代谢综合征患者血清脂蛋白脂酶含量变化的临床对照研究

Case control study of serum lipoprotein lipase disturbances in patients with metabolic syndrome

目的:了解代谢综合征(MS)患者的代谢紊乱特点,探讨血清脂蛋白酯酶(LPL)含量与MS的内在联系。方法:通过问卷调查、人体测量及生化检查获得腹围(WC)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素(INS)、胰岛素敏感指数(ISI)相关数据,纳入MS组24例和健康对照组24例。进行血清LPL(双抗体夹心ELISA法)和游离脂肪酸(FFA)含量的测定(比色法)。结果:(1)病例组WC、SBP、DBP、TGI、NS和FFA显著高于对照组(P<0.01);HDL-CI、SI、血清LPL含量显著低于对照组(血清LPL含量:43.84±4.43ng/mL vs 50.37±4.41ng/mL,P<0.05),而TC、LDL-C和FPG两组之间差别没有统计学意义(P>0.05);(2)血清LPL含量与WC(r=-0.640)、SBP(r=-0.590)、DBP(r=-0.432)、TG(r=-0.784)和FFA(r=-0.720)呈显著负相关(P<0.01);与ISI(r=0.533)、HDL-C(r=0.463)呈显著正相关(P<0.01);而与TC(r=-0.222)和LDL-C(r=-0.213)无明显相关性(P>0.05)。结论:MS患者存在明显的糖、脂代谢紊乱,其血清LPL含量明显降低,FFA水平明显升高,提示LPL可能在MS的发病中起着重要作用,因而可以作为MS的生化标志物之一。

Objective：Discussing the features of metabolic disturbances in patients with metabolic syndrome,investigating the internal relationship between the LPL mass in serum and metabolic syndrome.Methods：The data of WC,SBP,TG,TC,LDL-C,HDL-C,INS and ISI were obtained with questionnaire,physical measurement and biochemical examination.Then 24 patients with metabolic syndrome formed the experimental group and the other 24 normal individuals were used as the control group.Then,free fatty acid and serum LPL mass were measured in all subjects.Plasma preheparin LPL mass was measured by the sandwich enzyme-linked immunosorbent assay（ELISA） with the application of the kit of LPL.The free fatty acid was measured by colorimetry also with the application of kit of FFA.Results：（1）The WC,SBP,DBP of subjects and the means of TG,INS and FFA in the experimental group were significantly higher than those in the control group（P0.01）,while the means of plasma LPL mass,HDL-C and ISI were reversed（P0.05）.There were no obvious differences in LDL-C,TC and FPG in these two groups.（2） Correlation analysis revealed that plasma LPL mass was significantly negatively correlated with WC（r=-0.640,P0.01）,SBP（r=-0.590,P0.01）,DBP（r=-0.432,P0.01）,TG（r=-0.784,P0.01） and FFA（-0.720,P0.01）,but was positively correlated with ISI（r=0.533,P0.01）,HDL-C（r=0.463,P0.01）and was not correlated with TC（r=-0.222,P0.05）and LDL-C（r=-0.213,P0.05）.Conclusion：Patients with metabolic syndrome always have plasma glucose or lipid metabolic disorder.From the decreased serum LPL mass together with increased FFA mass,we can infer that LPL may be related to the onset of metabolic syndrome,so that serum pre-haparin LPL might be used as a biomarker of metabolic syndrome.