血浆纤溶酶原激活物抑制物1与胰岛素抵抗的相关性研究

The relationship between PAI-1 and insulin resistance syndrome

目的 探讨血浆纤溶酶原激活物抑制物 1(plasm inogen activitor inhibitor one,PAI- 1)活性及其基因启动子区 4 G/ 5 G多态性与胰岛素抵抗综合征的关系。 方法 应用等位基因特异性PCR扩增技术 ,对胰岛素抵抗综合征患者 (16 0例 )和对照组 (90例 ) PAI- 14 G/ 5 G多态位点的基因型进行检测 ,用发色底物法测血浆 PAI- 1活性。 结果 (1)胰岛素抵抗综合征患者 PAI- 1活性明显升高 ,空腹胰岛素、空腹血糖、甘油三酯与 PAI- 1活性升高密切相关 (P<0 .0 1)。 (2 )对照组和胰岛素抵抗综合征患者 ,4 G/ 5 G基因型频率分别为 0 .5 2和 0 .4 8,两组比较无明显差异 (P>0 .0 5 ) ,但胰岛素抵抗综合征不同基因型者 PAI- 1活性差异显著 (P<0 .0 1) ,4 G/ 4 G基因型者 PAI- 1活性高于 4 G/ 5 G和5 G/ 5 G基因型者 (P<0 .0 1)。 (3)血糖、甘油三酯对 PAI- 1活性的调节受基因型的影响。 4 G/ 4 G基因型者血糖、甘油三酯与 PAI- 1活性密切相关 (P<0 .0 1) ,而 4 G/ 5 G和 5 G/ 5 G基因型者血糖、甘油三酯与 PAI- 1活性无明显相关 (P>0 .0 5 )。 (4)胰岛素对 PAI- 1活性的影响无基因型依赖性。 结论 PAI- 1活性升高是胰岛素抵抗综合征患者的特征之一 ,免疫反应性胰岛素、血糖、甘油三酯与 PAI- 1活性升高有关 ,血糖?

Objective To investigate the corelationship between PAI 1 activity and PAI 1 promoter 4G/5G polymorphism with insulin resistance syndrome. Methods The 4G/5G allele polymorphism in the PAI 1 gene promoter region were genotyped with an allele specific PCR in patients with insulin resistance syndrome (160)and controls (90).The activity of PAI 1 was assayed by chromogenic substrate method. Results (1)PAI 1 activity was higher in patients with insulin resistance syndrome than in controls.Insulin,blood glucose and triglyceride were responsible for it. (2)Though the frequency of PAI 1 4G/4G genotype was equal in two groups,the plasma PAI 1 activity was significantly different in different genotypes.It was higher in 4G/4G group than in 4G/5G( P <0.01) and 5G/5G group( P <0.01). (3)The level of PAI 1 activity regulated by blood glucose and triglyceride depended on PAI 1 4G/5G genotype. The levels of blood glucose and triglyceride were significantly associated with PAI 1 activity only in 4G/4G group. (4)The plasma PAI 1 activity was regulated by insulin in each group. Conclusion Increased PAI 1 activity caused by insulin ,blood glucose and triglyceride is a character of insulin resistance syndrome. The presence of the 4G allele of PAI 1 gene and higher blood glucose and triglyceride concentrations are associated with higher level of PAI 1 activity and may be involved in the generation of insulin resistance syndrome.