New advances of adiponectin in regulating obesity and related metabolic syndromes

Obesity and related metabolic syndromes have been recognized as important disease risks,in which the role of adipokines cannot be ignored.Adiponectin(ADP)is one of the key adipokines with various beneficial effects,including improving glucose and lipid metabolism,enhancing insulin sensitivity,reducing oxidative stress and inflammation,promoting ceramides degradation,and stimulating adipose tissue vascularity.Based on those,it can serve as a positive regulator in many metabolic syndromes,such as type 2 diabetes(T2D),cardiovascular diseases,non-alcoholic fatty liver disease(NAFLD),sarcopenia,neurodegenerative diseases,and certain cancers.Therefore,a promising therapeutic approach for treating various metabolic diseases may involve elevating ADP levels or activating ADP receptors.The modulation of ADP genes,multimerization,and secretion covers the main processes of ADP generation,providing a comprehensive orientation for the development of more appropriate therapeutic strategies.In order to have a deeper understanding of ADP,this paper will provide an all-encompassing review of ADP.

Study on the Correlation between Adiponectin and Bone Mineral Density in Postmenopausal Women from Guangxi Zhuang Autonomous Region

Objectives: To explore the relationship between adiponectin (APN) and bone mineral density in this Zhuang ethnic group, thus providing a basis underpinning the prevention and treatment of osteoporosis (OP). Methods: Zhuang women over 50 years old in Guangxi Zhuang Autonomous Region were included in the study. The broadband ultrasound attenuation (BUA) was adopted as the reference to calculate the T value. Quantitative ultrasonic bone density was measured on the right. Body composition measuring instrument was used to measure weight, fat, and muscle mass. Plasma APN level was detected by ELISA and blood lipids were detected by enzymatic method. Results: Plasma APN level was found with significant differences in the normal bone mineral density group, bone mineral density reduction group, and osteoporosis group (P β = −0.176, P = 0.001) when the partial correlation coefficient of APN is −0.210. Elevated APN was an independent risk factor for bone mineral density reduction (OR = 1.191, 95%CI: 1.004 - 1.407, P = 0.04) and OP (OR = 1.1337, 95%CI: 1.137 - 1.572, P Conclusion: Increased APN in postmenopausal women of Zhuang is an independent risk factor for OP. The application of APN in the OP screening and prevention of middle-aged and ageing Zhuang women still needs further research.

Growth hormone improves insulin resistance in visceral adipose tissue after duodenal-jejunal bypass by regulating adiponectin secretion

BACKGROUND The mechanism of improvement of type 2 diabetes after duodenal-jejunal bypass(DJB)surgery is not clear.AIM To study the morphological and functional changes in adipose tissue after DJB and explore the potential mechanisms contributing to postoperative insulin sensitivity improvement of adipose tissue in a diabetic male rat model.METHODS DJB and sham surgery was performed in a-high-fat-diet/streptozotocin-induced diabetic rat model.All adipose tissue was weighed and observed under microscope.Use inguinal fat to represent subcutaneous adipose tissue(SAT)and mesangial fat to represent visceral adipose tissue.RNA-sequencing was utilized to evaluate gene expression alterations adipocytes.The hematoxylin and eosin staining,reverse transcription-quantitative polymerase chain reaction,western blot,and enzyme-linked immunosorbent assay were used to study the changes.Insulin resistance was evaluated by immunofluorescence.RESULTS After DJB,whole body blood glucose metabolism and insulin sensitivity in adipose tissue improved.Fat cell volume in both visceral adipose tissue(VAT)and SAT increased.Compared to SAT,VAT showed more significantly functional alterations after DJB and KEGG analysis indicated growth hormone(GH)pathway and downstream adiponectin secretion were involved in metabolic regulation.The circulating GH and adiponectin levels and GH receptor and adiponectin levels in VAT increased.Cytological experiment showed that GH stimulated adiponectin secretion and improve insulin sensitivity.CONCLUSION GH improves insulin resistance in VAT in male diabetic rats after receiving DJB,possibly by increasing adiponectin secretion.

Adiponectin orchestrates testosterone suppression in biological pathways

This current review highlights adiponectin engagement with AdipoR1 and AdipoR2 which subsequently triggers pathways such as AMPK,PPARα,and MAPK,thereby modulating testicular steroidogenesis.Adiponectin's actions on Leydig and adrenal cells inhibit androgen secretion by suppressing the steroidogenic acute regulatory protein(StAR).Given that StAR facilitates cholesterol to testosterone conversion,AMPK inhibits this process by modulating cholesterol transport and suppressing StAR expression through multiple avenues.Furthermore,adiponectin-induced PPARαactivation impedes mitochondrial cholesterol influx,further modulating androgen biosynthesis.The suppressive influence of PPARαon steroidogenic genes,notably StAR,is evident.Collectively,adiponectin signalling predominantly attenuates androgen production,ensuring metabolic and reproductive equilibrium.Imbalances,as seen in conditions like hypogonadism and obesity-related infertility,highlight their crucial roles and potential clinical interventions for reproductive disorders.

Exercise preconditioning alleviates ischemia-induced memory deficits by increasing circulating adiponectin

Cerebral ischemia is a major health risk that requires preventive approaches in addition to drug therapy.Physical exercise enhances neurogenesis and synaptogenesis,and has been widely used for functional rehabilitation after stroke.In this study,we determined whether exercise training before disease onset can alleviate the severity of cerebral ischemia.We also examined the role of exercise-induced circulating factors in these effects.Adult mice were subjected to 14 days of treadmill exercise training before surgery for middle cerebral artery occlusion.We found that this exercise pre-conditioning strategy effectively attenuated brain infarct area,inhibited gliogenesis,protected synaptic proteins,and improved novel object and spatial memory function.Further analysis showed that circulating adiponectin plays a critical role in these preventive effects of exercise.Agonist activation of adiponectin receptors by Adipo Ron mimicked the effects of exercise,while inhibiting receptor activation abolished the exercise effects.In summary,our results suggest a crucial role of circulating adiponectin in the effects of exercise pre-conditioning in protecting against cerebral ischemia and supporting the health benefits of exercise.

血清ADPN、FKN、Gremlin在糖尿病肾病患者中的表达及与患者肾功能的相关性

目的 探讨血清脂联素(ADPN)、不规则趋化因子(FKN)、Gremlin在糖尿病肾病(DN)患者中的表达及与患者肾功能的相关性。方法 回顾性选取2020年6月~2022年6月河南科技大学第一附属医院收治的DN患者100例为观察组,另选取同期单纯糖尿病(DM)患者100例为对照组。比较2组血清ADPN、FKN、Gremlin水平,比较2组肾功能指标[血胱抑素C(CysC)、血肌酐(SCr)、尿蛋白排泄率(UAER)]水平,分析血清各指标水平与肾功能指标的相关性,ROC分析血清各指标对DN的诊断价值。结果 观察组血清ADPN、FKN、Gremlin、CysC、SCr、UAER水平均高于对照组(P<0.05);血清ADPN、FKN、Gremlin水平与肾功能指标CysC、SCr、UAER水平均呈正相关,且血清各指标水平联合诊断DN的AUC为0.885,最佳诊断敏感度、特异度分别为90.00%、85.00%,约登指数为0.750。结论 ADPN、FKN、Gremlin在DN患者血清中表达上调,各指标水平与肾功能指标水平呈正相关,联合检测对DN具有一定诊断价值,可作为临床诊断DN、评估肾功能的有效指标。

LAP、ADPN、IGF-1水平与糖尿病的相关性分析

目的 探讨脂质蓄积指数(LAP)与脂联素(ADPN)、胰岛素样生长因子1(IGF-1)与糖尿病的相关性。方法 选择2023年1~6月芜湖市第一人民医院收治的120例2型糖尿病患者纳入观察组,另选取同期接受健康检查的100例患者作为健康对照组。计算并比较两组患者LAP,检测两组患者血清ADPN、IGF-1水平差异,采用Pearson相关性分析LAP与ADPN、IGF-1水平与血糖水平的相关性,多因素logistic回归分析糖尿病患病的危险因素。结果 观察组LAP水平高于健康对照组[(55.50±10.36)vs.(37.21±7.59)],ADPN、IGF-1水平低于健康对照组[(8.62±2.10)mg/L vs.(12.30±3.15)mg/L、(78.80±17.23)ng/ml vs.(95.82±21.50)ng/ml],差异均有统计学意义(t=13.547、9.917、6.190,P<0.05)。Pearson相关性分析结果提示,LAP与空腹血糖(FBG)及餐后2血糖(PBG)水平呈正相关(r=0.540、0.477,P<0.05);ADPN、 IGF-1水平与FBG、PBG均呈负相关(r=-0.432、-0.307,-0.333、-0.348,P<0.05);多因素logistic回归分析提示,年龄≥60岁、FBG、PBG、糖尿病家族史、体质量指数≥28 kg/m~2、LAP均为糖尿病患病的危险因素;高密度脂蛋白、ADPN、IGF-1为保护因素(P<0.05)。结论 LAP、ADPN、IGF-1与糖尿病的发生存在一定的关系,除此之外糖尿病还受多种因素影响,临床可针对相关因素采取一定的防治措施以降低糖尿病的发生风险。

糖尿病肾病湿热证与尿ADPN、L-FABP关系临床研究

目的如何通过中西医结合提高糖尿病肾病的临床疗效具有重要意义。从湿热证与尿ADPN、L-FABP的关系入手,通过对90例糖尿病肾病患者进行临床研究,为糖尿病肾病诊疗提供思路与方法。方法糖尿病肾病患者90例,根据肾络癥瘕理论,分为早期组、中期组、晚期组,采用SPSS 21.0版统计软件,研究湿热证与糖尿病肾病分期、临床症状、临床指标、尿ADPN、L-FABP的关系,为运用和解聚散方(黄芪、当归、海藻、生牡蛎、鳖甲)加减延缓肾脏纤维化进程开拓思路。结果随着糖尿病肾病病程由早期进展到晚期,湿热证早期11例、中期12例、晚期9例,可见湿热证贯穿其病程始终。大便干结或黏腻不爽(32例)、小便黄赤(27例)、口黏口臭(15例)是湿热证中最常见的症状。随着糖尿病肾病病程由早期进展到晚期,口黏口臭(2例增多到10例)、小便黄赤(4例增多到12例)等症状越来越明显。湿热组与非湿热组血红蛋白、尿素氮、血肌酐比较,均无统计学意义(P>0.05);湿热证组与非湿热证组的24 h尿蛋白定量比较,2组比较差异具有统计学意义(P<0.05)。湿热证组的尿ADPN、L-FABP较非湿热证组高,差异具有统计学意义(P<0.05)。结论湿热在糖尿病肾病的发生发展过程中,有着重要的作用,清利湿热法在糖尿病肾病的治疗过程中具有重要意义。本研究有助于提高中医学辨证的客观化水平,有助于提高临床辨证水平,有助于提高糖尿病肾病临床疗效。

分化型甲状腺腺癌患者血清ADPN、adipoR2和HSP70水平的临床意义

目的探讨血清脂联素(ADPN)、脂联素受体2(adipoR2)和热休克蛋白70(HSP70)检测在分化型甲状腺腺癌中的临床价值。方法选择2020年8月至2022年6月在上海市嘉定区江桥医院/上海市第一人民医院嘉定分院进行手术治疗的甲状腺腺癌患者75例为甲状腺腺癌组。选择同期在上海市嘉定区江桥医院/上海市第一人民医院嘉定分院诊断为甲状腺腺瘤的患者和健康体检者分别纳入甲状腺腺瘤组(65例)和对照组(45例)。比较甲状腺腺癌组(术前)与甲状腺腺瘤组、对照组,以及甲状腺腺癌组术前与术后血清ADPN、adipoR2和HSP70水平。分析3项指标之间的相关性,以及血清ADPN、adipoR2和HSP70对甲状腺腺癌的临床诊断价值及其与临床病理特征的关系。结果甲状腺腺癌组(术前)血清ADPN和adipoR2水平明显低于甲状腺腺瘤组和对照组,而甲状腺腺瘤组明显低于对照组,差异有统计学意义(P<0.05);而甲状腺腺癌组(术前)血清HSP70水平明显高于甲状腺腺瘤组和对照组,甲状腺腺瘤组明显高于对照组,差异有统计学意义(P<0.05)。血清ADPN、adipoR2和HSP70联合检测诊断甲状腺腺癌的灵敏度为85.3%,特异度为83.1%,曲线下面积(AUC)为0.906,AUC明显高于ADPN(Z=4.391,P<0.001)、adipoR2(Z=3.253,P<0.001)和HSP70(Z=3.795,P<0.001)单独检测,而3项指标单独检测的AUC比较,差异无统计学意义(P>0.05)。不同肿瘤最大径、淋巴结转移情况和TNM分期的甲状腺腺癌患者ADPN、adipoR2、HSP70水平比较,差异有统计学意义(P<0.05)。不同年龄、性别的甲状腺腺癌患者血清ADPN、adipoR2和HSP70水平比较,差异无统计学意义(P>0.05)。结论血清ADPN、adipoR2和HSP70水平参与了甲状腺腺癌的发生、发展过程,联合检测ADPN、adipoR2和HSP70有助于提高甲状腺腺癌的诊断效能。

血清ADPN、CA125及AMH检测在PCOS中的临床分析

目的探讨血清脂联素(ADPN)、糖类抗原125(CA125)及抗苗勒管激素(AMH)水平检测在多囊卵巢综合征(PCOS)中的临床诊断价值。方法选取2022年1月-2022年9月在东莞市中医院经鹿特丹诊断标准确诊的100例PCOS患者作为PCOS组;PCOS组通过测定患者体质量指数(BMI)是否大于28 kg/m2分为肥胖组和非肥胖组;测定患者的睾酮水平的高低是否大于80 ng/dL分为高雄激素组和非高雄激素组。另选身体健康、年龄与PCOS组相近的100名健康女性作为对照组。分别测定PCOS组和对照组的ADPN、CA125以及AMH,分析血清ADPN、CA125、AMH在PCOS患者中的检测价值。结果POCS组的BMI、AMH、CA125、睾酮、ADPN与健康组比较差异均有统计学意义(P<0.05)。与对照组比较,PCOS组的BMI、AMH、CA125、睾酮水平升高、ADPN水平降低。PCOS患者的CA125与AMH水平呈正相关(P<0.05),ADPN与AMH无关(P>0.05)。结论PCOS患者血清CA125和AMH水平升高,ADPN水平降低。

Boiogito Increases the Synthesis and Secretion of Adiponectin by Promoting Differentiation in Cultured Human Adipocytes

Boiogito (BOT) ameliorates insulin resistance and diabetes in several animal models;however, the underlying mechanisms for these in vivo effects remain unclear. Thiazolidine derivatives, which are peroxisome proliferator-activated receptor γ (PPARγ) agonists for the treatment of type II diabetes, promote adiponectin production by inducing adipocyte differentiation, thereby reducing insulin resistance. This study aimed to evaluate the effect of BOT on adipocyte differentiation using cultured human visceral preadipocytes (HVPAds) compared with the thiazolidine derivative troglitazone (TRG). We investigated the effects of BOT (0.125 - 1 mg/mL) and TRG (10 μM) on the differentiation of adipocytes treated with or without tumor necrosis factor-α (TNF-α: 5 ng/mL). On day 14 of culture, the following adipocyte differentiation marker levels were measured: intracellular lipids, extracellular (i.e., medium) adiponectin, and intracellular differentiation-related genes (PPARγ, CCAAT/enhancer binding protein, adiponectin, differentiation cluster 36, glucose transporter type 4). BOT and TRG increased factors associated with differentiation including lipid, adiponectin, and differentiation-related gene expression levels compared with the controls. The increases in these differentiation markers were inhibited by the PPARγ antagonist GW9662 (20 μM). Furthermore, TNF-α decreased all differentiation marker levels. The decreases in differentiation markers were inhibited by BOT and TRG;however, these inhibitory effects were blocked by GW9662. The results suggest that BOT increases the synthesis and secretion of adiponectin by promoting differentiation similar to TRG. This study is the first to demonstrate that adipocyte differentiation-promoting activity is a mechanism for the beneficial effects of BOT on diabetes and insulin resistance.

Adiponectin as a therapeutic target for diabetic foot ulcer

The global burden of diabetic foot ulcers(DFUs)is a significant public health concern,affecting millions of people worldwide.These wounds cause considerable suffering and have a high economic cost.Therefore,there is a need for effective strategies to prevent and treat DFUs.One promising therapeutic approach is the use of adiponectin,a hormone primarily produced and secreted by adipose tissue.Adiponectin has demonstrated anti-inflammatory and antiatherogenic properties,and researchers have suggested its potential therapeutic applications in the treatment of DFUs.Studies have indicated that adiponectin can inhibit the production of pro-inflammatory cytokines,increase the production of vascular endothelial growth factor,a key mediator of angiogenesis,and inhibit the activation of the intrinsic apoptotic pathway.Additionally,adiponectin has been found to possess antioxidant properties and impact glucose metabolism,the immune system,extracellular matrix remodeling,and nerve function.The objective of this review is to summarize the current state of research on the potential role of adiponectin in the treatment of DFUs and to identify areas where further research is needed in order to fully understand the effects of adiponectin on DFUs and to establish its safety and efficacy as a treatment for DFUs in the clinical setting.This will provide a deeper understanding of the underlying mechanisms of DFUs that can aid in the development of new and more effective treatment strategies.

血清HGF、ADPN、miR-126在脑动脉粥样硬化患者中的表达及临床意义探讨

目的探讨血清肝细胞生长因子(HGF)、脂联素(ADPN)、微小RNA-126(miR-126)在脑动脉粥样硬化(CAS)患者中的表达及临床意义。方法选取鹤壁市人民医院2021年12月至2022年12月收治的90例CAS患者作为观察组,选取90例同期门诊健康体检者作为对照组。比较两组研究对象一般资料及相关生化指标,分析血清HGF、ADPN、miR-126之间的相关性,对影响CAS发病的因素进行多因素分析,分析HGF、ADPN、miR-126单独及联合检测对CAS的诊断价值并绘制ROC曲线。结果观察组血清HGF高于对照组,ADPN、miR-126水平低于对照组,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,HGF与miR-126、ADPN呈负相关,差异有统计学意义(r=-0.244,r=-0.219,P<0.05);多因素分析结果显示,血清HGF、ADPN、miR-126均是影响CAS发病的危险因素,差异有统计学意义(P<0.05);HGF、ADPN、miR-126联合检测的AUC值高于单项检测,差异有统计学意义(P<0.05)。结论CAS患者中HGF呈高表达,ADPN、miR-126呈低表达,其水平在CAS发生发展过程中起重要作用,联合检测对CAS有潜在的辅助诊断价值。

2型糖尿病视网膜病变患者中医证型分布及其与血清炎症因子及脂联素水平的相关性研究

【目的】探讨2型糖尿病视网膜病变(type 2 diabetic retinopathy,T2DR)的中医证型分布及其与血清炎症因子、脂联素(APN)水平的相关性,为T2DR的中医辨证分型提供客观依据。【方法】采用横断面病例对照研究方法,选择2022年9月至2023年3月在江西省赣州市人民医院眼科诊断为T2DR的患者共42例84眼,观察T2DR患者眼底荧光血管造影(FFA)分期与中医辨证分型的关系,分析不同中医证型与血清炎症因子及APN水平的关系以及不同FFA分期的血清炎症因子及APN水平差异,探讨T2DR患者各变量与不同中医证型之间的相关性。【结果】(1)42例T2DR患者中,男性27例,女性15例,平均年龄为(54.0±12.0)岁;其中,肝肾亏虚、目络失养证14例(33.3%),阴精不足、燥热内生证15例(35.7%),气阴两虚、络脉瘀阻证9例(21.4%),阴阳两虚、血瘀痰凝证4例(9.5%),脾失健运、水湿阻滞证0例(0.0%)。(2)肝肾亏虚、目络失养证患者中双眼眼底FFA分期≥4期[增殖期糖尿病视网膜病变(PDR)]者占78.6%(11/14),阴精不足、燥热内生证患者占73.3%(11/15),气阴两虚、络脉瘀阻证患者和阴阳两虚、血瘀痰凝证患者均占100%(9/9;4/4),但组间比较,差异无统计学意义(P=0.272)。(3)42例T2DR患者中,有35例(83.3%)患者的肿瘤坏死因子α(TNF-α)、28例(68.3%)患者的C反应蛋白(CRP)、38例(90.5%)患者的糖化血红蛋白(HbA1c)水平均高于正常值;但不同FFA分期患者的血清炎症因子TNF-α、CRP、白细胞介素6(IL-6)、血管内皮生长因子(VEGF)及APN、HbA1c水平比较,差异均无统计学意义(P>0.05);同时,不同中医证型的血清APN、TNF-α、CRP、IL-6、VEGF水平比较,差异也均无统计学意义(P>0.05)。(4)相比肝肾亏虚、目络失养证患者,阴阳两虚、血瘀痰凝证患者的眼部病程较短,两者的相关性接近差异有统计学意义(r=-0.467,P=0.051);相比阴精不足、燥热内生证患者,阴阳两虚、血瘀痰凝证患者的CRP水平较高(r=0.592,P=0.010);相比气阴两虚、络脉瘀阻证患者,阴阳两虚、血瘀痰凝证患者的CRP水平较高(r=0.668,P=0.013)和糖尿病病程更长(r=0.629,P=0.021)。【结论】血清TNF-α及CRP在T2DR中有更高的表达;肝肾亏虚、目络失养证和阴精不足、燥热内生证为T2DR的常见证型;阴阳两虚、血瘀痰凝证与CRP密切相关,同时阴阳两虚、血瘀痰凝证型患者有更长的糖尿病病程。

二十碳五烯酸软胶囊治疗高脂血症的疗效及对血清TNF-α、ADPN、Hcy水平的影响

目的观察二十碳五烯酸软胶囊对高脂血症患者的降脂疗效,探讨其对血清肿瘤坏死因子-α(TNF-α)、脂联素(ADPN)及同型半胱氨酸(Hcy)水平的影响。方法本研究为随机对照试验。纳入2018年6月至2019年12月北京东城区朝阳门社区卫生服务中心108例高脂血症患者,采用随机数字表法分成两组,除剔除与脱落病例2例,106例完成研究。研究组52例,其中男17例,女35例,年龄(57.85±5.10)岁;对照组54例,其中男19例,女35例,年龄(56.69±6.27)岁。研究组口服二十碳五烯酸软胶囊,每日2次,每次1粒(1.0 g/粒);对照组服用安慰剂,每日2次,每次1粒,疗程为60 d。对比两组治疗前后脂代谢指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)]和血清TNF-α、ADPN、Hcy水平变化,并进行安全性评估。采用t检验、χ^(2)检验。结果治疗后研究组血清TC、TG、LDL-C水平分别为(5.03±0.59)、(1.59±0.19)、(2.95±0.53)mmol/L,显著低于对照组的(5.76±0.41)、(1.93±0.23)、(3.68±0.39)mmol/L(均P<0.05)。治疗后研究组血清TNF-α、Hcy水平较基线期显著降低,也低于对照组;血清ADPN水平较基线期显著升高,也高于对照组(均P<0.05)。治疗后两组安全性指标检查未见异常变化。结论二十碳五烯酸软胶囊治疗原发性高脂血症患者能明显改善脂代谢指标,调节血清TNF-α、ADPN、Hcy水平,具有明确临床降脂疗效。

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。

脂联素基因多态性与直肠腺瘤切除预后相关性分析

目的:探讨脂联素(APN)基因多态性与直肠腺瘤(RA)切除预后的相关性。方法:选取接受切除手术治疗的RA病人97例,根据预后情况,将复发RA病人52例作为观察组,无复发病人45例作为对照组。通过聚合酶链式反应-限制性片段长度多态性(PCR-RELP)法检测受试者血清中APN基因rs2241766位点多态性基因分布频率,并分析APN单核苷酸多态性各基因型与RA切除预后的相关性。结果:APN基因rs2241766位点基因型有TT野生型、TG杂合子型、GG纯合子型,对照组与观察组APN基因rs2241766位点基因型符合Hardy-Weinberg平衡定律,2组APN基因rs2241766位点基因型及等位基因频率差异均有统计学意义(P<0.01)。突变杂合子TG型、突变纯合子GG型病人的腺瘤数、腺瘤最大径及平均直径均大于野生TT型(P<0.05),纯合子GG型病人腺瘤数、腺瘤最大径及平均直径均大于杂合子TG型(P<0.05)。二元logistic回归分析显示,APN基因rs2241766位点TG型、GG型突变均为RA切除后复发的危险因素(P<0.01)。结论:APN基因rs2241766位点多态性与RA切除预后具有相关性。

泽茵丸联合常规西药治疗湿浊阻滞、瘀血内结型非酒精性脂肪性肝病的效果及对LBP、LEP、ADPN水平的影响

目的探讨泽茵丸联合常规西药治疗湿浊阻滞、瘀血内结型非酒精性脂肪性肝病(NAFLD)的效果。方法选取2020年1月至2021年12月陕西省中医医院肝病科收治的86例湿浊阻滞、瘀血内结型NAFLD患者为研究对象,按照随机数字表法将其分为对照组与观察组,各43例。对照组采用常规西药治疗,观察组在对照组基础上加泽茵丸治疗。比较两组的临床效果。结果观察组的治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的超氧化物歧化酶(SOD)水平高于对照组,丙二醛(MDA)、乳酸脱氢酶(LDH)水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的脂多糖结合蛋白(LBP)、瘦素(LEP)水平低于对照组,脂联素(ADPN)水平高于对照组,差异具有统计学意义(P<0.05)。结论泽茵丸联合常规西药治疗湿浊阻滞、瘀血内结型NAFLD的效果满意,可调节SOD、MDA、LDH、LBP、LEP、ADPN水平,值得推广。

血清脂联素、成纤维生长因子-23在心脏瓣膜置换术患者预后中的评估价值

目的探讨血清脂联素、成纤维生长因子-23(FGF23)水平在心脏瓣膜置换术患者预后中的评估价值。方法选取行心脏瓣膜置换术的患者98例为研究组。根据研究组患者的预后情况分为预后良好组(n=67)和预后不良组(n=31)。选取同期健康体检者90例为对照组。采用Spearman法分析血清脂联素、FGF23水平分别与血浆N末端B型利钠肽前体(NT-proBNP)水平和急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的相关性。采用多因素Logistic回归分析法分析心脏瓣膜置换术患者预后的影响因素。绘制受试者工作特征(ROC)曲线分析血清脂联素、FGF23水平对心脏瓣膜置换术患者预后的预测价值。结果研究组血清FGF23、NT-proBNP水平、APACHEⅡ评分高于对照组,血清脂联素水平低于对照组,差异有统计学意义(P<0.05)。预后不良组血清FGF23、NT-proBNP水平和APACHEⅡ评分高于预后良好组,血清脂联素水平低于预后良好组,差异有统计学意义(P<0.05)。患者的血清FGF23水平与NT-proBNP水平、APACHEⅡ评分呈正相关(P<0.05)。血清脂联素水平与NT-proBNP水平、APACHEⅡ评分呈负相关(P<0.05)。血清脂联素、FGF23、NT-proBNP水平和APACHEⅡ评分为心脏瓣膜置换术患者预后的影响因素(P<0.05)。血清脂联素、FGF23单独预测和联合预测心脏瓣膜置换术患者预后的曲线下面积(AUC)分别为0.862、0.807、0.911。脂联素、FGF23联合预测的AUC大于单独预测,差异有统计学意义(P<0.05)。结论血清脂联素、FGF23联合预测心脏瓣膜置换术患者预后的效果较好。血清脂联素、FGF23有望成为评估心脏瓣膜置换术患者预后效果的有效指标。