血清肿瘤坏死因子α、C反应蛋白在不同肥胖亚型中的变化及意义

Changes and significance of serum tumor necrosis factor α and C-reactive protein in different obese subtypes

目的:通过观察不同体重代谢类型患者血清肿瘤坏死因子α(Tumor necrosis factor-αTNF-α)、C反应蛋白(C-reactive protein CRP)水平,探讨血清TNF-α、CRP的变化在不同肥胖代谢亚型发病中的作用及意义。方法:选择201名在石河子大学第一附属医院就诊的成年人,进行血压、血脂、血糖、腰臀比(WHR)、体脂指数(BMI)、糖化血红蛋白(Hb A1C)等检查,将研究对象分为正常体重代谢正常(A)组、正常体重代谢异常(B)组、代谢正常性肥胖(C)组、代谢异常性肥胖(D)组。使用酶联免疫吸附测定的方法检测血清TNF-α和CRP的浓度。结果:1.各组Hb A1C、空腹血糖(FBG)、餐后2小时血糖(PBG)、甘油三酯(TG)比较,B组、D组高于A组和C组(P<0.05);2.各组血清TNF-α、CRP水平比较,B组、C组、D组高于A组(P<0.05),D组TNF-α、CRP高于A组和C组(P<0.05)。3.血清TNF-α、CRP水平与BMI、WHR、收缩压(SBP)、舒张压(DBP)、HbA1c、FBG、PBG、TG呈正相关,与高密度脂蛋白(HD-C)呈负相关(P<0.05)。4.BMI、FBG、HDL-C为TNF-α的影响因素(P<0.001);BMI、PBG、HDL-C为CRP的影响因素(P<0.001)。结论:B组、C组、D组人群体内均存在炎症状态,以D组最为明显;TNF-α、CRP可能参与了不同肥胖亚型的发病过程。

Abstract To investigate the effect and significance of serum tumor necrosis factor-α （TNF-α） and C-reactiveprotein（CRP） in the pathogenesis of different obesity metabolic subtypes. 201 subjects were enrolled in the first affiliated hospitalof Xinjiang Shihezi University. They were divided into four groups metabolically abnormal obese （D）, metabolically healthyobese （C）, metabolically obese but normal weight （B） , and metabolically healthy and normal weight （A）. Their waist-hip ratio（WHR）, body fat index （BMI）,blood pressure, blood lipids, blood sugar were collected. Concentrations of TNF-α and CRPwere determined by enzyme linked immunosorent assay. Results were showed as follows： Levels of HbA1c, fasting blood glucose（FBG）,postprandial blood glucose（PBG）, high-density lipoprotein（HDL -C） and triglyceride（TG） in B and D groups were higherthan those in A and C groups（ 〈0.05）; Serum levels of TNF-α and CRP in B,C group and D group were significantlyhigher than those in A group（ 〈0.05）. Serum TNF-α and CRP levels in A group were higher than those in C group（ 〈0.05）. Concentrations of serum TNF-α and CRP were correlated positively with BMI, WHR,systolic pressure （SBP）, diastolicpressure（DBP）, HbA1C, FBG, PBG, and TG , and negatively with HDL -C（ 〈0.05）. BMI, FBG and HDL -C were influencingfactors of TNF-α （ 〈0.001）; BMI, PBG and HDL -C were influencing factors of CRP（ 〈0.001）. Conclusion： there wasinflammatory state in B, C and D groups. Serum TNF-α and CRP may be involved in pathogenesis of obesity and metabolic.