代谢正常肥胖人群血清sfrp5和Wnt5a变化及意义

Changes and significance of serum sfrp5 and Wnt5a in normal obese population

目的探讨代谢正常肥胖(MHO)人群中分泌型卷曲相关蛋白5(sfrp5)及无翅型MMTV整合位点家族成员5a(Wnt5a)的变化及临床意义,并探讨其与MHO的相关性。方法根据纳入标准选取研究对象150例,分为正常组(n=50)、MHO组(n=50)、肥胖伴代谢综合征(MS)组(n=50),采用酶联吸附法(ELISA)测定血清sfrp5及Wnt5a的浓度。结果与正常组比较,MHO组和肥胖伴MS组血清sfrp5浓度明显降低(均P<0.01),血清Wnt5a浓度、Wnt5a/sfrp5比值升高(均P<0.05)。与MHO组比较,肥胖伴MS组血清sfrp5浓度明显降低(P<0.01),血清Wnt5a浓度、Wnt5a/sfrp5比值升高(均P<0.05)。经相关和回归分析,血清sfrp5与HDL-C呈正相关性(r=0.283,P<0.01),与体质指数(BMI)、腰围、收缩压、舒张压、空腹血糖(FBG)、餐后2h血糖(2h PBG)、TG、TC呈负相关性(r=-0.454、-0.450、-0.355、-0.328、-0.199、-0.201、-0.353、-0.266,均P<0.05);血清Wnt5a与BMI、腰围呈正相关性(r=0.285、0.281,均P<0.01)。血清sfrp5的主要影响因素是BMI、2h PBG、TG。结论 MHO人群中血清sfrp5呈低水平状态、血清Wnt5a呈高水平状态,且两者的水平及Wnt5a/sfrp5比值均介于正常人群和肥胖伴MS人群之间,该人群代谢之所以正常,可能与这两种因子的保护作用有关,尤其是血清sfrp5。

Objective To investigate the changes and clinical significance of secreted frizzled-related protein 5（sfrp5） and wingless MMTV integration family members 5 a（Wnt5 a） in metabolically healthy obese（MHO） individuals and to explore their correlation with metabolic normal obesity（ MHO）. Methods According to the inclusion criteria,150 adults subjects were chosen from which 50 subjects who were metabolically healthy but obese were selected as MHO group,50 subjects who had obesity with metabolic syndrome（ MS） as obesity with MS group,50 subjects of healthy people who received physical health examination were selected as the control group. The concentrations of serum sfrp5 and Wnt5 a were measured by enzyme-linked immunosorbent assay（ ELISA）. Results Compared with the normal control group,the levels of serum sfrp5 in both MHO group and obesity with MS group were significantly decreased（ P〈0. 01）,serum Wnt5 a concentration and Wnt5 a/sfrp5 radio increased（ P〈0. 05）. Compared with MHO group,serum sfrp5 concentration was significantly decreased in obesity with MS group（P〈0. 01）,serum Wnt5 a concentration and Wnt5 a/sfrp5 radio increased（P〈0. 05）. Pearson correlation analysis showed that serum sfrp5 was positively correlated with HDL-C（ r = 0. 283）,and negatively correlated with BMI,waist circumference,systolic blood pressure,diastolic blood pressure,FBG,2 h PBG,TG and TC（ r =-0. 454,-0. 450,-0. 355,-0. 328,-0. 199,-0. 201,-0. 353,-0. 266）. The serum Wnt5 a was positively correlated with BMI and waist circumference（ r = 0. 285,0. 281）. Multivariate stepwise regression analysis showed the main influencing factors of serum sfrp5 were BMI,2 h PBG,TG. Conclusion The level of serum sfrp5 is low in MHO and the level of serum Wnt5 a is high,the levels of both and Wnt5 a/sfrp5 are between normal populationand obese with MS population. It is possible that the metabolicaly healthy is correlated with the protective serum sfrp5 and Wnt5 a,especially serum sfrp5.