摘要
目的研究胰岛素抵抗(IR)与胆囊三角脂肪堆积程度及脂肪组织中脂肪三酰甘油酯酶(ATGL)、激素敏感性脂肪酶(HSL)表达的关系。方法选择本院择期行胆囊切除手术的住院患者55例,其胰岛素抵抗指数(HOMA-IR)中位数为2.89。将患者分为胰岛素敏感组(HOMA-IR<2.89)和胰岛素抵抗组(HOMA-IR≥2.89)。术前测定临床指标及血生化指标,术日在手术过程中对胆囊三角脂肪堆积程度分级,并取胆囊三角脂肪组织放入液氮中,测定脂肪组织中ATGL和HSLmRNA及其蛋白的表达。结果 (1)两组患者的年龄、性别间具有均衡性;与胰岛素敏感组比较,胰岛素抵抗组患者的体质指数、腰臀比、血清三酰甘油、空腹胰岛素(FINS)及游离脂肪酸(FFA)水平均显著增高,差异有统计学意义(P<0.05)。(2)与胰岛素敏感组比较,胰岛素抵抗组患者胆囊三角脂肪堆积程度明显严重(P<0.05)。(3)与胰岛素敏感组比较,胰岛素抵抗组患者ATGL、HSL mRNA及其蛋白表达均显著下降,差异有统计学意义(P<0.01)。(4)ATGL和HSL的蛋白表达与FINS、FFA呈负相关(P<0.05)。直线相关分析显示,ATGL与HSL蛋白的表达呈正相关(r=0.708,P<0.01)。结论 IR与胆囊三角脂肪堆积程度有关,内脏脂肪组织中ATGL和HSL的表达参与了这一过程。
Objective To investigate the relationship between insulin resistance （IR） and fatty disposition, ATGL expression, and HSL expression in the Calot＇s triangle. Methods Fifty -five inpatients underwent selective cholecystectomy with a median homeostasis model assessment -insulin resistance （HOMA -IR） of 2. 89 were devided into the insulin sensitive group （IS group, HOMA -IR 〈2. 89） and the insulin resistant group （IR group, HOMA - IR≥2. 89） . Anthropometric parameters and biochemical indicators were determined before operation. Degrees of Calot＇s triangle adipose accumulation were graded during the operation. Calot＇s triangle adipose tissues were preserved for further analysis of mRNA and protein levels of ATGL and HSL nsing RT - PCR and western blot. Results Matched for gender and age, the IR group showed increased body mass index （ BMI）, waist - to - hip ratio, triglyceride, fasting insulin and free fatty acids （FFA） compared with the IS group （ P 〈 0. 05 ）. Compared with the IS group, degrees of Calot＇s triangle adipose accumulation were higher in the IR group （P 〈0. 05）. Compared with the IS group, protein and mRNA expression levels of ATGL and HSL were lower in the IR group （ P 〈 0. 01 ）. Fasting insu- lin levels and FFA levels were negatively correlated with ATGL protein expression （ r = - 0. 235 and r = - 0. 214, P 〈 0. 05 ） and HSL protein expression （r = -O. 185 and r = -O. 246, P 〈 O. 05 ） . ATGL and HSL protein expression were positive lycorre lated （r=0.708, P〈O. O1） . Conclusion IR is correlated with Calot＇s triangle fatty disposition, and the mRNA and protein expression levels of ATGL and HSL are involved in this correlation.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第24期2724-2727,共4页
Chinese General Practice
