青海地区回族、汉族胆囊胆固醇结石患者的脂联素mRNA水平及临床意义

The mRNA level of adiponectin in patients with gallstone of Hui and Han nationality in Qinghai Province and its clinical significance

目的探讨青海地区回族、汉族胆囊胆固醇结石患者的脂联素mRNA水平及临床意义。方法选取2017年8月至2018年8月在青海大学附属医院同期住院的胆囊胆固醇结石病择期手术患者(108例)和不合并胆囊结石病的其他良性疾病择期手术患者(91例)作为研究对象,根据有无胆囊胆固醇结石及成人肥胖分类标准分为胆囊结石肥胖组56例、胆囊结石非肥胖组52例、非胆囊结石肥胖组48例、非胆囊结石非肥胖组43例。测定各组患者血甘油三酯(TG)、总胆固醇(TC)高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血糖(GLU)、尿酸、超敏反应C蛋白(hs-CRP)水平;同时实时荧光定量PCR(RT-PCR)法测定大网膜脂肪组织与腹壁皮下脂肪组织脂联素mRNA水平。结果与非胆囊结石非肥胖组比较,非胆囊结石肥胖组、胆囊结石非肥胖组、胆囊结石肥胖组TC[(4.57±0.49)mmol/L vs(5.63±0.53)mmol/L、(6.12±0.51)mmol/L、(6.85±0.43)mmo/L]、TC[(1.50±0.32)mmol/L vs(2.06±0.33)mmol/L、(2.53±0.39)mmol/L、(2.96±0.34)mmol/L]、LDL-C[(2.14±0.35)mmol/L vs(2.65±0.33)mmol/L、(3.05±0.37)mmol/L、(3.54±0.38)mmol/L]、尿酸[(188.63±13.52)mmol/L vs(257.69±14.63)mmol/L.(306.96±18.96)mmol/L、(359.96±16.58)mmol/L]、h-CRP[(228.32±18.96)μmol/L vs(298.96±19.96)μmol/L.(354.96±19.96)μmol/L.(405.98±19.47)μmol/L]水平升高,脂联素表达[皮下脂肪:(1.76±0.25)vs(1.43±0.23)、(0.98±0.23)、(0.68±0.29);大网膜:(2.15±0.29)vs(1.88±0.28)、(1.56±0.27)、(1.12±0.25)]及HDL-C[(2.15±0.11)mmol/L vs(1.79±0.15)mmo/L、(1.42±0.12)mmol/L、(I.15±0.09)mmol/L]水平降低(P<0.05);与非胆囊结石肥胖组比较,胆囊结石非肥胖组胆囊结石肥胖组TC、TC、LDL-C、GLU、尿酸、hs-CRP水平升高,脂联素表达及HDL-C水平降低(P<0.05);与胆囊结石非肥胖组比较,胆囊结石肥胖组TC、TC、LDL-C、CGLU、尿酸、hs-CRP水平升高,脂联素表达及HDL-C水平降低(P<0.05)。皮下、大网膜脂联素表达与HDL-C正相关,与TC、TG、LDL-C、尿酸、hs-CRP负相关(P<0.05)。Logistie回归分析结果显示,低水平皮下脂联素、大网膜脂联素及高水平TC均为非肥胖人群发生胆囊结石的危险因素(OR=2.340、1.9312、784,P<0.05);低水平皮下脂联素、大网膜脂联素及高水平LDL-C均为肥胖人群发生胆囊结石的危险因素(OR=2.358、2.596、2.115,P<0.05)。结论青海地区回族、汉族胆囊胆固醇结石患者脂联素mRNA水平降低;低水平皮下脂联素、大网膜脂联素均为青海地区回族、汉族肥胖、非肥胖人群发生胆囊结石的危险因素。

Objective To investigate the mRNA level of adiponectin in patients with gallstone of Hui and Han nationality in Qinghai Province and its clinical significance.Methods From August 2017 to August 2018,108 patients wilh gallbladder cholelithiasis and 91 patients with other benign diseases who were hospitalized in the Affiliated Hospital of Qinghai University from August 2017 to August 2018 were selected as the research objects.According to gallbladder cholesterol stone and the classification criteria of adult obesity,they were divided into gallstone-obesity group(56 cases),gallstone non-obesitv group(52 cases),non gallstone obesity group(48 cases)and non gallstone non obesity group(43 cases).The levels of serum lipid(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein choLesterol(LDL-C),blood glucose(GLU),uric acid and high-sensitivity C protein(hs-CRP)were measured.Meanwhile,the adiponertin mRNA levels in omental adipose tissue and abdominal subcutaneous adipose tissue were detected l)y real time fluorescent quantitative polymerase chain reaction(qRT-PCR).Results Compared with non gallstone an(l non obesity group,the serum TC[(4.57±0.49)mmol/L vs(5.63±0.53)mmol/L,(6.12±0.51)mmol/L,(6.85±0.43)mmol/L TG[(1.50±0.32)mmol/L vs(2.06±0.33)mmol/L,(2.53±0.39)mmol/L,(2.96±0.34)mmol/L],LDL-C[(2.14±0.35)mmol/L vs(2.65±0.33)mmol/L,(3.05±0.37)mmol/L,(3.54±0.38)],uric acid[(188.63±13.52)mmol/L vs(257.69±14.63)mmol/L,(306.96±18.96)mmol/L,(359.96±16.58)mmol/L],hs-CRP[(228.32±18.96)]mmol/L vs(298.96±19.96)mmol/L,(354.96±19.96)mmol/L,(405.98±19.47)mmol/L were increased in gallstone-obesity group,gallstone non-obesity group,non gallstone obesity group(P<0.05),while the adiponectin mRNA[subcutaneous adipose tissue:(1.76±0.25)vs(1.43±0.23),(0.98±0.23),(0.68±0.29);omental adipose tissue:(2.15±0.29)vs(1.88±0.28),(1.56±0.27),(1.12±0.25)]and HDL-C levels[(2.15±0.11)mmol/L vs(1.79±0.15)mmol/L,(1.42±0.12)mmol/L,(1.15±0.09)mmol/L]were decreased(P<0.05).Compared with the non gallstone obesity group,the serum levels of TC,TG,LDL-C,GLU,uric acid were increased in the gallstone non obesity group,gallstone obesity group,while the adiponectin mRNA and HDL-C levels were decreased(P<0.05).Compared with the gallstone non obese group,the serum levels of TC,TG,LDL-C,GLU,uric acid and hs-CRP were increased in gallstone obese group,while the levels of adiponectin mRNA and HDL-C were decreased(P<0.05).Adiponectin in omental adipose tissue and alxlominal subcutaneous adipose tissue was positively correlated with HDL-C and negatively correlated with TC,TG,LDL-C,uric acid and hs-CRP(P<0.05).Logistic regression analysis showed that low level of subcutaneous adiponectin,omental adiponectin and high level of TG were risk factors for gallstone in non obese population(OR=2.340,1.931,2.784,P<0.05),while low level of subcutaneous adiponectin,omental adiponectin and high level of LDL-C were risk factors for gallstone in obese population(OR=2.358,2.596,2.115,P<0.05).Conclusions The adiponectin mRNA is decreased in the patients with gallstone of Hui/Han nationality in Qinghai Province.The low level of subcutaneous adiponectin and omental adiponectin are the risk factors for gallstone in obese or non obese people of Hui/Han nationality in Qinghai Province.