血清脂联素水平与代谢综合征组分的相关性研究

Correlation of plasma adiponectin and components of metabolic syndrome

目的探讨血清脂联素水平与代谢综合征（metabolic syndrome，Ms）各组分的相关性。方法采用整群随机抽样的方法，抽取上海市的两个城区，经调查和体检，筛选出MS患者235例。通过对MS患者的脂联素水平与MS各组分（腰围、血压、血糖、血脂）相关性分析及主成分回归分析，初步探讨血清脂联素水平与Ms各组分的关系。结果男性脂联素水平为（2．82±1．73）μg／ml低于女性的（5．12±3．51）μg/ml，差异有统计学意义（Z=-5．25，P=0．00）。脂联素水平[（4．38±3．23）μg／ml]与腹部肥胖相关，其与腰围[（93．37±7．76）cm]的spearman秩相关系数为rs=-0．18（tr=-279，P=0.01）；与腰臀比（0．91±0.05）的spearrnan秩相关系数为rs=-0．28（tr=-444，P=0.00），而与人体质量指数（bodymBssindex，BMI）[（26．85±3．10）kg／m^2]无显著相关性（rs=-0.10，tr=-1．45，P=0.15）。脂联素与胰岛素抵抗相关指标关系密切，包括空腹血糖[（5．48±1．72）mmol／L]（rs=-0．13，tr=-2．00，P=0．05）、空腹胰岛素[（11．52±5．34）mU／L]（rs=-0．15，tr=-2．31，P=0．02）、稳态模式评估法的胰岛素抵抗指数（HOMA—IR）（2．90±2．07）（rs=-0．17，tr=-2．63，P=0．01）及甘油三酯水平[（2．11±1．24）mmoL／L]（rs=-0．24，tr=-3．77，P=0．00）。脂联素与总胆固醇水平[（5．01±1．19）mmoL／L]（rs=-0．05，tr=-0．78，P=0．44）、高密度脂蛋白胆固醇（HDL—C）[（1．21±0．32）mmol／L]（rs=0．06，tr=0．93，P=0．36）、收缩压[（131．40±14．93）mmHg，1mmHg=0．133kPa]（rs=-0．02，tr=-0．34，P=0．73）及舒张压[（86．77±9．14）mmHg]（rs=-0．02，tr=-0．27，P=0．78）无显著相关性。结论MS患者血清脂联素水平与腹部肥胖及胰岛素抵抗相关指标呈负相关，而与血压未见直接联系。

Objective To identify the relationship of adiponectin and the components of metabolic syndrome （MS）. Methods Cluster random sampling was applied in two districts of Shanghai. Two communities were selected. After investigating and physical examination, 235 MS subjects were obtained. Correlation analysis and principle components regression analysis were used to analyze the relationship between adiponectin and components of MS （ waist circumference, blood pressure, blood glucose and lipid ）. Results Adiponectin in male was （ 2. 82 ± 1.73 ） μg/ml, lower than in female [ （ 5.12± 3.51 ） μg/ml ] with statistical difference （ Z = - 5.25, P = 0. 00 ）. Adiponectin levels [ （ 4. 38 ± 3.23 ）μg/ ml] correlated with abdominal obesity, including waist circumference [ （ 93.37 ± 7.76 ） cm ] （ r, = - 0. 18, tr = -2. 79, P = 0. 01 ） and waist hip ratio （0. 91 ±0. 05 ） （rs = -0. 28, tr = -4.44,P = 0. 00）, but did not correlate significantly with body mass index （ BMI ） [ （ 26. 85±3.10 ） kg/m^2 ] （ rs = - 0. 10, tr = - 1.45, P = 0. 15 ）. Adiponectin correlated negatively with insulin resistance related indexes, including fasting glucose [ （5.48 ± 1.72） mmol/L] （rs = -0. 13,tr = -2. 00,P =0. 05） ,fasting insulin[ （11.52±5.34） mU/L] （rs = - 0. 15, tr = - 2. 31, P = 0. 02 ）, homeostasis model assessment of insulin resistance （HOMA-IR） （2.90±2.07） （rs = -0.17,tr= -2.63,P=0.01） and trigliceride[（2.11 ± 1.24） mmol/L] （rs =-0. 24, tr = -3.77, P = 0. 00 ）. The correlations were not observed between adiponectin with total cholesterol [ （5.01±1.19 ） mmol/L] （ rs= - 0. 05, tr = - 0. 78, P = 0.44 ）, high density lipoprotein- cholesterol （HDL-C） [ （ 1.21±0. 32） mmol/L ] （ rs= 0. 06, tr = 0. 93, P = 0. 36 ） , systolic blood pressure [（131.40±14.93） mm Hg,1 mm Hg=0.133 kPa]（rs= -0.02,tr= -0.34,P=0.73） and diastolic blood pressure[ （86. 77±9. 14）mm Hg]（rs = -0. 02,tr = -0. 27,P =0. 78）. Conehmion Adiponectin should correlate negatively with abdominal obesity and insulin resistance, but not directly correlate with blood pressure in MS.