血清抵抗素与代谢综合征患者内皮功能障碍的关系研究

目的：探讨抵抗素与代谢综合征（MS）患者内皮功能障碍的相关性。方法：人选2006年3月～2008年9月于我院门诊或住院的MS初诊患者48例为MS组，以门诊健康体检者48例为对照组。采用酶联免疫吸附测定（ELISA）法检测两组的血清抵抗素水平，同时应用高频超声探头分别测量两组的肱动脉基础内径、反应性充血内径、含服硝酸甘油（NTG）后内径，计算血流介导的肱动脉舒张反应（FMD），并运用多普勒技术测定血流速度峰值。应用第95百分位数法确定MS组的血清抵抗素水平界值点（65μg／L），根据该值将患者再分为两亚组：较高组和较低组。比较组间及组内上述参数的差别。结果：MS组的血清抵抗素水平较对照组明显升高[（83±6）μg／L：（16±5）μg／L，P〈0．001]，并且其FMD显著恶化[（4．80±0．60）％：（6．00±0．50）％，P=0．006]；在MS组中，与抵抗素水平较低组比较，较高组患者的肱动脉FMD显著恶化[（5．63±0．12）％：（3．68±0．20）%。P〈0．001]，然而，两组间NTG介导的肱动脉舒张反应及反应性充血时峰值血流速度没有显著差别（P均〉0．05）。偏相关分析显示，控制混杂因素以后，MS患者的血清抵抗素水平与内皮功能障碍仍存在负相关性（rs=-0．373，P〈0．001）。结论：代谢综合征患者的血清抵抗素水平明显升高，与其内皮功能障碍有一定相关性，可作为代谢综合征患者的内皮功能障碍的预测指标。

Relationship between serum resistin level and endothelial dysfunction in patients with metabolic syndrome

Objective： To investigate the relationship between serum resistin level and endothelial dysfunction in patients with metabolic syndrome （MS）. Methods： A total of 96 subjects were randomly divided into two groups： MS group （n=48） and control group （n=48）. The baseline diameter of brachial artery, the reactive hyperemia diameter and the diameter after sublingual nitroglycerin was respectively examined by high-resolution ultrasonic transducer and flow-mediated dilation as the percent change in the brachial artery in response to hyperemia was calculated. At the same time, the maximum blood flow velocity at rest and during reactive hyperemia was also determined by pulsed-Doppler signals. The cutoff point of the serum resistin level in the MS was determined by the 95th percentile. According to the cutoff point （65μg/L）, the MS patients were divided into two group： resistin level higher group and lower group. The parameters above were respectively compared in all groups. Results： Compared with control group, the serum resistin levelincreased [ （16±5）μg/L： （83±6）μg/L, P〈0.001], and the FMDdecreased [ （6.00±0.50）% ; （4.80±0.60）%, P=0.006] in MS group. In the MS group, compared with the resistin level lower group, FMD significantly decreased [ （5.63±0. 12）%： （3.68±0.20）%, P〈0. 001] in resistin level higher group, whereas the vasodilation reaction induced by NTG and the maximum blood flow velocity of reactive hyperemia in two groups remained unaltered （both P〉0.05）. Partial correlation analysis showed that there was negative relationship between the serum resistin level and endothelial dysfunction in MS patients （r=-0. 373, P〈0. 001） after adjusting confounding factors. Conclusion： There was significant correlation between resistin and endothelial dysfunction in MS. The serum resistin level can predict the occurrence of the endothelial dysfunction in MS.