代谢综合征患者FGF21水平与HDL亚类分布的关系

The relationship between the distribution of HDL subclass and the level of serum FGF21 in patients with metabolic syndrome

目的 探讨代谢综合征(MS)患者成纤维细胞生长因子21(FGF21)水平与高密度脂蛋白(HDL)亚类分布的关系。方法 选择2017年10月—2018年12月本院收治的40例代谢综合征患者作为研究对象(MS组),选择同期正常体检者37名作为对照组,采用全自动生化分析仪检测血脂水平,ELISA法检测FGF21水平,双向电泳-免疫印迹检测法检测HDL亚类分布情况。依据MS组FGF21均值±标准差将其分成三组,即低FGF21组(≤170.54 pg/ml)、中FGF21组(170.54 pg/ml<FGF21<346.34 pg/ml),高FGF21组(≥346.34 pg/ml)。结果 MS组与正常对照组相比,FGF21水平明显升高(P<0.01),空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B100(apo B100)及apo B_(100)/载脂蛋白A-I(apo A-I)比值明显升高,而高密度脂蛋白胆固醇(HDL-C)、apo A-I含量明显降低(P<0.01)。与正常对照组相比,MS患者血清preβ_1-HDL、HDL_(3b)含量明显升高(P<0.01),HDL_(2b)、HDL2a含量明显降低(P<0.01)。与低FGF21组相比,中FGF21组preβ_1-HDL、HDL_(3b)增多,HDL_(2b)减少;与低FGF21组相比,高FGF21组preβ_1-HDL、HDL_(3b)增多,HDL_(2b)、HDL2a减少。MS患者FGF21水平与FPG、TG正相关(P<0.05),与HDL-C负相关(P<0.05)。结论 MS患者FGF21水平升高,小颗粒的preβ_1-HDL、HDL_(3b)含量升高,而大颗粒的HDL_(2b)、HDL2a含量降低。随着FGF21水平的升高HDL亚类有变小的趋势,提示HDL亚类的成熟过程受到阻碍。

Objective The purpose of this study was to examine the correlation between the level of serum FGF21 and high-density lipoprotein( HDL) subclass distribution in patients with metabolic syndrome( MS).Methods A total of 77 subjects were recruited for this study,including 40 MS patients admitted to our hospital during October 2017 and December 2018 and 37 health controls were enrolled. Concentrations of plasma lipids were detected by automated biochemical analyzer.The level of serum FGF21 was measured by enzyme linked immunosorbent assay( ELISA) kits. HDL subclasses were determined by two-dimensional gel electrophoresis associated with immune-detection.According to the level of serum FGF21,the MS subjects were divided into three groups: low FGF21 group(≤170.54 pg/ml),middle FGF21 group(170.54 pg/ml FGF21 346. 34 pg/ml)and high FGF21 group(≥346. 34 pg/ml). Results Compared with the health controls,the levels of FGF21,fasting plasma glucose( FPG),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),apolipoprotein B100( apo B100),apo B100/apo A-I,preβ1-HDL,HDL3b were increased in the MS patients( P<0.01).Meanwhile,HDL-C,apo A-I,HDL2 a,HDL2 bwere decreased in the MS patients( P <0.01). Compared with low FGF21 group,preβ1-HDL,and HDL3b levels were increased,while level of HDL2 bwas decreased in middle FGF21 group.Meanwhile,preβ1-HDL,HDL3b were increased while HDL2 b,HDL2 awere decreased in high FGF21 group.The correlation analysis showed that HDL-C was negatively correlated with the levels of FGF21( P<0.05),while FPG,TG were positively correlated with the level of FGF21( P<0.05).Conclusions The levels of FGF21,preβ1-HDL,HDL3b were increased while HDL2 a,HDL2 bwere decreased in the MS patients. With the increase in the FGF21 level,HDL particles have minifying tendency,and the maturation metabolism of HDL particles is disrupted.