糖尿病高危人群脂肪细胞因子与代谢综合征关系的研究

张秀娟; 黎明; 高珊; 王永慧; 刘书筠

Abstract

张秀娟,黎明,高珊,王永慧,刘书筠.糖尿病高危人群脂肪细胞因子与代谢综合征关系的研究[J].Chinese journal of Epidemiology,2012,33(4):418-422

糖尿病高危人群脂肪细胞因子与代谢综合征关系的研究

Relationship between metabolic syndrome and adipokines on diabetes among high-risk populations

Received:February 10, 2012

DOI：

KeyWord: 代谢综合征瘦素内脂素脂联素抵抗素视黄醇结合蛋白-4

English Key Word: Metabolic syndrome Leptin Visfatin Adiponectin Resistin RetinoI binding protein-4

FundProject:北京市科技新星计划(2004A27);首都医学发展基金(ZD2002-3034)

Author Name	Affiliation	E-mail
ZHANG Xiu-juan	Department of Endocrinology, Beijing Chaoyang Hospital, Beijing 100043, China
LI Ming	Department of Endocrinology,Peking Union Medical College, Peking Union Medical College Hospital	lmpeking@yahoo.com.cn
GAO Shan	Department of Endocrinology, Beijing Chaoyang Hospital, Beijing 100043, China	gaoshanmw@yahoo.com.cn
WANG Yong-hui	Department of Endocrinology, Beijing Chaoyang Hospital, Beijing 100043, China
LIU Shu-jun	Department of Endocrinology, Beijing Chaoyang Hospital, Beijing 100043, China

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Abstract:

目的研究脂肪细胞因子与代谢综合征(MS)的关系,探讨其对MS临床诊断的预测价值.方法收集414名2型糖尿病(T2DM)一级亲属,根据2005年国际糖尿病联盟(IDF)共识诊断MS标准,分为MS₀组(无MS组分)115例,MS₁组(1种MS组分)118例,MS₂组(2种MS组分)77例,MS₃组(≥3种MS组分)104例,酶联免疫法测定上述人群的瘦素、内脂素、脂联素及抵抗素水平,放射免疫法测定血清视黄醇结合蛋白-4(RBP-4).结果 (1)随MS组分个数的聚集,血清脂联素水平逐渐降低,瘦素及女性RBP-4水平逐渐增加,三者均与MS组分聚集有较强的平行关系；而内脂素水平只在MS3组有明显降低；抵抗素水平则未见随MS组分聚集有变化趋势.(2)高瘦素水平Q4组(以四分位值分组)与低瘦素水平Q1组比较,MS的各组分(高血压、高血糖、血脂异常、胰岛素抵抗和肥胖)的检出率明显增加(Q4/Q1的OR值分别为1.3、1.8、1.6、5.2和3.0).(3)血清RBP-4水平增加不仅与糖调节异常相关(Q4/Q1,OR=2.6),且与高血压(Q4/Q1,OR=1.6)、血脂异常(Q4/Q1,OR=1.9)和肥胖(Q4/Q1,OR=1.5)及聚集即MS更相关(Q4/Q1,OR=2.7).在RBP-4水平高的Q4组,MS检出率为50％.(4)处于脂联素水平最低的Q1组与最高的Q4组相比,MS及其组分(血脂异常、肥胖、高血糖和胰岛素抵抗)的检出率显著增加(Q4/Q1,OR值为2.1～4.1),但高血压的检出率却呈下降趋势.结论脂肪因子中以脂联素、瘦素和RBP-4与MS的关系最密切.提示三者可能也是参与MS形成的关键因子,可作为MS发病的早期预示标志物和治疗新靶点.

English Abstract:

Objective To study the relationship between adipokines and metabolic syndrome (MS),and the predictive value of adipokines on diagnosis of MS.Methods According to the IDF consensus worldwide definition on MS in 2005,we divided the subjects into 4 groups:115 in MS₀ (with none of MS component); 118 in MS₁ (with one MS component); 77 in MS₂ (with two MS components) and 104 in MS₃ (with none of MS component).Serum levels of leptin,visfatin adiponectin and resistin were measured in these groups,using the enzymelinked immunosorbent assay (ELISA) method.Retinol-binding protein 4 (RBP-4) was assessed by radioimmtmoassay (RIA).Results ( 1 ) Serum adiponectin level decreased while the serum level of leptin and RBP-4 increased in women with the number of MS components gathered.However,the level of visfatin obviously decreased only in the MS3 phase.The level of resistin showed no changes with MS components gathered.(2) Detection rates of the MS components such as high blood pressure,hyperglycemia,dyslipidemia,insulin resistance and obesity were significantly higher in the Q4 group with high level of leptin when compared to the Q1 group with lower level (odd ratio:Q4/Q1 is 1.3,1.8,1.6,5.2,3.0respectively).(3) The higher level of serum RBP-4 was not only associated with greater risk for impaired glucose regulation (odd ratio:Q4/Q1=2.6),but also significantly with the risks for hyperglycemia ( odd ratio:Q4/Q 1 =1.6 ) dyslipidemia ( odd ratio:Q4/Q 1 =1.9 ),obesity ( odd ratio:Q4/Q 1 =1.5 ) and MS (odd ratio:Q4/Q 1 =2.7).In the Q4 group with higher levels of RBP-4,the positive rates of MS reached 50％.(4) The detection rates of MS components such as dyslipidemia,obesity,hyperglycemia,and insulin resistance were significantly higher in the Q1 group with the lowest level of adiponeptin when compared to the Q4 group with the highest level.Conclusion The levels of adipokines,serum adiponectin,leptin and RBP-4 showed significant associations with MS.Our findings suggested that these adipokines might serve as the key factors that participating in MS and could be used as markers for early prediction of MS as well as the new targets for therapy.?

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