血清脂联素、内脂素水平与代谢综合征的相关性

Correlation of serum visfatin and adiponectin levels with metabolic syndrome

目的了解代谢综合征(MS)患者血清脂联素、内脂素水平的变化,探讨脂联素、内脂素与MS的关系。方法按2004年中华医学会MS标准进行筛选,分为MS组(42例)和对照组(健康体格检查者,30名),检测人体测量参数和生化指标,并留取血清测定空腹血糖(FPG)、胰岛素(FINS)、血脂、脂联素和内脂素。采用稳态模式评估胰岛素抵抗指数(HOMA-IR)。结果①MS组中,男22例,女20例,平均年龄为(53±10)岁;对照组中,男18名,女12名,平均年龄为(49±10)岁,两组间年龄、性别构成的差异均无统计学意义(P值均>0.05)。②MS组的血清内脂素水平为(97.57±40.69)μg/L,显著高于对照组的(50.54±19.14)μg/L(P<0.05),脂联素水平为(7.98±3.62)mg/L,显著低于对照组的(13.55±5.72)mg/L(P<0.01)。③多元回归分析显示,MS组中腰围是影响血清内脂素水平的独立相关因素(标准偏回归系数=0.415,P=0.000),而与其他指标不相关;脂联素水平与HOMA-IR(标准偏回归系数=-0.341)、腰臀比(标准偏回归系数=-0.211)呈显著负相关(P=0.002、0.048),与高密度脂蛋白胆固醇呈显著正相关(标准偏回归系数=0.312,P=0.004)。结论MS患者的内脂素水平升高,而脂联素水平下降;内脂素可能参与腹型肥胖的发生,脂联素可能对胰岛素抵抗和血脂紊乱有抑制作用,内脂素与脂联素之间的关系不明显。

Objective To investigate the changes of serum adiponectin and visfatin/pre-B cell colony-enhancing factor（PBEF） levels in patients with metabolic syndrome（MS）, so as to understand their association with MS. Methods According to the diagnostic criteria for MS recommended by the Chinese Medical Association in 2004, 42 patients with MS were selected for this study with 30 healthy subjects as the control group. After measurement of the height, body weight and waist circumference, fasting blood samples were collected from all participants to determine the fasting plasma glucose（FPG）, serum insulin, adiponectin and visfatin levels. Radioimmunoassay（RIA） was employed for serum adiponectin level measurement; enzyme-linked immunoassay（EIA） was used for visfatin detection; and homeostasis model assessment of insulin resistance（HOMA-IR） was calculated based on FPG and insulin measurements. Results （1） There were 22 males and 20 females in the MS group, with a mean age of （53±10） years old; there were 18 males and 12 females in the control group, with a mean age of （49±10） years. The ages and sex structure were matchable between the two groups（both P 〉 0.05）. （2） Serum visfatin levels was significantly higher in the MS patients than in the control subjects （[97.57 ± 40.69] μg/L vs [50.54 ± 19. 14] μg/L, P 〈 0.05）, but the adiponectin level was significantly lower（[7.98 ± 3.62] mg/L vs [13. 55 ± 5.72] mg/L, P 〈 0.01）. （3） In patients with MS, serum visfatin level was positively correlated with the waist circumference（Satandard partial regression cofficient = 0. 415, P = 0. 000）, but not with other metabolic indices such as adiponectin, serum insulin, body mass index, HOMA-IR, or triglycerol; adiponectin level was positively correlated with high-density lipoprotein-cholesterol（HDL-C） level（Satandard partial regression cofficient = 0.312, P = 0. 004） but inversely with HOMA-IR（Satandard partial regression cofficient = -0. 341, P = 0. 002） and the waist-hip ratio（Satandard partial regression cofficient =0. 211, P=0. 048）. Conclusions Significantly elevated visfatin and decreased adiponectin levels occur in MS patients. Visfatin may play a role in the development of visceral obesity, and adiponectin may inhibit insulin resistance and dyslipidiemia. No obvious correlation between visfatin and adiponectin is suggested.