【摘要】 目的探讨代谢综合征(MS)及合并冠心病(CHD)患者空腹血浆单核细胞趋化蛋白-1(MCP-1)、超敏C反应蛋白(hs-CRP)水平和胰岛素抵抗及MS其他指标的关系。方法用液相蛋白芯片结合流式细胞仪测定单纯MS组、MS+CHD组和正常对照组空腹血浆MCP-1水平,用速率散射比浊法测定hs-CRP水平,用酶联免疫吸附法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(BMI)、空腹血糖(FBG)和血脂,计算胰岛素敏感指数(ISI)。结果 (1)MCP-1在正常对照组、MS组和MS+CHD组间差异有统计学意义(F=82.6,P<0.05);hs-CRP在正常对照组、MS组和MS+CHD组间差异有统计学意义(F=32.02,P<0.05)。(2)MCP-1水平与ISI呈负相关,与空腹真胰岛素、CRP、BMI呈正相关;hs-CRP与ISI呈负相关,与FBG、BMI呈正相关;(3)以MCP-1为应变量的多元逐步回归分析提示,ISI、空腹真胰岛素、hs-CRP、BMI与MCP-1具有相关性;以hs-CRP为应变量的多元逐步回归分析提示,ISI、FBG、BMI与hs-CRP具有相关性。结论 MS患者的MCP-1、hs-CRP水平增加,合并CHD的MS患者更为明显,并与胰岛素敏感性有关,可能在MS发展为CHD中起一定作用。更多还原

【Abstract】 Objective To investigate the relationship between the fasting plasma levels of monocyte chemoattractant protein-1, high-sensitive C-reactive protein and insulin resistance or other metabolic parameters in patients with metabolic syndrome( MS) or MS complicated by coronary atherosclerotic heart disease( MS + CHD) . Methods Fasting plasma levels of monocyte chemoattractant protein-1 were measured in MS patients,MS + CHD patients and healthy controls using by cytometric bead array combined with flow cytometer,high-sensitive C-reactive protein levels by immunonephelometry and insulin levels by means of enzyme linked immunosorbent assay method. Other information on the conventional clinical features of MS,such as waist circumference,BMI,fasting blood levels of glucose and fat,were collected and the insulin sensitivity index( ISI) were calculated. Results ( 1) There was a significant difference in plasma levels of monocyte chemoattractant protein-1 ( F = 82. 6,P < 0. 05) and high-sensitive C-reactive protein ( F = 32. 02,P < 0. 05) between the controls,subjects with MS and subjects with MS + CHD. ( 2) Correlation analysis results suggested that the fasting plasma level of monocyte chemoattractant protein-1 was related negtively to insulin sensitivity index( ISI) and positively to the levels of fasting insulin and high-sensitive C-reactive protein and the body mass index. Likewise,the fasting plasma high-sensitive C-reactive protein concentration was related negtively to ISI and positively to the fasting blood glucose levels and the body mass index. ( 3) Logistic regression analysis indicated a statistically significant relationship between monocyte chemoattractant protein-1 concentration and ISI,the levels of fasting insulin and high-sensitive C-reactive protein,and body mass index as well as between high-sensitive C-reactive protein concentration and ISI,the level of fasting blood glucose,and body mass index. Conclusions The levels of monocyte chemoattractant protein-1and high-sensitive C-reactive protein in patients with MS were higer compared with the controls and more noticeable in those with MS + CHD. The phenomenon was related significantly to the insulin resistance and may contribute to the development of coronary atherosclerotic heart disease from metabolic syndrome.更多还原