脂联素与瘦素比值作为脂肪组织功能障碍生物标志物的应用

Application of adiponectin/leptin ratio as a marker for adipose tissue dysfunction

目的探讨脂联素(ADPN)/瘦素(LEP)比值作为脂肪组织功能障碍生物标志物的应用。方法选择2021年1—12月在江苏省太湖疗养院进行体检的456名体检者作为研究对象,测量身高、体质量、体质量指数(BMI),腰围、体脂率等身体指标,检测ADPN、LEP、三酰甘油(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)、尿酸(UA)、超敏C-反应蛋白(hs-CRP)、葡萄糖(GLU)、同型半胱氨酸(Hcy)、胰岛素(INS)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血清淀粉样蛋白A(SAA)水平,计算ADPN/LEP比值。根据ADPN/LEP比值将研究对象分为ADPN/LEP>1.0组(78例),ADPN/LEP 0.5~1.0组(77例),ADPN/LEP<0.5组(301例),分析并比较各组体格检查和实验室检查指标的变化及相关性;比较肥胖、糖尿病、代谢综合征(MS)患者与正常BMI、血糖正常、非MS受检者的ADPN/LEP比值差异;采用Pearson相关分析法分析ADPN/LEP比值与SAA的相关性。结果ADPN/LEP<0.5组的体脂率、BMI、腰围及TG、LDL-C、UA、hs-CRP、GLU、Hcy、INS、ALT水平均明显高于ADPN/LEP>1.0组和ADPN/LEP0.5~1.0组,HDL-C水平明显低于ADPN/LEP>1.0组和ADPN/LEP 0.5~1.0组[体脂率:(50.6±8.2)%比(24.6±6.9)%、(32.8±7.2)%,BMI(kg/m2):31.8±2.1比22.7±2.5、26.9±2.3,腰围(cm):119±13比77±10、95±15,TG(mmol/L):1.58±1.20比0.87±0.46、1.07±0.70,LDL-C(mmol/L):3.31±0.93比2.87±0.85、3.15±0.91,U A(μm o l/L):362±83比247±65、303±83,h s-C R P(m g/L):7.8±6.8比1.5±1.1、3.0±2.2,G L U(m m o l/L):5.9±1.5比5.1±0.9、5.5±1.5,H c y(μm o l/L):10.6±5.0比6.9±2.3、7.9±2.4,I N S(m U/L):17.3±7.3比4.3±3.1、5.2±3.2,ALT(U/L):30±18比13±8、17±14,HDL-C(mmol/L):1.24±0.31比1.68±0.41、1.58±0.44,均P<0.05]。正常BMI组、血糖正常组和非MS组分别有13%、56%和28%的受检者ADPN/LEP<0.5;而肥胖组、糖尿病组、MS组分别有93%、85%和87%的受检者ADPN/LEP<0.5。ADPN/LEP比值与SAA水平呈负相关(r=-0.21,P=0.005)。结论ADPN/LEP比值是脂肪组织功能障碍的可靠生物标志物,ADPN/LEP比值<0.5表明患心血管疾病风险明显增加。

Objective To explore the application of adiponectin(ADPN)/leptin(LEP)ratio as a biomarker for adipose tissue dysfunction.Methods The 456 physical examiners in Taihu Sanatorium of Jiangsu Province from January to December 2021 were selected as research objects.Their height,body mass,body mass index(BMI),waist circumference and body fat rate were measured and the levels of ADPN,LEP,triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),uric acid(UA),hypersensitive C-reactive protein(hs-CRP),glucose(GLU),homocysteine(Hcy),insulin(INS),alanine transaminase(ALT),aspartate aminotransferase(AST)and serum amyloid A(SAA)were detected.The ADPN/LEP ratio was calculated.According to ADPN/LEP ratio,the examiners were divided into ADPN/LEP>1.0 group(78 cases),ADPN/LEP 0.5-1.0 group(77 cases)and ADPN/LEP<0.5 group(301 cases).The changes and relationship of physical and laboratory examination indexes among three groups were analyzed and compared.The differences of ADPN/LEP ratio among obesity,diabetes,metabolic syndrome(MS)patients and normal BMI,normal GLU and non-MS examiners were compared.Pearson correlation analysis was used to analyze the correlation between ADPN/LEP ratio and SAA level.Results The body mass,body fat rate,BMI,waist circumference and TG,LDL-C,UA,hs-CRP,GLU,Hcy,INS and ALT in ADPN/LEP<0.5 group were higher than those in ADPN/LEP>1.0 and ADPN/LEP 0.5-1.0 groups,and HDL-C was lower than those of ADPN/LEP>1.0 and ADPN/LEP 0.5-1.0 groups[body fat rate:(50.6±8.2)%vs.(24.6±6.9)%,(32.8±7.2)%,BMI(kg/m~2):31.8±2.1 vs.22.7±2.5,26.9±2.3,waist circumference(cm):119±13 vs.77±10,95±15,TG(mmol/L):1.58±1.20 vs.0.87±0.46,1.07±0.70,LDL-C(mmol/L):3.31±0.93 vs.2.87±0.85,3.15±0.91,UA(μmol/L):362±83 vs.247±65,303±83,hs-CRP(mg/L):7.8±6.8 vs.1.5±1.1,3.0±2.2,GLU(mmol/L):5.9±1.5 vs.5.1±0.9,5.5±1.5,Hcy(μmol/L):10.6±5.0 vs.6.9±2.3,7.9±2.4,INS(m U/L):17.3±7.3 vs.4.3±3.1,5.2±3.2.ALT(U/L):30±18 vs.13±8,17±14,HDL-C(mmol/L):1.24±0.31 vs 1.68±0.41,1.58±0.44,all P<0.05].There were 13%,56%and 28%of examiners in normal BMI group,normal GLU group and non-MS group,while 93%,85%and 87%of examiners in obesity group,diabetes group and MS group had ADPN/LEP levels<0.5.There was a negative correlation between ADPN/LEP ratio and SAA level(r=-0.21,P=0.005).Conclusions The ratio of serum ADPN/LEP ratio is a reliable biomarker for adipose tissue dysfunction.When the ratio of ADPN/LEP<0.5,the risk of cardiovascular disease is significantly increased.