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目的研究非糖尿病代谢综合征(MS)患者血清脂联素与C肽的水平及临床意义。方法 2010-08-2011-12,选取广州市海珠区龙凤、素社社区心血管疾病流行病学调查中的随访人群共689例,根据MS的诊断标准确诊MS患者192例,其中不合并糖尿病MS患者55例为单纯MS组(n=55),从合并糖尿病MS患者137例中随机选取53例作为合并MS组(n=53),选择健康受试对象51例为对照组(n=51),测量体质量指数(BMI)、血压,检测空腹血糖、血脂、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)及尿酸,ELISA法检测血清脂联素和C肽。结果单纯MS组和合并MS组血清脂联素较对照组明显下降[(7.5±2.5)、(7.4±2.9)比(10.0±3.8)μg/L,P<0.05],单纯MS组与合并MS组脂联素差异无统计学意义(P>0.05);对照组、单纯MS组、合并MS组血清C肽依次升高[(384.4±128.0)、(606.2±254.0)、(734.7±311.5)pmol/L,均P<0.05]。线性相关分析显示,脂联素水平与BMI、三酰甘油、胆固醇、尿酸和C肽呈负相关;与年龄、高密度脂蛋白胆固醇(HDL-C)、apoA1/apoB呈正相关(均P<0.01)。血清C肽与BMI、三酰甘油、总胆固醇和尿酸呈正相关(均P<0.01);与HDL-C、apoA1/B、脂联素呈负相关(均P<0.01)。多元逐步回归分析显示,apoA1/apoB、年龄、C肽、尿酸是脂联素水平的调节因子(均P<0.01)。结论非糖尿病MS患者血清脂联素水平下降而C肽水平升高。
Objective To study the serum levels of adiponectin and C-peptide in patients with non-diabetic metabolic syndrome (MS) and their clinical significance. Methods A total of 689 follow-up population from the epidemiological survey of cardiovascular disease in Longfeng and Suhe community of Haizhu District, Guangzhou City from August 2010 to August 2010 were selected. 192 patients were diagnosed as MS according to the diagnostic criteria of MS, Fifty-five patients were randomly selected from 137 patients with MS with diabetes mellitus (n = 53), and 51 healthy subjects were selected as control group (n = 51) , Body mass index (BMI), blood pressure, fasting blood glucose, serum lipids, apolipoprotein A1 (apoA1), apolipoprotein B (apoB) and uric acid were measured. Serum adiponectin and C peptide were detected by ELISA. Results The levels of serum adiponectin in MS group and MS group were significantly lower than those in control group [(7.5 ± 2.5) vs (7.4 ± 2.9) vs (10.0 ± 3.8) μg / L, P <0.05] (P <0.05). The levels of serum C-peptide in the control group, MS group and MS group were significantly higher than those in the control group [(384.4 ± 128.0), (606.2 ± 254.0), (734.7 ± 311.5) pmol / L, all P <0.05]. Linear correlation analysis showed that adiponectin level was negatively correlated with BMI, triglyceride, cholesterol, uric acid and C-peptide, and positively correlated with age, HDL-C and apoA1 / apoB ). Serum C-peptide was positively correlated with BMI, triglyceride, total cholesterol and uric acid (all P <0.01), but negatively correlated with HDL-C, apoA1 / B and adiponectin (all P <0.01). Multivariate stepwise regression analysis showed that apoA1 / apoB, age, C-peptide, and uric acid were all regulators of adiponectin levels (all P <0.01). Conclusion Serum levels of adiponectin are decreased and C-peptide levels are elevated in non-diabetic MS patients.