代谢综合征患者内脂素和脂联素与颈动脉粥样硬化的关系

Correlation of Carotid Atherosclerosis with Visfatin and Adiponectin in Patients with Metabolic Syndrome

目的研究代谢综合征患者血浆内脂素和脂联素水平的变化,并探讨其与动脉粥样硬化的关系。方法 64例代谢综合征患者根据颈动脉超声检查结果分为有颈动脉斑块组27例(MS-B组),无颈动脉斑块组(MS-A组)37例,同时分别测定其血浆内脂素和脂联素,行双侧颈动脉超声检查半定量估计斑块的范围及严重程度。以32例健康体检者为对照组。分析血浆内脂素和脂联素与颈动脉粥样硬化的关系。结果有颈动脉斑块组代谢综合征患者内脂素水平高于和脂联素水平低于无颈动脉斑块组代谢综合征患者(P<0.01),且代谢综合征患者内脂素水平高于和脂联素水平低于健康对照组(P分别<0.05和0.01)。多元逐步回归分析显示颈动脉斑块与内脂素、胰岛素抵抗指数和hsCRP呈正相关(r=0.76,r=0.78,r=0.36,P<0.01);颈动脉斑块与脂联素呈负相关(r=-0.685,P<0.01)。结论颈动脉斑块与血浆内脂素水平呈明显正相关,颈动脉斑块与血浆脂联素水平呈明显负相关。内脂素和脂联素分别可能是颈动脉粥样硬化的独立预测因子,可用于MS病人危险分层的评估。

Objective investigate the changes of visfatin and adiponectin （APN） levels in patients with metabolic syndrome （MS） and its correlation with carotid atherosclerosis. Methods Based on the results of bilateral carotid artery echocardiography, 64 MS patients were divided into two groups： MS group without carot- id plaque and MS group with carotid plaque. Plasma visfatin and APN levels were examined. The relationships between visfatin, APN and IMT were investigated. Results Plasma visfatin level was elevated in MS patients compared with that in control group（ P 〈0.01 ）, and the level was much highere in MS with carotid plaque than that in MS without carotid plaque （P 〈 0.01 ）. Plasma APN content was lowered in MS group as compared to that in control group （P 〈0.01 ）,and it was lower in MS with carotid plaque than that in MS without carotid plaque （P 〈 0.01 ）. Multiple stepwise regression analysis revealed that carotid atherosclerotic plaque was posi- tively related with visfatin level, HOMA-IR and hs-CRP （ r = 0.76, r = 0.78, r = 0.36, P 〈 0.01 ）, but it was negatively correlated with APN （ r = - 0. 685, P 〈 0.01 ） in MS patients. Conclusion Carotid atherosclerotic plaque is positively related with visfatin level, but is negatively correlated with APN level. Elevated plasma vis- fatin and reduced APN may be respectively an independent predictor of carotid atherosclerosis, and it can be used for assessment of the risk stratification of MS patients