老年代谢综合征患者血清游离脂肪酸与胰岛素抵抗的相关性研究

Study on the relationship between serum free fatty acid levels and insulin resistance in aged patients with metabolic syndrome

目的探讨老年代谢综合征（MS）患者中血清游离脂肪酸（FFA）水平与胰岛素抵抗（IR）的相关性。方法选取2009年1月至2010年6月上海交通大学附属第一人民医院老年科住院患者96例，年龄≥65岁。采用2005年国际糖尿病联盟提出的标准，分为MS组38例及非MS组58例，分别检测血清FFA、胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆同醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FBG）、空腹胰岛素（FINS），用稳态模式（HOMAModel）公式计算HOMA—IR评估胰岛素抵抗。分别测各组体重、腰围、身高，计算体质指数（BMI）。结果1、MS组的身高、体重、腰围、BMI、FBG、FINS及HOMA—IR、TC、HDL—C、TG水平均高于非MS组（P〈0．01），MS组的FFA水平高于非MS组（P〈0．01）；2、直线相关分析显示在MS组中FFA水平与FBG、FINS、HOMA-IR呈正相关（P〈0．05）；3、多元逐步回归分析结果显示FFA与HOMA—IR独立相关（P〈0．05）。结论老年MS患者FFA升高，FFA水平与m存在相关性，FFA是老年MS患者IR的独立危险因素。

Objective To study the relationship between serum free fatty acid （FFA） levels and insulin resistance （IR） in aged patients with metabolic syndrome （MS）. Methods Ninety-six patients （≥65 years old） were divided into MS group （n=38） and non-MS group （n=58） according to the criteria defined by NCEP-ATP III. Height, weight, waistline, body massindex （BMI）, blood pressure （BP）, cholesterol （TC）, triglyceride （TG）, fasting bloodglucose （FBG）, fasting blood insulin （FINS） were measured. Homa-IR indices were calculated by Homa Model. Results Height, weight, waistline, BMI, TC, TG, FBG, FINS and Homa-IR in patients with MS increased significantly, compared with those of non-MS group （P 〈 0.05）. The serum FFA levels of patients with MS were higher than those of non-MS group （P〈0.05）. Correlation analyses indicated that a positive correlation existed among the serum FFA levels and FBG, FINS, HOMA-IR. Multiple regression analysis showed that there was an independent correlation between serum FFA levels and HOMA-IR （P〈0.05）. Conclusion There is a significant increase of serum FFA levels in aged patients with MS. FFA has positive correlation with IR. FFA is the independent dangerous factor of IR in aged MS.