【摘要】 目的：代谢综合征(metabolic syndrome,MetS)是严重威胁人类健康的重大公共卫生问题，深入探索其病理机制和潜在干预靶点具有重要临床意义。本研究旨在探讨血清胃生物标志物与MetS的关系。方法：本研究为横断面研究，纳入2017年5月至2021年6月在中南大学湘雅三医院健康管理医学中心进行健康体检的24 635名体检者(年龄为18～80岁)，收集人口统计学、既往史、用药史、身高、体重、血压、空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇及肌酐等数据。通过酶联免疫吸附试验试剂盒检测研究参与者血清胃蛋白酶原(pepsinogen,PG)I、PGII和胃泌素17(gastrin-17,G-17)的水平。根据国际糖尿病联合会标准定义MetS，分为MetS患者组和非MetS患者组，通过Logistic回归分析血清胃生物标志物与MetS的相关性。结果：24 635名研究参与者中，MetS的总患病率为35.72%，男性患病率高于女性(42.41%vs 24.31%)。相较于非MetS患者组，MetS患者组的年龄、腰围更大，BMI、患代谢相关疾病比例、幽门螺杆菌感染率、收缩压、舒张压、总胆固醇、甘油三酯、空腹血糖、糖化血红蛋白和肌酐水平更高，血清G-17水平显著升高，PGI水平降低(均P<0.05)。男性G-17、PGI、PGII水平及PGI/PGII比值均高于女性(均P<0.05)。亚组分析显示：无论男女，MetS患者血清G-17均升高，PGI均降低，而PGII水平呈现性别差异(均P<0.05)。校正混杂因素后，Logistic回归分析显示：高水平G-17与MetS患病独立相关，男性关联性更强，且随着MetS评分的增加，G-17水平逐渐升高(均P<0.05)。结论：血清G-17水平与MetS患病及严重程度呈显著正相关，在男性中关联更显著。血清G-17可能参与MetS的代谢紊乱过程。更多还原

【Abstract】 Objective: Metabolic syndrome(Met S) is a major public health concern that poses a significant threat to human health. Investigating its underlying mechanisms and identifying potential intervention targets has important clinical implications. This study aims to explore the association between serum gastric biomarkers and Met S and its components.Methods: A cross-sectional study was conducted among 24 635 individuals(aged 18 to 80 years) who underwent routine health examinations from May 2017 to June 2021 at the Health Management Medical Center, Third Xiangya Hospital, Central South University. Demographic data, medical and medication history, height, weight, blood pressure, fasting blood glucose, glycated hemoglobin(Hb A1c), total cholesterol, triglycerides, low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), and creatinine levels were collected. Serum levels of pepsinogen(PG) I, PGII, and gastrin-17(G-17) were measured using enzyme-linked immunosorbent assay kits. Met S was diagnosed based on the International Diabetes Federation criteria. Logistic regression was used to assess the association between gastric biomarkers and Met S.Results: Among the 24 635 participants, the overall prevalence of Met S was 35.72%, with a higher rate in males than in females(42.41% vs 24.31%). Compared with the non-Met S group, Met S group were older and had higher metabolic-related diseases rate, Helicobacter pylori infection rate, body mass index(BMI), waist circumference, systolic and diastolic blood pressure, total cholesterol, triglycerides, fasting blood glucose, glycated hemoglobin, and creatinine levels(all P<0.05). Serum G-17 levels were significantly elevated in the Met S group, and PGI levels decreased(both P<0.05). Males had higher G-17, PGI, PGII, and PGI/PGII ratios than females(all P<0.05). Subgroup analysis revealed that G-17 was consistently elevated in Met S patients regardless of sex, whereas PGI was decreased. PGII levels exhibited sex-specific differences. After adjusting for confounders, Logistic regression analysis revealed that high G-17 level was independently associated with Met S, with a stronger correlation observed in males. Moreover, G-17 level progressively increased with higher Met S scores(all P<0.05).Conclusion: Serum G-17 level is positively associated with both the presence and severity of Met S, with a more pronounced correlation in males, suggesting its potential involvement in Met S-related metabolic dysregulation.更多还原