目的初步探讨代谢正常肥胖(MHO)人群中脂联素(APN)分子构成的变化及临床意义,分析MHO人群代谢正常的原因,并探讨其与MHO的相关性。方法根据纳入标准选取成年人161例,分为MHO组(n=52)、肥胖伴代谢综合征(MS)组(n=52)、正常对照组(n=57)...目的初步探讨代谢正常肥胖(MHO)人群中脂联素(APN)分子构成的变化及临床意义,分析MHO人群代谢正常的原因,并探讨其与MHO的相关性。方法根据纳入标准选取成年人161例,分为MHO组(n=52)、肥胖伴代谢综合征(MS)组(n=52)、正常对照组(n=57)。采用酶联免疫吸附法(ELISA)测定患者血清总APN、高分子量脂联素(HMW-adp)浓度,并分析其分子构成在MHO人群中的变化及相关临床意义。结果 (1)与正常对照组相比,肥胖伴MS组及MHO组血清总APN、HMW-adp均明显降低(P<0.01);(2)MHO组总APN、HMW-adp较肥胖伴MS组明显升高(P<0.01);(3)MHO组HMW-adp/总APN(H/A)较肥胖伴MS组及正常对照组均升高(P<0.05);(4)多元逐步回归分析显示体质指数(BMI)、腰围、餐后2 h血糖(2 hP BG)是总APN的重要危险因素,腰围、2 hP BG是HMW-adp的负性预测因子,而高密度脂蛋白胆固醇(HDL-C)是其唯一的阳性预测因子,而H/A的主要影响因素却是BMI、腰围、HDL-C。结论 APN分子构成在MHO人群中呈高水平状态,该人群代谢之所以正常可能与这两种因子的保护作用有关,尤其HMW-adp。由此可以认为血清总APN、HMW-adp的检测可作为定量检测MHO人群及其转归以及判断预后的指标。展开更多
AIM:To investigate the association of obesity and elevated alanine aminotransferase with insulin resistance and compare these factors with metabolic syndrome. METHODS:We enrolled a total of 1308 male workers aged from...AIM:To investigate the association of obesity and elevated alanine aminotransferase with insulin resistance and compare these factors with metabolic syndrome. METHODS:We enrolled a total of 1308 male workers aged from 22 to 63 years.Data was extracted from the workers'periodic health check-ups in hospitals.All cases were from the community of northern Taiwan. This was a cross-sectional observational study from July to September in 2004.We grouped all cases into four groups,based on the quartile of homeostasis model assessment.The top fourth quartile group was defined as the group with insulin resistance.We performed multivariate logistic regression analysis for the odds ratio of the risk factors for insulin resistance. RESULTS:Compared with metabolic syndrome,the coexistence of both factors had a 4.3-fold(95%CI: 2.7-6.8)increased risk,which was more than metabolic syndrome with a 3.6-fold(95%CI:2.6-5.0)increased risk.The two factors had a synergistic effect.The synergistic index of obesity and elevated alanine aminotransferase(ALT)was 2.1(95%CI:1.01-4.3).CONCLUSION:Obesity and elevated ALT are associatedwith insulin resistance.The effects are synergistic. Coexistence of them is better than metabolic syndrome in predicting insulin resistance.展开更多
Fatty liver, including non-alcoholic fatty liver disease, is closely associated with metabolic syndrome (MS). Thus, the presence of fatty liver without MS in some conditions may be clinically important. Many studies h...Fatty liver, including non-alcoholic fatty liver disease, is closely associated with metabolic syndrome (MS). Thus, the presence of fatty liver without MS in some conditions may be clinically important. Many studies have shown that compared with no or occasional alcohol intake, moderate alcohol consumption is associated with lower prevalence rates of hypertension and type 2 diabetes, and lower levels of circulating C-reactive protein, a valuable marker for MS and insulin resistance. Considering these findings, light to moderate alcohol consumption has theoretical benefits on fatty liver and MS. Fatty liver, including non-alcoholic fatty liver disease, may be more clinically important than MS, particularly in non-obese individuals, because fatty liver can develop before MS in several conditions, such as regular alcohol consumers. Furthermore, most of the currently used MS criteria are unable to detect "true MS" because of variations in multiple factors such as age, height, medications, and complications.展开更多
文摘目的初步探讨代谢正常肥胖(MHO)人群中脂联素(APN)分子构成的变化及临床意义,分析MHO人群代谢正常的原因,并探讨其与MHO的相关性。方法根据纳入标准选取成年人161例,分为MHO组(n=52)、肥胖伴代谢综合征(MS)组(n=52)、正常对照组(n=57)。采用酶联免疫吸附法(ELISA)测定患者血清总APN、高分子量脂联素(HMW-adp)浓度,并分析其分子构成在MHO人群中的变化及相关临床意义。结果 (1)与正常对照组相比,肥胖伴MS组及MHO组血清总APN、HMW-adp均明显降低(P<0.01);(2)MHO组总APN、HMW-adp较肥胖伴MS组明显升高(P<0.01);(3)MHO组HMW-adp/总APN(H/A)较肥胖伴MS组及正常对照组均升高(P<0.05);(4)多元逐步回归分析显示体质指数(BMI)、腰围、餐后2 h血糖(2 hP BG)是总APN的重要危险因素,腰围、2 hP BG是HMW-adp的负性预测因子,而高密度脂蛋白胆固醇(HDL-C)是其唯一的阳性预测因子,而H/A的主要影响因素却是BMI、腰围、HDL-C。结论 APN分子构成在MHO人群中呈高水平状态,该人群代谢之所以正常可能与这两种因子的保护作用有关,尤其HMW-adp。由此可以认为血清总APN、HMW-adp的检测可作为定量检测MHO人群及其转归以及判断预后的指标。
文摘AIM:To investigate the association of obesity and elevated alanine aminotransferase with insulin resistance and compare these factors with metabolic syndrome. METHODS:We enrolled a total of 1308 male workers aged from 22 to 63 years.Data was extracted from the workers'periodic health check-ups in hospitals.All cases were from the community of northern Taiwan. This was a cross-sectional observational study from July to September in 2004.We grouped all cases into four groups,based on the quartile of homeostasis model assessment.The top fourth quartile group was defined as the group with insulin resistance.We performed multivariate logistic regression analysis for the odds ratio of the risk factors for insulin resistance. RESULTS:Compared with metabolic syndrome,the coexistence of both factors had a 4.3-fold(95%CI: 2.7-6.8)increased risk,which was more than metabolic syndrome with a 3.6-fold(95%CI:2.6-5.0)increased risk.The two factors had a synergistic effect.The synergistic index of obesity and elevated alanine aminotransferase(ALT)was 2.1(95%CI:1.01-4.3).CONCLUSION:Obesity and elevated ALT are associatedwith insulin resistance.The effects are synergistic. Coexistence of them is better than metabolic syndrome in predicting insulin resistance.
文摘Fatty liver, including non-alcoholic fatty liver disease, is closely associated with metabolic syndrome (MS). Thus, the presence of fatty liver without MS in some conditions may be clinically important. Many studies have shown that compared with no or occasional alcohol intake, moderate alcohol consumption is associated with lower prevalence rates of hypertension and type 2 diabetes, and lower levels of circulating C-reactive protein, a valuable marker for MS and insulin resistance. Considering these findings, light to moderate alcohol consumption has theoretical benefits on fatty liver and MS. Fatty liver, including non-alcoholic fatty liver disease, may be more clinically important than MS, particularly in non-obese individuals, because fatty liver can develop before MS in several conditions, such as regular alcohol consumers. Furthermore, most of the currently used MS criteria are unable to detect "true MS" because of variations in multiple factors such as age, height, medications, and complications.