肥胖患者血清游离胰岛素样生长因子Ⅰ及其结合蛋白水平与代谢因素的关系

Serum levels of free insulin-like growth factor- 1 and its binding proteins and their relationships to metabolic factors in obese patients

目的 观察肥胖患者血清游离胰岛素样生长因子Ⅰ(IGF-Ⅰ)、胰岛素样生长因子结合蛋白1(IGFBP-1)及IGFBP-3水平,分析其与年龄、性别、体重指数(BMI)、糖代谢、脂代谢等指标的关系。方法应用ELSA法测定97例肥胖患者和84例正常人血清游离IGF-Ⅰ、IGFBP-3、IGFBP-1、真胰岛素和血脂水平。结果 肥胖组与对照组比较,IGFBP-3明显增高(P<0.01),IGFBP-1下降(P<0.05),而游离的IGF-Ⅰ水平差异无显著性。游离IGF-Ⅰ水平与年龄呈显著负相关(正常组r=-0.26,P<0.05;肥胖组r=-0.42,P<0.01)。在肥胖组,游离IGF-Ⅰ水平与空腹血糖(r=-0.31,P<0.01)、低密度脂蛋白(r=-0.23,P<0.05)及IGFBP-1(r=-0.24,P<0.05)呈负相关,IGFBP-1与BMI(r=-0.41,P<0.01)、空腹胰岛素(FINS)(r=-0.35,P<0.01)和Homa-IR指数呈负相关(r=-0.31,P<0.01),IGFBP-3与FINS呈正相关(r=0.26,P<0.05)。结论 游离IGF-Ⅰ水平随年龄的增长有下降的趋势,并可能参与糖代谢及脂代谢的调节。IGFBP-1浓度可能反映胰岛素抵抗状态。

Objective To observe serum free insulin-like growth factor (ICF)- I , ICF binding protein ( BP)-1 , ICFBP-3 levels in obese and normal subjects, and to evaluate their possible relationships to age, sex, hotly mass index ( BM1),fat distribution, glucose and lipid metabolism in obese patients. Methods Ninety-seven obese outpatients (57 females and 40 males aged 18-71,BM1>25 but <40kg/m2) and 84 healthy subjects (36 females and 48 males aged 18-67, BMI > 18. 5 but <23 kg/m2) were recruited. Their BMI, waist-hip ratio (WHR), blood pressure (BP), serum glucose and insulin levels during oral glucose tolerance test, free ICF-I, IGFBP-1, ICFBP-3, total cholesterol, triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL) and uric acid levels were measured. Results Comparing with control, ICFBP-3 was significantly increased (P<0.01) while IGFBP-1 decreased (P<0.05), and free ICF- I level was not varied in obesity patients. Free IGF- I level was negatively correlated with age (normal group r = -0.26, P<0.05; obesity group r= -0. 42,P <0.01). Free ICF- [ level was negatively correlated with fasting plasma glucose(r = -0.31, P <0. 01 ) , LDL(r= -0.23, P <0. 05) and ICFBP-1 (r= -0.24, P < 0. 05) , and ICFBP-1 was negatively correlated with BMI ( r = -0. 41 , P <0. 01 ) and fasting insulin ( FINS) ( r = -0. 35 , P <0. 01 ) and Homa-IR (r= -0.31, P<0.01), while ICFBP-3 was positively correlated with FINS (r=0.26, P < 0. 05 ) in obesity group. Conclusion Free IGF- I level shows negative correlation with age, and it may play a role in the regulation of glucose and lipid metabolism, ICFBP-1 concentrations may reflect insulin resistance status.