急性冠状动脉综合征血清瘦素与血脂、胰岛素的关联研究

Study on the Correlationship Between Serum Leptin and Lipids, Insulin Levels in Patients with Acute Coronary Syndrome (ACS)

目的:探讨瘦素、胰岛素抵抗与血脂的相互关系,评价瘦素在急性冠状动脉综合征(ACS)中的作用。方法:38例ACS、34例稳定型心绞痛患者和36例正常人,采用放射免疫分析和生化法测定空腹血清瘦素、血脂、胰岛素水平,并进行相关分析。结果:ACS患者瘦素水平明显高于对照组;血脂与胰岛素水平类似瘦素变化。相关实验显示,瘦素水平与CH、TG呈正相关(r=0.41,P<0.05;r=0.36,P<0.05),与INS呈显著正相关(r=0.58;P<0.01),与HDL-c呈显著负相关(r=-0.40,P<0.05)。结论:ACS患者的瘦素水平与血脂代谢、高胰岛素血症/胰岛素抵抗以及代谢综合征的其他成分密切相关,并通过氧化应激、血栓形成等加速动脉粥样硬化的发展。

Objective To explore the role of leptin in the pathogenesis of ACS through study on the correlationship between serum leptin and lipids, insulin levels in patients with ACS. Methods Serum leptin, insulin (with RIA) and lipids (with biochemical method) levels were measured in 72 patients with coronary heart disease (ACS n=38, stable CHD n=34) and 36 controls. Results Serum leptin, lipids and insulin levels were all significantly higher in the ACS patients than those in controls. Leptin levels were positively correlated with those of CH and TG (r=0.41, P<0.05; r=0.36,P<0.05); significantly positively correlated with those of insulin (r=0.58;P<0.01) and negatively correlated with those of HDL-C (r=-0.40,P<0.05). Conclusion The higher serum leptin levels in patients with ACS were closely related to the derrangement of lipid metabolism and increase of insulin resistance in metabolic syndrome. It could also accerlate the deposition of atheromatous plaque and initiate inflammation.