【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P-选择素水平和胰岛素抵抗及MS其他指标的相互关系。方法:用液相蛋白芯片结合流式细胞仪测定单纯MS组(17例)、MS+CHD组(40例)和正常对照组(19例)空腹血浆P-选择素水平,用酶联免疫吸附法(ELISA)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、空腹血糖和血脂,计算胰岛素敏感指数。结果:①P-选择素在正常对照组(25．1±3．6)μg／L,MS组(33．1±5．1)μg／L,MS+CHD组(41．3±8．4)μg/L,3组间差异有显著性意义(F=37．54,P<0．05);②空腹血浆P-选择素水平与胰岛素敏感指数呈负相关(r=-0．460,P< 0．05),与体重指数(r=0．402,P<0．05)、低密度脂蛋白胆固醇(r=0．406,P<0．05)、腰围(r=0．538,P<0．05)、空腹真胰岛素(r=0．478,P<0．05)呈正相关;③以空腹血浆P-选择素水平为应变量的多元逐步回归分析提示,胰岛素敏感指数(r2=0．212)、腰围(r2=0．290)、空腹真胰岛素(r2=0．228)、低密度脂蛋白胆固醇(r2=0．165)、体重指数(r2=0．162)与P-选择素具有相关性(P<0．05)。结论:MS患者的P-选择素水平增加,合并CHD的MS患者更为明显,并与胰岛素抵抗相关,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 fasting plasma P-selectin level versus insulin resistance and the metabolic parameters in patients with metabolic syndrome (MS) or MS complicated by coronary atherosclerotic heart disease (MS + CHD). Methods:Fasting plasma P-selectin levels were measured in 17 MS patients,40 MS + CHD patients and 19 healthy controls using cytometric bead array combined with flow cytometer,fasting plasma insulin levels were measured by means of enzyme linked immunosorbent assay method. Other information on conventional clinical features of MS, such as waist,BMI,fasting blood glucose and blood fat were collected and the insulin sensitivity index(ISI) were calculated. Results: (1) There was significant difference in P-selectin concentrations between controls, subjects with MS and subjects with MS + CHD,25. 1±3.6,33. 1±5. 1 and 41. 3±8. 4μg/L. (2) Correlation analysis results suggests that the fasting plasma P-selectin concentration was related to insulin sensitivity index (r= -0.460, P <0. 05) ,and the metabolic parameters including body mass index (r = 0. 402, P < 0. 05), low density lipoprotein cholesterol (r = 0. 406, P < 0. 05) , waist (r = 0. 538, P < 0. 05) and fasting insulin(r =0. 478 ,P <0. 05). (3)Logistic regression analysis indicated a statistically significant relationship between P-seletin concentration and ISI (r2 = 0. 212, P < 0. 05), waist (r2 = 0. 290, P < 0. 05) , fasting insulin (r2 = 0. 228, P < 0. 05) , LDL (r2 =0. 165,P<0.05)or body mass index(r2 =0. 162,P<0. 05). Conclusion:P-selectin concentration was highest in patients with MS + CHD,and increased in patients with MS, which were significantly correlated with insulin resistance. This may contribute to development to coronary atherosclerotic heart disease from metabolic syndrome.更多还原