代谢综合征患者氧化修饰型低密度脂蛋白与胰岛素抵抗的关系

Relationship Between Oxidized Low Density Lipoprotein and Insulin Resistance in Patients with Metabolic Syndrome

目的:探讨氧化修饰型低密度脂蛋白(ox-LDL)在代谢综合征(MS)患者中的水平及其和胰岛素抵抗的相关程度。方法:用酶联免疫吸附法(ELISA)测定单纯MS组(17例)、MS+CHD组(40例)和正常对照组(19例)氧化修饰型低密度脂蛋白(ox-LDL)水平和空腹血浆真胰岛素水平,并收集MS的其他有关数据:腰围、体重指数、空腹血糖和血脂,计算胰岛素敏感指数(ISI)。结果:氧化修饰型低密度脂蛋白(ox-LDL)水平在正常对照组为(5.97±5.18)μg/L,MS组为(24.68±12.00)μg/L,两组间差异有显著性意义,(F=11.48,P<0.05)。氧化修饰型低密度脂蛋白水平与ISI呈负相关(r=-0.472,P<0.05),与体重指数、腰围、低密度脂蛋白胆固醇、空腹真胰岛素无明显相关性。以氧化修饰型低密度脂蛋白水平为应变量的多元逐步回归分析提示,胰岛素敏感指数(r2=0.224)与氧化修饰型低密度脂蛋白具有相关性,体重指数、腰围、低密度脂蛋白胆固醇、空腹真胰岛素与氧化低密度脂蛋白无明显相关性。结论:MS患者的氧化修饰型低密度脂蛋白(ox-LDL)水平增加,并与胰岛素抵抗相关,而且可能在MS发展为CHD中起一定作用。

Objective： To investigate the relationship between oxidized low density lipoprotein versus insulin resistance and the metabolic parameters in patients with metabolic syndrome （ MS ） or MS complicated by coronary atherosclerotie heart disease （ MS ＋ CHD ）. Method： Oxidized low density lipoprotein level and fasting plasma insulin level were measured by means of enzyme linked immunosorbentassay rriethod in 17 MS patients,40 MS ＋ CHD patients and 19 healthy controls. Other information on conventional clinical features of MS, such as waist, BMI ,fasting blood glucose and blood fat were collected and the insulin sensitivity index （ ISI ） were calculated. Result： （1）There was significant difference in oxidized low density lipoprotein concentrations between controls （5.97 ±5.18 ）μg/L, subjects with MS（24.68 ± 12.00） μg/L. （2）Correlation analysis results suggested that the oxidized low density lipoprotein concentration was related to insulin sensitivity index （ r = - 0.472, P 〈 0.05 ） , there was no obvious relation between oxidized low density lipoprotein concentration and the metabolic parameters including body mass index,waist,low density lipoprotein cholesterol, fasting insulin. （3）Logistic regression analysis indicated a statistically significant relationship between oxidized low density lipoprotein concentration and ISI （rE = 0. 224, P 〈 0.05 ）, the metabolic parameters including body mass index,waist,low density lipoprotein cholesterol,fasting insulin were not correlated to oxidized low density lipoprotein. Conclusion：The oxidized low density lipoprotein concentration was highest in patients with MS ＋ CHD, and increased in patients with MS, which were significantly correlated with insulin resistance. This may contribute to development to coronary atherosclerotic heart disease from metabolic syndrome.