游离脂肪酸、胰岛素抵抗与代谢综合征相关因素的关系

Correlations of serum free fatty acid and insulin resistance with metabolic syndrome

目的了解代谢综合征(MS)患者血清游离脂肪酸(FFA)水平的变化,探讨血清FFA与MS各危险因素的关系。方法检测400例MS患者和100名健康体检者(正常对照组)空腹血清FFA、空腹胰岛素(FINS)、空腹血糖(FPG)及血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]浓度,按稳态模型公式计算各组胰岛素抵抗指数(HOMAIR);同时测量身高、体重、腰围、臀围及血压,计算体重指数(BMI)、腰臀比(WHR)。将400例MS患者按原发病分为单纯肥胖组(120例)、糖尿病组(110例)、高血压组(170例)。采用Spearman等级相关分析FFA与血脂、血压、FPG、BMI、WHR及胰岛素的相关性。结果 MS组FFA、FPG、FINS、TC、TG、LDL-C、HOMA-IR、收缩压(SBP)、舒张压(DBP)、BMI、WHR均明显高于正常对照组(P<0.05),而HDL-C明显低于正常对照组(P<0.05)。单纯肥胖组、糖尿病组、高血压组及正常对照组之间HOMA-IR、FFA差异均有统计学意义(P<0.05)。血清FFA与BMI、WHR、HOMA-IR、SBP、DBP、FPG、FINS、TG、LDL-C呈正相关(r值分别为0.581、0.480、0.321、0.215、0.267、0.223、0.325、0.369、0.561,P<0.05),与HDL-C呈负相关(r=-0.613,P<0.05),与TC无相关关系(r=0.674,P>0.05)。结论 MS患者空腹血清FFA水平较正常人明显升高,并与胰岛素敏感性相关。FFA与MS各组分之间均有关系,其中FBG、WHR、HDL-C、FINS与血清FFA及HOMA-IR有一定关系。

Objective To study the change of serum free fatty acid（FFA）in metabolic syndrome（MS）patients,and to investigate the correlation of serum FFA with the risk factors of MS. Methods A total of 400 patients with MS and 100 healthy subjects（healthy control group） were enrolled. Their fasting serum FFA,fasting insulin（FINS）,fasting plasma glucose（FPG） and blood lipids [total cholesterol（TC）,triglyceride（TG）,lowdensity lipoprotein cholesterol（LDL-C）and high-density lipoprotein cholesterol（HDL-C）] were determined,and homeostasis model assessment for insulin resistance（HOMA-IR）was calculated. The height,weight,waist circumference,hip circumference,blood pressure,body mass index（BMI）and waist-to-hip ratio（WHR）were determined simultaneously. The 400 MS patients were classified into simple obesity group（120 cases）,diabetes mellitus group（110 cases）and hypertension group（170 cases）according to protopathies. Spearman analysis was used to analyze the correlations of serum FFA with blood lipids,blood pressure,FPG,BMI,WHR and insulin. Results Serum FFA,FPG,FINS,TC,TG,LDL-C,HOMA-IR,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,BMI and WHR in MS group were higher than those in healthy control group（P〈0.05）,but HDL-C was lower（P〈0.05）. There was statistical significance for HOMA-IR and serum FFA in simple obesity,diabetes mellitus,hypertension and healthy control groups（P〈0.05）. There were positive correlations of serum FFA with BMI,WHR,HOMA-IR,SBP,DBP,FPG,FINS,TG and LDL-C（r were 0.581,0.480,0.321,0.215,0.267,0.223,0.325,0.369 and 0.561,P〈0.05）,and there was a negative correlation with HDL-C（r=-0.613,P〈0.05）and no correlation with TC（r=0.674,P〉0.05）. Conclusions Fasting serum FFA in MS patients is higher than that in healthy subjects with insulin sensitivity. Serum FFA is correlated in MS subgroups,and FPG,WHR,HDL-C and FINS have relationships with serum FFA and HOMA-IR.