肥胖患者胰岛素抵抗和血浆vWF水平的变化

The Study of Relationship between Insulin Resistance and Plasma vWF in Obesity

目的:研究肥胖患者体脂参数、代谢异常、胰岛素抵抗的程度及血浆vWF水平的变化,探讨肥胖患者的代谢特点、胰岛素抵抗与血管内皮损伤的关系。方法:测定59例肥胖患者和49例正常人的血压、体脂参数、血糖、血脂谱、血浆vWF水平;采用稳定模式评估法评价胰岛素抵抗的程度。结果:肥胖组腰围、臀围、腰臀围比、血压、TC、TG、LDL水平均高于正常对照组,HDL低于对照组(P<0.001),FIN和HOMA-IR明显高于对照组(P=0.000)。肥胖组vWF水平与对照组比较有显著差异(P<0.05)。肥胖组经性别分层后,除HDL男性低于女性、TG男性高于女性外(P<0.05),其余各项指数在男女之间无显著差异。结论:肥胖患者存在明显体脂分布异常、胰岛素抵抗、血压改变及代谢紊乱,代表血管内皮损伤的血浆vWF水平的增高,提示肥胖病人有血管内皮损伤存在,血管内皮损伤可能是胰岛素抵抗的一个原因。

Objective: To investigate the changes of body fat parameter, metabolic parameter, insulin resistance and level of plasm vWF in obesity. To study the ralationship between insulin resistance and endothelial repair in obesity. Methods: BP, BMI, waist, WHR, FPG, lipid metabolic parameters, FIN, vWF and insulin resistance index were analyzed in 59 obese subjects and 49 normal controls. Results: Compared with control group ,the obese subjects had a higher waist, hip, waist hip ratio, BP, TC, TG, LDL and a lower HDL (P<0.001). The obese subjects had a higher fasting insulin level and HOMA- IR value than the control group (P =0.000). The obese subjects had a higher vWF level than control subjects (P<0.05). Conclusion: There are insulin resistance, abnormal body fat distribution, changes of blood pressure and metabolic disorder in obese subjects. The increase of vWF in obese subjects indicated endothelial repair.