肥胖人群抵抗素表达与血清游离脂肪酸、肿瘤坏死因子α、脂联素水平的研究

Expression of resistin in obese subjects with serum free fatty acid,tumor necrosis factor-α and adiponectin

目的了解3种脂肪细胞因子(游离脂肪酸、肿瘤坏死因子α和脂联素)与肥胖人群抵抗素表达的关系。方法选取19例肥胖和29例非肥胖受试者,采用逆转录聚合酶链反应(RT-PCR)方法,检测腹部皮下与大网膜脂肪组织中抵抗素mRNA的表达,同时测定血清抵抗素、肿瘤坏死因子α(TNF-α)、游离脂肪酸(FFA)和脂联素等指标,计算胰岛素敏感性指数及胰岛素抵抗指数(HOMA-IR)。结果肥胖组的血清FFA、TNF-α和抵抗素水平高于非肥胖组(均P<0.05);而血清脂联素水平却低于非肥胖组(P<0.05);抵抗素在各组皮下及网膜脂肪组织中的表达差异均无统计学意义;以血清抵抗素为因变量进行多元逐步回归分析,显示脂联素、TNF-α、皮下脂肪组织中抵抗素表达、FFA进入回归方程;相关分析显示,血清抵抗素与体质量指数、FFA、TNF-α、HOMA-IR呈正相关(分别r=0.457,P=0.008;r=0.708,P=0.000;r=0.520,P=0.006;r=0.703,P=0.000),与血清脂联素水平呈负相关(r=-0.928,P=0.000);皮下脂肪中抵抗素表达与TNF-α呈负相关(r=-0.352,P=0.039),与网膜脂肪中抵抗素的表达呈正相关(r=0.285,P=0.05),与血清FFA和脂联素水平无相关性。结论提示TNF-α、皮下脂肪组织中抵抗素表达和FFA对血清抵抗素水平具有正性影响,而脂联素对抵抗素水平产生负性作用;TNF-α可能下调皮下脂肪中抵抗素的表达。

Objective To observe the relationship between the adipocytokines,tumor necrosis factor（TNF-α）, free fatty acid（FFA） and adiponectin, and the expression of the resistin mRNA in obese subjects. Methods The expression levels of resistin mRNA were measured by RT-PCR in adipose tissue of 19 subjects with obesity（BMI≥25） and 29 normal controls（BMI〈25）. Serum resistin, APN, TNF-α, FFA were also detected. Results Serum resistin, TNF-α and FFA levels in obese subjects were significantly higher than those of normal controls（all P 〈0.05）, serum adiponectin level was significantly lower than that of normal controls. There was no statistical significance between the expression level of resistin mRNA in omental adipose tissue and that in abdominal subcutaneous adipose tissue（ P 〈0.05）. The serum resistin was positively correlated with BMI, FFA, TNF-α, HOMA-IR and negatively correlated with serum adiponectin. Among 48 subjects observed, the expression level of resistin mRNA in abdominal subcutaneous adipose tissue was negatively correlated with serum TNF-α （r =-0. 352, P = 0. 039）; and those were positively correlated with the resistin mRNA expression level in omental adipose adipose （ r =0. 285, P =0.05） ; and there was no significant difference with the serum adiponectin, FFA. Conclusion Serum TNF-α, the expression level of resistin mRNA in subcutaneous adipose tissue and FFA have positive effects on the serum resistin, while serum adiponectin has negative effects on it. The serum level of TNF-α may downregulate the expression of the resistin in abdominal subcutaneous adipose tissue.