脂源性分泌因子leptin、resistin、adiponectin、visfatin mRNA在子痫前期患者胎盘组织中表达及意义

目的:探讨子痫前期患者胎盘组织中脂源性分泌因子瘦素(leptin)、抵抗素(resistin)、脂联素(adiponectin)、内脂素(visfatin)mRNA表达水平及其意义。方法:采用RT-PCR方法测定36例正常足月妊娠妇女(A组)、24例轻度子痫前期患者(B组)和17例重度子痫前期患者(C组)胎盘组织中脂源性分泌因子leptin、resistin、adiponectin、visfatin mRNA表达水平。结果:①C组leptin、resistin mRNA表达水平分别为1.361±0.261、1.515±0.177,显著高于B组的0.898±0.201、1.055±0.113和A组的0.559±0.175、0.508±0.119(P<0.05);②C组adiponectin mRNA表达水平为0.222±0.115,显著低于B组的0.776±0.176和A组的1.422±0.193(P<0.05);③C组visfatin基因mRNA表达水平为0.253±0.119,显著低于B组的1.298±0.193和A组的1.308±0.208(P<0.05),B组与A组比较无显著差异(P>0.05)。结论:脂源性分泌因子leptin、resistin、adiponectin、visfatin在子痫前期的发病中有重要作用,可能参与了胰岛素抵抗的病理生理过程。

Significance of serum leptin and adiponectin levels in Egyptian patients with chronic hepatitis C virus associated hepatic steatosis and fibrosis

AIM:To study serum levels of leptin and adiponectin in patients with chronic hepatitis C virus infection genotype-4(HCV-4) related steatosis and fibrosis.METHODS:We prospectively studied 45 untreated men with chronic HCV-4,with proven steatosis(group Ⅰ,30 patients),and fibrosis(group Ⅱ,15 patients),on liver biopsy.In addition,15 healthy men(group Ⅲ),matched for age,and body mass index were included.However,we excluded another five patients with steatohepatitis,and six patients with cirrhosis.We measured total serum leptin and adiponectin levels,as potential predictors for liver steatosis and fibrosis.Also,a correlation between these adipokines and various clinical and laboratory data were evaluated.All subjects were selected from Tropical and Internal medicine departments,Menoufiya University Hospital,Menoufiya,Egypt,during the period from February 2010 to August 2011.RESULTS:In group Ⅰ,severity of hepatic steatosis was mild,moderate,and severe,in 19 patients(63.5%),8 patients(26.5%),and 3 patients(10%),respectively.In contrast,in group Ⅱ,hepatic fibrosis was found to be in stage 1,2,and 3,in 6 patients(40%),in 6 patients(40%),and in 3 patients(20%),respectively.On comparing group Ⅰ with group Ⅱ,there was a significant decrease in serum adiponectin levels(131.4 ± 7.91 pg/mL vs 436 ± 9.75 pg/mL,P < 0.001),while there was no significant difference between both groups regarding serum leptin levels(34.69 ± 7.69 ng/mL vs 35.17 ± 1.06 ng/mL,P > 0.05).However,in the same group,when compared with group Ⅲ,there was a significant increase in serum leptin levels(34.69 ± 7.69 ng/mL vs 10.69 ± 0.84 ng/mL,P < 0.001),while there was a significant decrease in serum adiponectin levels(131.4 ± 7.91 pg/mL vs 342.4 ± 44.48 pg/mL,P < 0.001).In contrast,in group Ⅱ,when compared with group Ⅲ,there was a significant increase in serum leptin and adiponectin levels(35.17 ± 1.06 ng/mL vs 10.69 ± 0.84 ng/mL,P < 0.001,and 436 ± 9.75 pg /mL vs 342.4 ± 44.48 pg/mL,P < 0.05,respectively),while there was no significant difference between both groups regarding serum creatinine(0.83 ± 0.34 vs 0.89 ± 0.24,P > 0.05).On the other hand,serum leptin was not correlated with serum adiponectin in group Ⅰ and in group Ⅱ(r = 0.09,P > 0.05,and r =-0.1,P > 0.05,respectively).However,serum adiponectin was significantly negatively correlated with serum aspartate transaminase in group Ⅰ,but no correlation detected in group Ⅱ(r =-0.39,P > 0.05,and r =-0.03,P > 0.05).CONCLUSION:In male patients with chronic HCV-4,serum adiponectin levels are elevated in hepatic fibrosis,but decreased in steatosis.Therefore,in contrast to leptin,adiponectin may be used as a non-invasive marker.

Effects of pioglitazone on serum leptin and adiponectin in polycystic ovary syndrome patients with insulin resistance

Objective To investigate the effects of pioglitazone on serum leptin and adiponectin in polycystic ovary syndrome(PCOS)patients with insulin resistance(IR).Methods Thirty-five PCOS patients with IR were treated with pioglitazone 15mg/d for 12 weeks.The results of ovulation induction were observed.The changes of fasting plasma glucose(FPG),fasting serum insulin(FINS),serum levels of leptin,adiponectin,follicle-stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T)and blood fat were examined at the baseline and after the therapy by enzyme-linked immunosorbent assay(ELISA)and radioimmunoassay(RIA).Results After the treatment,the rate of ovulation per cycle was improved in 31(88.5%)out of the 35 patients.After treatment,the level of serum leptin was decreased(P<0.05)while the level of serum adiponectin was increased(P<0.05).After 12 weeks’ treatment,waist-to-hip ratio and F-G score were significantly decreased(P<0.05),BMI declined but without significant difference(P>0.05).The levels of LH,T,FINS,Homa-IR,total cholesterol,triglyceride and low density lipoprotein-cholesterol were significantly decreased(P<0.01,P<0.05),whereas the level of high density lipoprotein-cholesterol was significantly increased(P<0.01).No significant difference was seen in FSH and FPG following treatment(P>0.05).Conclusion Pioglitazone treatment can effectively improve PCOS with IR patients’ clinical syndromes,insulin sensitivity,glucose and lipid metabolism at least partly through improving the profiles of leptin and adiponectin.

STUDY ON OBESITY RELATED FACTORS: FFA, LEPTIN AND ADIPONECTIN IN SUBJECTS WITH VARYING GLUCOSE TOLERANCE

Objective To study the fasting serum levels of obesity related factors: FFA, leptin and adi-ponectin in subjects with varying glucose tolerance and their relationship with BMI, insulin sensitivity index and isletbeta-cell function. Methods Serum levels of FFA, leptin and adiponectin in 24 normal, 32 simple obese, 34IGT and 36 T2DM subjects were measured by ACS-ACOD assay or RIA. Results The serum levels of leptin andFFA in three groups:simple obese, IGT and DM were much higher than those in normal control (P <0. 001). Incontrast, serum level of adiponectin of simple obese, IGT and DM groups were significant lower than that of normalcontrol, among them DM subjects had the lowest level (P <0. 001). Correlation analysis showed that FFA was pos-itively correlated to BMI, WHR, FBG, fasting insulin level and negatively correlated to SI; adiponectin was negativelycorrelated to BMI, WHR, FBG, PBG, but positively correlated to SI and AIRg; and leptin was positively correlated toBMI, fasting insulin and AIRg when negatively correlated to FBG and SI. None of them was correlated to age.Conclusion Subjects with insulin resistance have high serum FFA and leptin levels but low serum adiponectin level.With the glucose tolerance deterioration, serum FFA level increases much higher while the adiponectin deceases muchlower. Unlike insulin, none of these obesity related factors can be used as the simple indicating or determining factorof SI, though each of them, to different extent, takes part in the development of insulin resistance.

Effects of Dietary and Physical Activity Intervention during Pregnancy on Circulating Leptin and Adiponectin Levels

Objective: We investigated whether lifestyle intervention during pregnancy modifies pregnancy leptin and adiponectin levels, adipokines and their association with body mass index (BMI). Methods: Of the 126 pregnant nulliparous women recruited, 43 in the intervention and 56 in the control group completed the study. Blood samples were collected on gestation weeks 8 - 10 (baseline) and weeks 36 - 38 (end of the intervention). Statistical analyses included group-based correlations between adipokines, pre-pregnancy BMI and gestational weight gain and covariance analysis including all confounding factors. Results: Pre-pregnancy BMI correlated with baseline (p = 0.023 and p = 0.079) and end leptin levels (p = 0.128 and p < 0.001). Similarly, gestational weight gain correlated with both baseline (p = 0.009 and p = 0.046) and end leptin levels (p = 0.065 and p = 0.011). BMI at the end of pregnancy correlated with the end leptin levels, but the correlation was weaker in the control (p = 0.043) than intervention women (p < 0.001). Control women having the highest pre-pregnancy BMI tended to exhibit the lowest increase in leptin levels during pregnancy (p = 0.10), whilst in the intervention group, women who had the highest pre-pregnancy BMI exhibited the highest increase in pregnancy leptin (p = 0.058). In covariance analysis including all covariates change in leptin was associated with gestational weight gain (p = 0.036), but change in adiponectin was not (p = 0.93). Conclusions: In contrast to the control group, women in the life-style intervention group exhibited a stronger association between gestational weight gain and leptin levels, indicating that they maintained insulin sensitivity.

Influence of Adiponectin and Leptin on the Kinetics of Human Pulp Cells

Adipocytokines, such as adiponectin and leptin, are expressed by adipocytes and are known as anti-metabolic syndrome factors. They are also thought to mediate calcification in mineralized tissue. We investigated the effects of adiponectin and leptin on the kinetics of human pulp cells using ELISA and western blot. After gaining informed consent, we obtained human pulp cells from three patients. After cultivation in Dulbecco’s Modified Eagle Medium (DMEM) without serum, cells from the 4th to 6th passages were incubated with various concentrations of adiponectin (1, 10, or 100 ng/mL) in DMEM or leptin (0.1, 1, or 10 ng/mL) in DMEM for 24 h. We confirmed that human pulp cells expressed adiponectin receptor 1 and leptin receptor. Although the proliferation index of these cells as measured by 5-bromo-2'-deoxyuridine (BrdU) incorporation increased in the presence of adiponectin in a dose-dependent manner, pulp cells stimulated with leptin showed no significant changes in BrdU incorporation. Alkaline phosphatase activity showed no significant changes after stimulation with either adipocytokine. Adiponectin induced expression of BMP-2 and osteopontin more strongly than did leptin. In particular, expression of BMP-2 increased in the presence of adiponectin in a dose-dependent manner. In contrast, the expression of dentin sialoprotein increased after stimulation with leptin. The expression of Runx2 was not observed from the cultured pulp cells stimulated with both molecules. These results indicate that adiponectin and leptin contribute to growth and differentiation of human pulp cells and may consequently affect the formation of secondary dentin or reparative dentin in the dentin-pulp complex.

Effects of marine omega-3 PUFA on adiponectin and leptin in overweight and obese patients: A meta-analysis of randomized controlled trials

Objective:To systematically evaluate the effect of marine Omega-3 polyunsaturated fatty acids(Omega-3 PUFA)on adiponectin and leptin levels in overweight and obese patients.Methods:The computer searched PubMed,Embase,Cochrane Library and CNKI electronic databases for randomized controlled experiments on the levels of marine Omega-3 PUFA and adiponectin and leptin in overweight and obese patients.The two researchers independently screened,evaluated and included the literatures and extracted the data.Meta analysis was carried out with Revman 5.3 software.Results:A total of 8 articles and 607 subjects were included.The results showed that Omega-3 PUFA from marine sources did not increase in adiponectin levels[SMD=0.32,95%CI=(-0.13,0.76)],while there was no significant did not reduce the leptin level of patients[SMD=-0.22,95%CI=(-0.53,0.09)].Conclusion:Marinederived Omega-3 PUFA can improve circulating leptin and adiponectin levels in overweight and obese patients,increase serum adiponectin levels and reduce leptin levels,but the difference is not obvious.Further research is still needed to determine the effect of Omega-3 PUFA on Adipokine in overweight and obese people.

Relationship Research of PPAR-γ Gene Polymorphisms with Adiponectin and Leptin in Type 2 Diabetes Mellitus

Objective:To investigate the peroxisome proliferator-activated receptor-γ (peroxisome)in patients with type 2 diabetes mellitus.Proliferators-activated receptors-γ ,PPARs-γ (γ )gene.polymorphisms about serum lipofuscin and leptin.Methods:One humdred and twenty patients with type 2 diabetes admitted to our hospital from June 2015 to June 2018 were selected.The patients were divided into an obese group and a non-obese group of 60 patients each according to their waist circumference.A polymerase chain reaction-length polymorphism protocol was implemented in all patients to explore the PPAR-γ gene polymorphism and blood glucose,lipid,adiponectin and leptin levels were measured in both groups.Results:PPAR-γ gene polymorphisms in type 2 diabetic patients were dominated by wild-type homozygous;The levels of total cholesterol,triglyceride and LDL cholesterol in the obese group were significantly higher than those in the non-obese group,while the levels of HDL cholesterol were lower than those in the non-obese group.There is significant difference in comparison between groups(P<0.05)Those canrying the A alele had a significant lipid disorder profile and decreased adiponectin levels.Conclusions:PPAR-γ gene polymorphisms in type 2 diabetes are not significantly associated with adiponectin and leptin,and only in the obese group,the patients with the Allele A showed significant dyslipidemia and a declining trend of adiponectin levels.

Initial research of cord blood leptin, adiponectin and IGF-I with fetus growth and development

Objective:In order to reveal the relationship between cord blood leptin,adiponectin and insulin-like growth factor-I(IGF-I)and the fetus growth and development,and discuss the interaction and clinical significance on fetus growth and development.Methods:The levels of cord blood leptin,adiponectin,IGF-I in 86 newborns were examined by radio immunoassay,according to gestation age and birth weight percentile relation,the objects were divided into the SGA group(n=16),the AGA group(n=41),the LGA group(n=29),meanwhile,neonatal birth weight,body length,head circumference,foot length,and placental weight were measured,and body mass index(BMI)was computed.Dependability analysis was taken.Results:The levels of cord blood leptin,adiponectin and IGF-I were as follows:LGA group>AGA group>SGA group.The level of cord blood adiponectin was positively correlated with birth weight,placental weight and BMI(p<.05).Cord blood leptin and IGF-I concentrations were positively correlated with their birth weight,body length,head circumference,foot length,placental weight and BMI,respectively(p<.01),cord blood leptin was positively correlated with adiponectin and IGF-I(p<.01).The levels of cord blood leptin and adiponectin had no statistical significance with neonatal sexuality and deliver style(p>.05);the levels of cord blood IGF-I had no statistical significance with neonatal sexuality(p>.05),but had statistical significance with deliver style(p<.05).Conclusions:Cord blood leptin,adiponectin and IGF-I played an important part in adjusting fetus growth and development as well as participating in the process of fetus growth and development,and could be regarded as one of the clinical indexes to evaluate fetus growth and development or state of nutrition.The abnormal level of cord blood leptin and IGF-I might be one of the reasons to cause intrauterine growth retardation and fetal macrosomia.

腹腔镜胃袖状切除术治疗肥胖症的效果及对血清瘦素、脂联素水平的影响

目的分析腹腔镜胃袖状切除术(LSG)治疗肥胖症的效果及对血清瘦素、脂联素水平的影响。方法纳入50例行LSG治疗的肥胖症患者,统计患者的手术情况(手术时间、术中出血量、术后肛门排气时间、术后住院时间)。术后随访6个月,比较患者术前和术后1个月、3个月、6个月的血清瘦素、脂联素水平及减重指标[体重、体质指数、多余体重减少百分比(EWL%)、腰围]。统计患者术后6个月内不良反应的发生情况及合并症的改善情况。结果50例患者均顺利完成手术,手术时间为70~160(118.6±20.4)min,术中出血量为24~75(48.3±18.7)mL,术后肛门排气时间为2~4(2.3±0.5)d,术后住院天数为4~10(8.2±2.4)d。患者的血清瘦素、脂联素水平及体重、体质指数、EWL%、腰围均有随时间变化的趋势(P<0.05),其中,术后1个月、3个月、6个月,患者血清瘦素水平、体重、体质指数、腰围低于术前,血清脂联素水平高于术前,术后EWL%呈逐渐升高的趋势(P<0.05)。术后6个月,仅有1例患者出现肺部感染,患者的合并疾病均得到明显改善。结论LSG治疗肥胖症的效果显著,可明显改善患者的血清瘦素和脂联素水平,还可以改善肥胖症的合并疾病,临床效果较好。

脂联素、瘦素、Pref-1与胰岛素抵抗关系及联合检测预测糖尿病前期病情进展风险的效能

目的探讨脂联素、瘦素、前脂肪细胞因子-1(Pref-1)与胰岛素抵抗的关系及联合检测预测糖尿病前期病情进展风险的效能。方法选取2019年1月至2023年1月郑州大学第一附属医院收治的304例糖尿病前期患者进行前瞻性队列研究。根据1年内是否进展为糖尿病分为糖尿病组(62例)、糖尿病前期组(242例),另选同期正常糖耐量人群60例作为对照组。比较三组受检者的基线资料及血清脂联素、瘦素、Pref-1表达水平,采用Pearson法分析血清脂联素、瘦素、Pref-1水平与胰岛素抵抗(IR)的相关性,采用Logistic回归分析血清脂联素、瘦素、Pref-1水平对糖尿病前期病情进展的影响,采用受试者工作特征曲线(ROC)分析血清脂联素、瘦素、Pref-1单独及联合检测对糖尿病前期病情进展风险的预测效能。结果三组受检者的年龄、体质量指数(BMI)、甘油三酯、空腹血糖、胰岛素抵抗指数(HOMA-IR)比较,糖尿病组高于糖尿病前期组,且糖尿病前期组高于对照组,差异均有统计学意义(P<0.05);糖尿病组患者的脂联素、Pref-1分别为(2.82±0.93)mg/L、(0.30±0.10)μg/L,明显低于糖尿病前期组的(6.76±2.17)mg/L、(0.51±0.16)μg/L,且糖尿病前期组患者的脂联素、Pref-1明显低于对照组的(8.45±2.80)mg/L、(0.84±0.27)μg/L,而糖尿病组患者的瘦素为(12.00±2.98)μg/L,明显高于糖尿病前期组的(8.79±2.87)μg/L,且糖尿病前期组患者的瘦素明显高于对照组的(3.56±1.09)μg/L,差异均有统计学意义(P<0.05);脂联素(r=-0.694)、Pref-1(r=-0.853)与HOMA-IR呈负相关(P<0.05),瘦素(r=0.660)与HOMA-IR呈正相关(P<0.05);Logistic回归分析结果显示,年龄、BMI、甘油三酯、空腹血糖、脂联素、瘦素、Pref-1是糖尿病前期患者病情进展的独立影响因素,将年龄、BMI、甘油三酯、空腹血糖进行校正,以脂联素、瘦素、Pref-1作为自变量,脂联素、瘦素、Pref-1仍是糖尿病前期患者病情进展的独立影响因素(P<0.05);ROC曲线分析结果显示,脂联素预测糖尿病前期病情进展风险的曲线下面积(AUC)为0.730,截断值≤3.51 mg/L,敏感度为79.03%,特异度为59.09%,瘦素预测的AUC为0.760,截断值>10.78μg/L,敏感度为67.74%,特异度为73.55%,Pref-1预测的AUC为0.795,截断值≤0.37μg/L,敏感度为80.65%,特异度为65.70%,且联合检测预测糖尿病前期病情进展的AUC为0.904,敏感度为87.10%,特异度为82.23%(P<0.05)。结论血清脂肪因子脂联素、Pref-1与不同糖耐量受损人群IR呈负相关,瘦素与之呈正相关,且联合检测对糖尿病前期病情进展风险具有一定预测价值,可作为临床早期预测病情进展风险的辅助指标。

慢性牙周炎患者入院时血清脂联素、瘦素水平与疾病严重程度的关系

目的探讨慢性牙周炎(CP)患者血清脂联素(ADPN)、瘦素(LEP)的表达及与疾病严重程度的关系。方法前瞻性纳入郑州大学第一附属医院2021年3月至2023年3月收治的90例CP患者为研究组,并依据入院时疾病严重程度分为轻度组(48例)、中度组(28例)、重度组(14例),另选取同期至医院体检的90例健康人群作为对照组。对比研究组与对照组、不同疾病严重程度CP患者间的血清ADPN、LEP水平及其他临床资料。结果研究组血清LEP水平高于对照组,ADPN水平低于对照组(P<0.05)。重度组、中度组、轻度组患者LEP、既往吸烟史占比依次降低,ADPN水平依次升高(P<0.05)。经点二列相关性分析显示,血清LEP与CP患者疾病严重程度呈正相关(r>0,P<0.05);血清ADPN、既往吸烟史与CP患者疾病严重程度呈负相关(r<0,P<0.05)。结论血清ADPN、LEP在CP患者中呈异常表达,且随着病情严重程度的提升,ADPN水平下降,LEP水平升高。

2型糖尿病视网膜病变患者血清APN、SUA及MLR水平的变化及诊断价值研究

目的通过比较血清脂联素(APN)、血尿酸(SUA)及单核细胞与淋巴细胞比值(MLR)在2型糖尿病视网膜病变(DR)患者中的水平变化,探讨其辅助DR早期诊断的价值。方法选取2022年1月至2022年8月在首都医科大学附属北京同仁医院(以下简称为“我院”)收治的2型糖尿病(T2DM)患者150例,依据临床诊断分为3组:糖尿病无视网膜病变组(T2DM组)55例,非增生性糖尿病视网膜病变组(NPDR组)39例、增生性糖尿病视网膜病变组(PDR组)56例;另选取我院同期健康体检者51例作对照组。测定所有研究对象的血清APN水平,并收集所有对象的血糖、血脂、肝功、肾功等生化指标及血常规中单核细胞计数和淋巴细胞计数,计算三酰甘油-葡萄糖(TyG)指数、MLR。比较各项指标在4组之间水平变化,寻找差异性指标,运用ROC曲线分析各指标单独及联合辅助诊断DR的价值。结果(1)4组间比较,血清APN、SUA、MLR比较差异具有统计学意义(P<0.001、P=0.004、P=0.001),T2DM组、NPDR组、PDR组APN水平均低于对照组;T2DM组、NPDR组及PDR组SUA、MLR均高于对照组,且随病情加重而上升。(2)2组间比较中,PDR组APN、SUA、MLR水平均显著高于T2DM组,差异均有统计学意义(P<0.05),而NPDR组APN、SUA、MLR水平与T2DM组和PDR组的组间比较差异无统计学意义(P>0.05)。(3)Logistic回归分析中,结果显示APN、MLR、SUA为2型糖尿病患者发生视网膜病变的危险因素(OR>1,P<0.05)。(4)ROC曲线分析显示APN、SUA、MLR、APN+SUA+MLR的灵敏度分别为56.8%、61.1%、68.4%、77.9%,特异性分别为74.5%、63.6%、58.2%、74.5%,曲线下面积(AUC)分别为0.691、0.615、0.639、0.816,阴性预测值分别为50.0%、48.6%、51.6%、66.1%,阳性预测值分别为79.4%、74.4%、73.9%、84.1%,对判断糖尿病是否合并视网膜病变具有一定诊断价值。结论DR的发生发展与APN、SUA、MLR水平相关,3项指标单独检测对DR的辅助诊断价值有限,3者联合检测更有助于DR的辅助诊断。

女性小儿单纯肥胖症患者血清leptin及其相关因子含量的相关性

目的:探讨了女性小儿单纯性肥胖症患儿血清瘦素(leptin)、神经肽Y(NPY)和脂联素(ADP)的含量变化及相关性。方法:应用放射免疫分析对32例女性小儿单纯肥胖症患者进行了血清leptin、NPY和ADP水平检测,并与35名正常女性小儿作比较。结果:女性小儿单纯性肥胖症患者血清leptin、NPY水平非常显著地高于正常女童组(P<0.01),而ADP水平则非常显著地低于正常女童组(P<0.01),且血清leptin水平与NPY水平呈明显的正相关(r=0.6014,P<0.01),与ADP水平呈明显的负相关(r=-0.4786,P<0.01)。结论:检测女性小儿单纯性肥胖症患儿血清leptin、NPY和ADP水平的变化对了解病情、指导临床实践均具有一定的临床实用价值。

血清脂联素和瘦素与原发性醛固酮增多症靶器官损害和术后临床转归的相关性

目的:探索基线血清脂联素和瘦素与原发性醛固酮增多症(primary aldosteronism,PA)靶器官损害和术后临床转归的相关性。方法:纳入68例行单侧肾上腺切除术且有术后至少6个月随访信息的PA患者,检测患者基线血清脂联素和瘦素浓度,依据PA手术结局(primary aldosteronism surgical outcome,PASO)标准进行术后临床转归分型,分析脂联素和瘦素与靶器官损害指标和不同术后分型的相关性。结果:28例(41.2%)PA患者术后临床治愈,40例(58.8%)临床未治愈。临床治愈组基线脂联素和估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)水平均高于临床未治愈组(P均<0.05),体重指数(body mass index,BMI)、高血压药物限定日剂量值、高脂血症占比和糖尿病占比低于临床未治愈组(P均<0.05),两组间瘦素水平差异无统计学意义。瘦素水平与心脏彩超指标二尖瓣舒张早期E峰峰值速度/舒张晚期A峰峰值速度比值和踝肱指数呈负相关(P均<0.05),脂联素水平与靶器官损害指标无相关。多因素逐步Logistic回归分析显示,低BMI(OR=0.422,95%CI:0.272~0.653,P<0.001)和高脂联素(OR=1.359,95%CI:1.004~1.840,P=0.047)水平与临床治愈独立相关。进一步按BMI分层,在非肥胖PA患者中高eGFR(OR=1.074,95%CI:1.023~1.127,P=0.004)和高脂联素(OR=1.816,95%CI:1.261~2.616,P=0.001)水平与临床治愈有关。结论:基线血清脂联素和瘦素检测有助于评估PA靶器官损害,预测术后临床转归,协助指导PA精准管理。

原发性高血压肾病患者血浆leptin和血清APN及尿mAlb检测的临床意义

目的:探讨了原发性高血压肾病患者血浆瘦素(leptin)和血清脂联素(APN)及尿微量白蛋白(mAlb)水平的变化及意义。方法:应用放射免疫分析、酶联免疫法和化学法对38例原发性高血压肾病患者血浆leptin和血清APN及尿mAlb进行检测,并与35名正常健康人作比较。结果:原发性高血压肾病患者血浆leptin和尿mAlb水平非常显著地高于正常人组(P<0.01)。而血清APN水平则显著地低于正常人组(P<0.01)。血清APN水平与leptin、尿mAlb水平呈显著的负相关(r=-0.4084、-0.5132,P<0.01)。结论:检测原发性高血压肾病患者血浆leptin和血清APN及尿mAlb水平的变化对了解病情、探讨其发病机理、预防和指导用药均有重要的临床价值。

血清L/A、NRG-1、Tie-2水平与首发精神分裂症患者临床症状严重程度的相关性

目的探讨血清瘦素与脂联素比值(L/A)、神经调节蛋白-1(NRG-1)、血管生成素受体酪氨酸激酶-2(Tie-2)水平与首发精神分裂症患者临床症状严重程度的相关性及对认知障碍的评估价值。方法选择2021年5月—2023年5月收治的首发精神分裂症103例为研究组,另选取同期正常健康体检志愿者103例为对照组。比较2组血清L/A、NRG-1、Tie-2水平,对比研究组认知障碍与认知正常患者临床症状[阳性和阴性症状量表(PANSS)、简明精神病评定量表(BPRS)评分]、血清L/A、NRG-1、Tie-2水平。分析血清L/A、NRG-1、Tie-2水平与临床症状严重程度的相关性及其联合检测对认知障碍的评估价值。结果研究组血清瘦素、L/A水平高于对照组,脂联素、NRG-1、Tie-2水平低于对照组(P<0.01)。研究组认知障碍患者PANSS各分量表评分及总分、BPRS量表各维度评分及总分、血清瘦素、L/A水平高于认知正常患者,脂联素、NRG-1、Tie-2水平低于认知正常患者(P<0.01)。血清L/A水平与PANSS各分量表评分及总分、BPRS量表各维度评分及总分呈正相关,NRG-1、Tie-2水平与PANSS各分量表评分及总分、BPRS量表各维度评分及总分呈负相关(P<0.01)。血清L/A、NRG-1、Tie-2评估认知障碍的曲线下面积(AUC)分别为0.764、0.708、0.755,最佳截断值分别为6.81、8.52 pg/mL、1962.62 pg/mL;血清L/A高表达、NRG-1、Tie-2低表达分别提示认知障碍发生风险增加5.237、6.172、4.538倍;L/A、NRG-1、Tie-2两两联合及三者联合评估认知障碍的AUC分别为0.882、0.868、0.876、0.932。结论血清L/A、NRG-1、Tie-2与首发精神分裂症患者临床症状严重程度显著相关,异常表达增加认知障碍发生风险,联合评估认知障碍的价值更为可靠。

三子养亲汤对营养性肥胖Wistar大鼠肥胖因子的影响

目的探究三子养亲汤对营养性肥胖Wistar大鼠肥胖因子的影响。方法将50只大鼠随机分为空白组10只与造模组40只,造模组随机分为模型组及三子养亲汤高、中、低组,每组各10只。浓缩制得药液浓度为1.875 g/mL的水煎剂,给药剂量为高剂量组每只10.8 g/(kg·d),中剂量组每只5.4 g/(kg·d),低剂量组每只2.7 g/(kg·d),模型组及空白组按每只0.1 mL/(10 g·d)灌胃给予纯净水。给药时间为6周。实验结束后根据各ELISA试剂盒说明书方法步骤检测肥胖因子指标:肾素活性(PRA),血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、瘦素(LP)、游离脂肪酸(FFA)、空腹血糖(FBG)及血清胰岛素(INS)。结果血糖各组均无显著差异。胰岛素、瘦素、肾素、醛固酮、血管紧张素Ⅱ、游离脂肪酸浓度,高脂饲料饲养各组均高于空白组(P<0.05),高中低剂量组均低于模型组(P<0.05),且高剂量组最低(P<0.05)。脂联素浓度高脂饲料饲养各组均低于空白组(P<0.05),高中低剂量组明显高于模型组(P<0.05),高剂量组最高(P<0.05)。结论三子养亲汤可改善肥胖大鼠的胰岛素抵抗,降低RAS系统中肾素、醛固酮、血管紧张素Ⅱ的浓度,同时降低游离脂肪酸及瘦素的浓度,增加脂联素的浓度,调节肥胖因子,达到治疗肥胖的效果。

孕早期母体血清瘦素、脂连蛋白水平对妊娠糖尿病的预测价值

为观察孕早期母体血清瘦素(LEP)、脂连蛋白(APN)水平对妊娠糖尿病(GDM)的预测价值,根据孕24~28周孕妇是否合并GDM,将研究对象分为GDM组和非GDM组。比较2组孕妇孕4~12周时血清LEP和APN水平。分析GDM发生的影响因素及血清LEP、APN对GDM的早期预测价值。结果显示,GDM组血清LEP水平高于非GDM组(P<0.05),APN水平低于非GDM组(P<0.05);血清LEP和APN水平为GDM发生的独立影响因素(P<0.05);血清LEP与APN联合预测GDM的AUC高于二者单独预测(Z=3.029,3.154;P<0.05)。结果表明,血清LEP、APN均对GDM有较高的预测价值,血清LEP与APN联合检测可提升预测价值。

经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折对APN及leptin水平的影响

目的探讨经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折对血清脂联素(APN)及瘦素(leptin)水平的影响。方法选取江苏省宿迁市中医院2018年1月至2019年1月收治的骨质疏松性胸腰椎压缩性骨折患者60例进行回顾性分析,根据治疗方法将60例患者分成2组,每组30例,对照组(经皮椎体成形术)与观察组(经皮椎体后凸成形术)。术后随访9个月。分别于术前及术后1个月评估患者疼痛程度和椎体高度的变化;术前和术后1个月、9个月评价患者的胸腰椎活动功能;于术前、术后7d、1个月检测血清APN及leptin水平。结果与术前比较,术后1个月2组患者的视觉模拟评分法(VAS)评分降低,且观察组低于对照组(P<0.05);2组患者的椎体高度升高,且观察组高于对照组(P<0.05);与术前比较,术后1个月、9个月2组患者的Oswestry功能障碍指数(ODI)评分均降低,且观察组低于对照组(P<0.05);与术前比较,术后7 d、1个月2组患者血清APN及leptin水平均降低,且观察组低于对照组(P<0.05)。结论经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折的效果突出,改善了患者的腰椎功能,降低患者疼痛程度及血清APN及leptin水平,效果优于经皮椎体成形术。