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目的:探讨代谢综合征(MS)及合并冠心病(CHD)患者空腹血浆P-选择素水平和胰岛素抵抗及MS其他指标的相互关系。方法:用液相蛋白芯片结合流式细胞仪测定单纯MS组(17例)、MS+CHD组(40例)和正常对照组(19例)空腹血浆P-选择素水平,用酶联免疫吸附法(ELISA)测定空腹血浆真胰岛素水平,并收集MS的其他有关数据:腰围、体重指数、空腹血糖和血脂,计算胰岛素敏感指数。结果:①P-选择素在正常对照组(25．1±3．6)μg／L,MS组(33．1±5．1)μg／L,MS+CHD组(41．3±8．4)μg/L,3组间差异有显著性意义(F=37．54,P<0．05);②空腹血浆P-选择素水平与胰岛素敏感指数呈负相关(r=-0．460,P< 0．05),与体重指数(r=0．402,P<0．05)、低密度脂蛋白胆固醇(r=0．406,P<0．05)、腰围(r=0．538,P<0．05)、空腹真胰岛素(r=0．478,P<0．05)呈正相关;③以空腹血浆P-选择素水平为应变量的多元逐步回归分析提示,胰岛素敏感指数(r2=0．212)、腰围(r2=0．290)、空腹真胰岛素(r2=0．228)、低密度脂蛋白胆固醇(r2=0．165)、体重指数(r2=0．162)与P-选择素具有相关性(P<0．05)。结论:MS患者的P-选择素水平增加,合并CHD的MS患者更为明显,并与胰岛素抵抗相关,可能在MS发展为CHD中起一定作用。
Objective: To investigate the relationship between fasting plasma P-selectin level and insulin resistance and other MS in metabolic syndrome (MS) and patients with coronary heart disease (CHD). Methods: Fasting plasma P-selectin level was determined by liquid protein chip combined with flow cytometry in MS group (MS) (17 cases), MS + CHD group (40 cases) and normal control group (19 cases) (ELISA) was used to measure fasting plasma true insulin levels and to collect other relevant data of MS: waist circumference, body mass index, fasting blood glucose and lipids, and to calculate insulin sensitivity index. Results: ①P-selectin levels in normal control group (25.1 ± 3.6) μg / L, MS group (33.1 ± 5.1) μg / L and MS + CHD group ) μg / L, there was a significant difference between the three groups (F = 37.54, P <0.05); ② There was a negative correlation between fasting plasma P-selectin and insulin sensitivity index (r = -0.460, (R = 0.402, P <0.05), body mass index (r = 0.402, P <0.05), low density lipoprotein cholesterol , P <0.05), fasting true insulin (r = 0.478, P <0.05); ③Four stepwise regression analysis of fasting plasma P-selectin level as a dependent variable suggested that insulin sensitivity index waist circumference (r2 = 0.290), fasting true insulin (r2 = 0.228), low density lipoprotein cholesterol (r2 = 0.165), body mass index (r2 = P-selectin was correlated (P <0.05). CONCLUSIONS: Patients with MS have an increased level of P-selectin, which is more pronounced in MS patients with CHD and is associated with insulin resistance and may play a role in the progression of MS to CHD.