单纯性肥胖成人血浆纤维蛋白原与胰岛素抵抗的相关性研究

Relationship between Insulin Resistance and Plasma Fibrinogen in Adult with Simple Obesity

目的探讨单纯性肥胖成人血浆纤维蛋白原(FIB)、血脂水平与胰岛素抵抗(IR)的关系。方法选取2012年9月—2013年3月我院单纯性肥胖成人78例〔按体质指数(BMI)分为Ⅰ度肥胖组34例,Ⅱ度肥胖组30例,Ⅲ度肥胖组14例〕和单纯性超重成人35例及健康成人67例。测定受试者的身高、体质量、腰围、臀围、空腹血糖(FBG)、空腹胰岛素(FIN)、血脂、FIB水平,并计算胰岛素抵抗指数(HOMA-IR)、BMI及腰臀比(WHR)。结果 FBG、FIN、HOMA-IR、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、FIB水平随着BMI的升高呈逐渐上升的趋势,而高密度脂蛋白胆固醇(HDL-C)则逐渐降低。FIB与BMI、WHR、FBG、FIN、HOMA-IR、TC、TG、LDL-C水平呈正相关(P<0.01),与HDL-C呈负相关(P<0.01)。多元逐步回归分析提示,BMI、TG是影响FIB的独立危险因素,FIB、BMI、FBG、FIN、LDL-C是影响HOMA-IR的独立危险因素。结论单纯性肥胖成人存在IR和血脂紊乱,FIB过量表达与之密切相关。

Objective To explore the relationships of plasma fibrinogen( FIB) with insulin resistance( IR) and blood lipid levels in adults with simple obesity. Methods Seventy- eight adults with simple obesity treated in our hospital between September 2012 and March 2013 were included in this study,which were divided into three groups according to the body mass index( BMI),including Class I obesity group( n = 34),Class II obesity group( n = 30),and Class III obesity group( n = 14).And 35 adults with simple overweight and 67 healthy adults visiting our hospital during the same period were enrolled as the control groups. The height,weight,waistline,hip circumference,fasting blood glucose( FBG) level,fasting insulin( FIN) level,blood lipid levels,and FIB level were tested,and the body mass index( BMI),waist- to- hip ratio( WHR),and IR index( HOMA- IR) were calculated. Results With the increase of BMI,the levels of FIB,HOMA- IR,FBG,FIN,triglyceride( TG),cholesterol( TC),low density lipoprotein- cholesterol( LDL- C) increased gradually,while the level of high density lipoprotein- cholesterol( HDL- C) decreased gradually. FIB was significantly positively correlated with BMI,WRH,FBG,FIN,HOMA- IR,TC,TG,and LDL- C( P < 0. 01),and negatively correlated with HDL- C( P < 0. 01). Multiple stepwise regression analyses indicated that BMI and TG were the independent risk factors of FIB; and FIB,BMI,FBG,FIN,and LDL- C were the independent risk factors of HOMA- IR. Conclusion The levels of IR and blood lipids are abnormal in adult with simple obesity,which might be due to the overexpression of FIB.