肥胖痰湿体质与肥胖非痰湿体质、代谢综合征患者血清NO相关指标比较研究

Comparison of serum NO and related indexes of obesity: phlegm-dampness constitution,non phlegm-dampness constitution and metabolic syndrome

目的检测肥胖痰湿体质人群血清一氧化氮自由基(NO)及其相关指标,并与肥胖非痰湿及代谢综合征患者比较,揭示肥胖痰湿体质人群内皮功能状态。方法选取符合标准的平和体质组(N)25例,肥胖痰湿组(OPD)33例,肥胖非痰湿组(ONPD)31例,代谢综合征组(MS)26例,进行BMI、WC、体脂率等肥胖相关指标检测及代谢相关指标检测。用硝酸还原酶法测定血清NO含量,用化学比色法测定i NOS、NOS含量,用电化学发光免疫法检测血清胰岛素水平,并采用稳态模式评估法计算胰岛素抵抗值(HOMA-IR)。结果 1)与N组相比,各组肥胖程度和代谢指标均有不同程度的升高或降低(P<0.05或P<0.01),除MS组外其余均不够构成MS诊断。ONPD与OPD相比,肥胖程度无明显变化(P>0.05),但DBP、TG有显著增高(P<0.05)。2)与N组相比,NO含量ONPD无明显变化,OPD及MS组有显著降低(P<0.05,P<0.01)。NOS含量OPD组有显著升高(P<0.05),其余2组无变化,MS组与OPD组相比亦有显著降低(P<0.05)。i NOS在ONPD组无明显变化,OPD和MS组有显著升高(P<0.05)。OPD与ONPD相比亦有显著升高(P<0.05)。3)MS和OPD组水平显著增高(P<0.01),ONPD组有一定程度的升高,但无统计学意义(P>0.05)。OPD和MS组较ONPD组亦明显升高(P<0.05)。结论肥胖痰湿体质人群在构成MS诊断前即出现内皮功能紊乱征兆,是否具备痰湿体质是肥胖者内皮功能紊乱危险度的关键因素。早关注痰湿人群内皮功能状态并早干预,对预防代谢综合征及心脑血管并发症具有重要意义。

Objective To investigate the serum concentration of NO and related indexes of obesity with Phlegmdampness constitution（ OPD）,compared with obesity with no Phlegm-dampness constitution（ ONPD） and Metabolic Syndrome（ MS）,so as to reveal the endothelial function of OPD,which can provide guidance for taking precautions against MS and Cardio-cerebrovascular Complications from the perspective of Phlegm-dampness constitution. Methods Four groups of volunteers were chose in this study： 33 cases of obesity with Phlegm-dampness constitution（ OPD）,31 cases of obesity with NO Phlegm-dampness constitution（ ONPD）,24 cases of metabolic syndrome group（ MS）,and 25 cases of the normal balanced constitution group（ N）. In each group,we detect obesity related indices such as BMI,WC,F%,and MSrelated indices such as DBP,SBP,FPG,TG,HDL-C,LDL-C and TC. We detect NO related indices such as NOS,iN OS,insulin and ralculated the Insulin Resistance Indexes HOMA-IR. Results Compared with the group N,obesity and MS related indices were significantly higher or lower in the group MS（P〈0. 05 orP〈0. 01）. In the group ONPD,there were no significant differences in other indices（P〈0. 05）. In the group OPD,Obesity related indices were significantly higher（P〈0. 01）,SBP,DBP,TG were significantly higher（P〈0. 05）,HDL-C,and HDL-C were significantly lower（P〈0. 01）,but there were no significant differences with FPG,LDL-C,TC. In group OPD,Obesity related indices were similar（P〈0. 05）,and DBP,TG were significantly higher,and other MS indices were similar（P〈0. 05） than the group ONPD. As for NO,compared with N,there were no significant differences in ONPD,but significantly higher in OPD and MS（P〈0. 05 orP〈0. 01）. As for NOS,compared with N,there were no significant differences in ONPD and MS,but significantly higher in OPD（P〈0. 05）. As for iN OS,compared with N,there were no significant differences in ONPD,but significantly higher in OPD and MS（P〈0. 05）. There were also significant differences between OPD and ONPD（P〈0. 05）. As for IR,compared with N,there were no statistical significance in ONPD（P〈0. 05）. Compared with ONPD,there were also significant differences in OPD and MS（P〈0. 05）. Conclusion The persons with OPD have had vascular endothelial dysfunction even not reaching the clinical diagnostic criteria of MS,with the significant differences of NO,iN OS,IR. Obesity whether with Phlegm-dampness constitution is the key risk factor for endothelial dysfunction.So,we should pay close attention to the endothelial function of persons with Phlegm-dampness constitution and give early intervention and treatment,taking advantage of Traditional Chinese Medicine ＂Preventive Treatment of Disease＂,which has important significance for preventing MS and cardio-cerebrovascular complications.