沿海地区单纯性肥胖患者骨成型蛋白-4的表达及意义

The expression and significance of bone morphogenetic protein-4 in the patients with simple obesity in coastal areas

目的 探讨沿海地区单纯性肥胖患者骨成型蛋白（BMP）-4表达水平及其与体质量指数（BMI）、腰臀比（WHR）、空腹血糖（FBG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）等的相关性.方法 采用ELISA方法检测了正常对照组和单纯性肥胖各44例血浆BMP-4水平,并采用Logistic回归分析了BMP-4水平与BMI、WHR、血脂、糖化血红蛋白（HbA1c）、FBG、FINS和HOMA-IR等的相关性.结果 单纯性肥胖患者BMP-4水平（10.98±6.76）明显高于对照组（5.12±3.01）,差异有统计学意义（P＜0.01）;Logistic回归线性相关分析表明,BMP-4与三酰甘油（TG）、BMI、FINS和HOMA-IR呈明显正相关（r值分别为0.421、0.425、0.473、0.396,均P＜0.01）.以BMP-4为因变量,性别、年龄、WHR、BMI、TG、总胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、HbA1c、FBG、FINS和HOMA-IR为自变量,进行多元线性逐步回归分析,结果表明FINS是影响BMP-4的相关因素.二项Logistic回归分析表明：控制性别、年龄、WHR、TC、TG、HDL、LDL、HbA1c、FBG和FINS后BMP-4水平与单纯性肥胖仍呈显著相关.结论 BMP-4水平的改变与肥胖患者的代谢紊乱有关,并可能参与了单纯性肥胖的发生和发展.

Objective To investigate the expression levels of bone morphogenetic protein （BMP-4） in the people with simple obesity in coastal areas and its relationship with the BMP-4 expression,body mass index （BMI）,waist hip ratio （WHR）,fasting blood glucose （FBG）,fasting insulin （FINS） and HOMA-IR.Plasma BMP-4 levels of 40 cases with simple obesity and the controls were respectively detected by ELISA.And then,the association of BMP-4 levels with BMI,WHR,HOMA-IR,blood lipids,HbA1c,FBG,FINS and HOMAIR were analyzed by Logistic regression.Methods The BMP-4 levels in the patients with simple obesity （10.98 ±6.76） were significantly higher than those of the control group （5.12 ±3.01）,with statistical significance （P 〈 0.01）.Logistic regression analysis indicated that the BMP-4 levels were positively correlated with the levels of triglyceride（TG）,BMI,FINS and HOMA-IR,with the r value being respectively 0.421,0.425,0.473 and 0.396 （P 〈 0.01）.Multiple regression analysis was made with BMP-4 as the function,sex,age,WHR,BMI,TG,total cholesterol （TC）,low density lipid （LDL）,high density lipid （HDL）,HbA1c,FBG,FINS and BMP-4 as the independent variables.Results indicated that the FINS level was a related factor affecting the BMP-4 level.Binomial Logistic regression analysis indicated that the BMP-4 level was still significantly correlated with simple obesity,following tight control of such factors as sex,age,WHR,TG,TC,LDL,HDL,HbA1c,FBG and FINS.Conclusions The changes in the BMP-4 levels were associated with metabolism disorder of the patients with simple obesity,which might be involved in the pathogenesis of simple obesity.