代谢综合征患者血清内脏脂肪素和肾功能变化的相关性研究

The relationship of serum visfatin and renal function in metabolic syndrome

目的研究代谢综合征(MS)患者血清内脏脂肪素(Visfatin,简称内脂素)和肾功能的变化;并分析它们之间的内在联系。方法以85例MS患者和88例正常对照为研究对象,MS患者按GFR≥90 ml.min-1.1.73 m-2和GFR<90 ml.min-1.1.73 m-2分为两组,记录并检测临床和生化指标,采用酶联免疫法检测血清内脂素水平,MDRD公式法计算肾小球滤过率(GFR)。结果MS组和对照组年龄性别匹配。与对照组比较,MS组患者血清内脂素(对数值)和肌酐水平显著升高〔(1.06±0.16)vs(0.98±0.25)ng/ml,P<0.05;(73.20±13.95)vs(63.93±13.78)μmol/L,P<0.01〕;GFR水平显著减低〔(90.88±19.91)vs(109.10±32.43)ml.min-1.1.73 m-2,P<0.01〕;GFR减低的MS患者血清内脂素水平明显高于GFR正常的MS患者〔(1.11±0.15)vs(1.03±0.16)ng/ml,P<0.05〕;直线相关分析GFR与血清内脂素水平呈显著负相关(r=-0.19,P<0.05);多元线性回归分析显示血清内脂素水平是GFR的独立危险因素(β=-0.17,P<0.01)。结论血清内脂素水平与MS患者肾功能密切相关,可能是MS患者肾脏病变的重要参与因素。

Objective To investigate the concentration of serum visfatin and renal function,and their relationship in metabolic syndrome（MS）.Methods A total of 85 patients with MS and 88 controls were included.The patients were further divided into two groups： 58 cases with Glomerular filtration rate（GFR）≥90 ml·min-1·1.73 m-2 and 27 cases with GFR90 ·min-1·1.73 m2.Serum visfatin concentration was measured by enzyme immunoassay method.Results Compared with age-and sex-matched controls,the concentrations of serum visfatin and creatinine were significantly elevated in MS patients（（1.06±0.16） vs（0.98±0.25） ng/ml,P0.05;（73.20±13.95） vs（63.93±13.78） μmol/L,P0.01）;the GFR was significantly decreased（（90.88±19.91） vs（109.10±32.43） ml·min-1·1.73 m-2（P0.01）;and the concentration of serum visfatin was significantly higher in patients with GFR≥90 ml·min-1·1.73 m-2 than that in patients with GFR90 ml·min-1·1.73 m-2（（1.11±0.15） vs（1.03±0.16） ng/ml,P0.05）.Linear correlation analysis showed that GFR was significantly negatively related to serum visfatin（r=-0.19,P0.05）.Multiple stepwise regression analysis revealed that elevated concentration of serum visfatin was an independent risk factor for reduced GFR（β=-0.17,P0.01）.Conclusions Elevated concentration of serum visfatin significantly correlates with the declined renal function in MS.Visfatin may participate in renal damage in MS.