代谢紊乱患者脂联素水平和血管内皮细胞功能的变化

目的探讨代谢紊乱患者脂联素水平和内皮依赖性血管舒张功能(EDF)的关系。方法100例患者根据代谢紊乱的数目,分为无代谢紊乱组(对照组,M0)、1项代谢紊乱组(M1)、2项代谢紊乱组(M2)和代谢综合征组(M3)。采用高分辨率血管外彩色超声测定肱动脉内径,以肱动脉反应性充血前后血管内径变化百分比反映EDF,并测定脂联素、一氧化氮(NO)、一氧化氮合成酶(NOS)、内皮素-1(ET-1)的水平。结果随着代谢紊乱数目的增多,BMI、SBP、TG、FINS、HOMA-IR呈增高趋势,HDL-C呈降低趋势,各组间比较差异有显著意义(P<0.05或P<0.01)。M2组和M3组EDF、NO、NOS下降,ET-1升高,与M0组比较差异有显著意义(P<0.05或P<0.01);M3组ET-1与M2组比较差异有显著意义(P<0.05);M3组NO、NOS、ET-1与M1组比较差异有显著意义(P<0.05);M3组脂联素水平与HOMA-IR呈负相关(r=-0.516,P<0.05)。结论脂联素可能通过影响内皮细胞NOS活性、NO和ET-1的分泌,维持正常内皮细胞的功能。

The changes of adiponectin levels and vascular endothelial function in patients with metabolic disorder

Objective To investigate the relationship between the levels of adiponectin and endothelium-dependent diastolic function(EDF) in patients with metabolic disorder.Methods 100 patients with metabolic disorder were randomly divided into four groups:non-metabolic disorder group (M0),one-item metabolic disorder group (M1),two-item metabolic disorders group (M2) and metabolic syndrome group (M3).The inner diameter of brachial artery was measured by high-resolution ultrasound system before and after reactive hyperemia,and blood adiponectin,blood concentrations of NO,NOS and ET-1 were detected.Results With the increase of the items of metabolic disorder,BMI,SBP,TG,FINS,HOMA-IR presented the tendency of increase,however,HDL-C presented the tendency of decrease,there were significant differences among groups (P>0.05 or P<0.01).Threre was a significant difference in ET-1 between group M3 and group M2 (P<0.05);there were significant differences in NO,NOS,ET-1 between group M3 and group M1;the levels of adiponectin were negatively correlated with HOMA-IR (r=-0.516,P<0.05).Conclusion Adiponectin can maintain normal endothelial function by affecting the activity of NOS and secretion of NO and ET-1.