计学意义(P<0.05)。(3)直线相关分析显示血浆内脂素水平与BMI、WC、WHR、WHtR、TC、TG、HDL-C、Apo-B、FBG、HOMA-IR呈正相关(r值依次为0.473、0.366、0.327、0.415、0.460、0.325、0.465、0.331、0.327、0.344,P均<0.05)。多元线性回归分析显示WC、WHtR为影响血浆内脂素水平的最显著因素。结论 (1)MS患者血浆内脂素水平明显高于健康人群。随着MS组分的聚集,血浆内脂素水平逐渐升高。(2)WC、WHtR是影响血浆内脂素的独立相关因素。内脂素可能在MS以及相关疾病的发病过程中起一定作用。

The level of plasma visfatin in components of metabolic syndrome and associated factors

Objective To detect the changes of plasma visfatin levels in healthy people and patients with metabolic syndrome（MS）.Methods As a case control study,118 patients were enrolled in the study,included normal control group （48 cases） and metabolic syndrome group（70 cases）,which were further divided according to the definition of components of MS cumulative score（1～4）：1 component（10 cases）,2 components（18 cases）,3 components（24 cases）,4 components （18 cases）.MS group was defined over than score 3（42 cases）.Fasting plasma visfatin level（by ELISA）,fasting insulin （by electorchemiluminescence immunoassay）,height,weight,WC,hip,BP,BMI,WHR,WHtR,fasting blood glucose （FBG）,total cholesterol（TC）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,apoprotein-A（Apo-A）,apoprotein-B（Apo-B）,and blood uricemia acid（UA） were measured in each patient and the HOMA-IR was calculated according to the typical HOMA model.The differences in each parameter were compared among subgroups and groups.The correlations between visfatin and other parameters were investigated by multiple linear stepwise regression analysis.And observing the changes of plasma visfatin levels and the aggregation of the MS components. Results（1） The visfatin level in MS group（547μg/L±67μg/L）was significantly higher than that in normal control group （498μg/L±46μg/L）（P〈0.01）.（2） The visfatin level in MS 1～4 group were（469±59）μg/L,（530±54）μg/L, （538±70）μg/L,（559±66 ）μg/L.The visfatin level in MS 1 group were significantly lower than that in MS 3 group and MS 4 group（P〈0.05）.（3） The correlation analysis showed significantly positively correlations between plasma visfatin and BMI,WC,WHR,WHtR,TC,TG,HDL-C,Apo-B,FBG,HOMA-IR（r=0.473,0.366,0.327,0.415,0.460,0.325, 0.465,0.331,0.327,0.344 respectively,P〈0.05）.Multiple linear regression analysis showed that WC,WHtR were the most significant factors which affecting plasma visfatin levels.Conclusion（1） The plasma visfatin level was significantly higher in patients with MS.With the aggregation of MS components,plasma visfatin level was gradually increased.（2） There was an independent correlation between the levels of plasma visfatin and WC,WHtR,which implied that visfatin may play a role in the pathogenesis of MS and related disease.