摘要
目的:检测青年人血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)水平,探讨其与胰岛素抵抗的相关性及其临床意义。方法:选取160名受试者,其中女性87人,男性73人。平均年龄(33.4±1.2)岁。检测其身高、体质量等人体测量学指标及血脂、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)等生化指标,并用ELISA检测所有受试者血清Lp-PLA2水平。根据体质指数(body mass index,BMI)和口服葡萄糖耐量(oral glucose tolerance test,OGTT)结果,所有受试者正常体质量-正常葡萄糖耐量(normal weight-normal glucose tolerance,NW-NGT)65例,超重肥胖-正常葡萄糖耐(overweight-obesity-glucose tolerance,OB-NGT)50例和超重肥胖2型糖尿病(overweight-obesity-type 2 diabetes mellitus,OBT2DM)45例。结果:OB-NGT、OB-T2DM组的Lp-PLA2水平、BMI、FPG、FINS、低密度脂蛋白胆固醇(low density lipoproteincholesterol,LDL-C)、超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)及胰岛素抵抗指数(homeostasis model assessment-insulin resistance index,HOMA-IR)均高于NW-NGT,差异有统计学意义(P<0.05)。Pearson相关分析显示,HOMA-IR与血清Lp-PLA2水平、BMI、腰围及hs-CRP呈正相关。多元线性逐步回归分析统计显示,HOMA-IR仍是血清Lp-PLA2水平的独立危险因素(t=4.201,P=0.000)。此外,用尤登指数(Youden’s index,YI)来估测最佳界值,YI值最大时,Lp-PLA2值为21.0 ng/ml,是诊断胰岛素抵抗的最佳切点。结论:青年人中,血清Lp-PLA2水平增高与胰岛素抵抗密切相关,是胰岛素抵抗的独立危险因素,对预测胰岛素抵抗的发生具有一定的临床价值。
Objective：To investigate the relation between youth serum lipoprotein-associated phospholipase A2 levels and insulin resistance and its clinical significance. Methods：One hundred and sixty subjects were enrolled into this study,including 87 women and73 men with an average age of（33.4±1.2） years. Anthropometric indicators such as height,weight and biochemical markers such as serum lipid profile,plasma glucose,and serum insulin level were examined. ELISA was used to detect serum lipoprotein-associated phospholipase A2（Lp-PLA2） levels. According to body mass index（BMI） and the results of oral glucose tolerance test（OGTT）,we recruited 65 cases of normal weight-normal glucose tolerance（NW-NGT）,45 cases of overweight-obesity-normal glucose tolerance（OB-NGT） and overweight-obesity-type 2 diabetes（OB-T2DM） in total. Results：The OB-NGT group and OB-T2 DM group had higher Lp-PLA2,homeostasis model assessment-insulin resistance index（HOMA-IR）,BMI,low density lipoprotein-cholesterol（LDLC）,fasting insulin（FINS） and high sensitivity C-reactive protein（hs-CRP） levels compared with those of NW-NGT group（all P0.05）. As was shown by Pearson correlation analysis,HOMA-IR had a significantly positive correlation with serum Lp-PLA2 level,BMI,hs-CRP and waistline. Multiple linear stepwise regression analysis statistics indicated that HOMA-IR was the independent factor of serum Lp-PLA2 level（t=4.201,P=0.000）. In addition,we used Youden＇s index（YI） to determine the best threshold. YI got its maximum value,when Lp-PLA2 level was 21.0 ng/ml,which therefore was thought to be the best cut-off point for diagnosis of insulin resistance. Conclusion：Increased youth serum LpPLA2 level is closely related to insulin resistance,At the same time serum Lp-PLA2 is an independent risk factor of insulin resistance,which provides a certain clinical value in predicting the occurrence of insulin resistance.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2015年第7期981-985,共5页
Journal of Chongqing Medical University
基金
国家临床重点专科建设经费资助项目(编号:ZHTNB-2013-1231-0550(2011)
关键词
血清脂蛋白相关磷脂酶A2
胰岛素抵抗
炎症因子
肥胖
2型糖尿病
lipoprotein-associated phospholipase A2
insulin resistance
inflammatory factors
obesity
type 2 diabetes
