脂肪因子与代谢综合征关系的研究进展

代谢综合症是一系列代谢和心血管功能失调的临床特征,包括中心性肥胖、高血压、血脂异常、高血糖及胰岛素抵抗等,其发病机制及如何预防及控制代谢综合症正日益成为目前的学术热点。目前已经公认,脂肪不仅是能量存储器官,也是一个重要的内分泌器官。脂肪组织分泌的生物活性分子被称为脂肪因子。近年来的研究表明,脂肪因子广泛参与肥胖、2型糖尿病、高血压病及心血管疾病等一系列代谢相关性疾病的病理生理过程。脂肪因子能通过介导一系列的信号转导通路,并广泛参与机体复杂的代谢平衡网络的调节。脂肪因子的失衡能导致机体发生对胰岛素敏感性改变等一系列的生物学反应,从而在肥胖和代谢综合症的病理过程中发挥重要的作用。本文综述了脂肪因子与代谢综合征的关系的研究进展。     

The Quantitative Relationship Between Autonomous Cortisol Secretion,Dysglycemia and the Metabolic Syndrome

Objective: Autonomous cortisol secretion (ACS) is the most common endocrine abnormality in the evaluation of adrenal incidentalomas. The categorization of ACS is derived from a 1 mg dexamethasone suppression test (DST). Impaired DST is associated with several metabolic derangements. In this study we analyzed the association between post-DST cortisol level, analyzed as a continuous parameter, and indices of glycemic metabolism.Methods: We prospectively collected data of 1,976 patients evaluated for adrenal incidentalomas in a large tertiary medical center between December 1, 2017, and August 31, 2019. Seventy-three patients completed the evaluation process. Post-DST cortisol levels were analyzed for correlation with various metabolic parameters, including fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) among the general cohort and for subgroups stratified by the number of metabolic syndrome (MS) criteria.Results: Post-DST cortisol demonstrated a linear association with FPG and HbA1c across its entire cortisol range (R = 0.51 and 0.41, respectively; P≤.01). The association between post-DST cortisol and FPG was strengthened with an increased number of metabolic syndrome criteria. Patients with 4 MS criteria show a stronger association (R = 0.92) compared to patients with only a single criterion (R = 0.509). Furthermore, mean post-DST cortisol levels increased as the number of MS criteria accumulated.Conclusion: Post-DST cortisol should be viewed as a continuous parameter in risk stratification algorithms for the development of MS and particularly dysglycemia.     

代谢综合征与非酒精性脂肪肝临床特征的关系

目的:探讨代谢综合征(metabolic syndrome,MS)与非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)临床特征之间的相关性。方法:从我院2012年1月-2014年2月健康体检资料中抽选326例经超声确诊为NAFLD的患者,作为NAFLD组,并随机抽选335例无脂肪肝患者作为对照组;观察两组患者间的临床特征,并采用Logistic回归分析MS与NAFLD临床特征之间的相关性。结果:NAFLD组患者体重指数(BMI)、血压、丙氨酸氨基转移酶(ALT)、空腹血糖(FBG)、血尿酸(UA)、高密度脂蛋白(HDL-C)、甘油三酯(TG)、天冬氨酸氨基转移酶(AST)水平显著高于对照组(P0.05):两组间低密度脂蛋白(LDL-C)、总胆固醇(TC)比较无显著性(P0.05)。NAFLD组中MS、血脂及糖代谢异常、肥胖以及高血压的检出率明显高于对照组(P0.05)。经Logistic回归分析显示,NAFLD、BMI、TG、HDL-C、高血压及血糖是MS的独立危险因素。结论:NAFLD患者中存在MS的各种组分聚集特征,MS患病率明显升高,NAFLD是MS的独立危险因素之一,因此MS与NAFLD关系密切。     

阻塞型睡眠呼吸暂停低通气综合征与代谢综合征组分关系探讨

目的：探讨阻塞型睡眠呼吸暂停低通气综合征（OSAHS）与代谢综合征（MS）组分关系。方法：对我院2003年1月至2010年7月39例诊断为0SAHS住院患者进行回顾性调查,30例同期住院病人为对照组,均记录年龄、性别,测量身高、体重、血压,检测空腹血糖、血脂,分析OSAHS患者合并MS组分情况。结果：1．OSAHS组与对照组比较,体重指数（BMI）、血压、血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白Al升高,高密度脂蛋白胆固醇降低（P〈0．05）;2．OSAHS组与对照组相比较,无MS组分比例低于对照组,差异有统计学意义（P〈0．05）;3．OSAHS组与对照组相比较,OSAHS组合并MS组分,包括BMI〉25Kg／m2,血脂紊乱的比例,均高于对照组,差异有统计学意义（P〈0．05）。结论：OSAHS患者易合并代谢综合征组分。     

阻塞型睡眠呼吸暂停低通气综合征与代谢综合征组分关系探讨

目的:探讨阻塞型睡眠呼吸暂停低通气综合征(OSAHS)与代谢综合征(MS)组分关系。方法:对我院2003年1月至2010年7月39例诊断为OSAHS住院患者进行回顾性调查,30例同期住院病人为对照组,均记录年龄、性别,测量身高、体重、血压,检测空腹血糖、血脂,分析OSAHS患者合并MS组分情况。结果:1.OSAHS组与对照组比较,体重指数(BMI)、血压、血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1升高,高密度脂蛋白胆固醇降低(P<0.05);2.OSAHS组与对照组相比较,无MS组分比例低于对照组,差异有统计学意义(P<0.05);3.OSAHS组与对照组相比较,OSAHS组合并MS组分,包括BMI≥25Kg/m2,血脂紊乱的比例,均高于对照组,差异有统计学意义(P<0.05)。结论:OSAHS患者易合并代谢综合征组分。     

Relationship between Lung Function and Metabolic Syndrome

Although the link between impaired lung function and cardiovascular events and type 2 diabetes mellitus has been recognized, the association between impaired lung function and metabolic syndrome has not been comprehensively assessed in the United States (U.S.) population. The aim of our study was to explore the association between impaired lung function and metabolic syndrome in a nationally representative sample of men and women. This cross-sectional population-based study included 8602 participants aged 20–65 years in the Third National Health and Nutrition Examination Survey (NHANES III). We examined the relationship between the different features of metabolic syndrome and lung function, including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). After adjusting for potential confounders such as age, body mass index, inflammatory factors, medical condition, and smoking status, participants with more components of metabolic syndrome had lower predicted values of FVC and FEV1 (p for trend <0.001 for both). Impaired pulmonary function was also associated with individual components of metabolic syndrome, such as abdominal obesity, high blood pressure, high triglycerides, and low high density lipoprotein (HDL) cholesterol (p<0.05 for all parameters). These results from a nationally representative sample of US adults suggest that a greater number of features of metabolic syndrome is strongly associated with poorer FVC and FEV1. In clinical practice, more comprehensive management strategies to address subjects with metabolic syndrome and impaired lung function need to be developed and investigated.     

The Association Between First-Degree Family History of Diabetes and Metabolic Syndrome

Objective: Because they share genetic and environmental factors with patients with diabetes, the first-degree relatives (FDRs) of patients with diabetes exhibit early signs of metabolic abnormalities. The present study aimed to investigate the correlation between family history of diabetes in FDRs and metabolic syndrome (MS), as well as changes in related risk factors.Methods: The present study population was a part of the baseline survey from the REACTION study. FDRs were defined as individuals having one or more FDRs with diabetes. MS and its components were defined according to the 2007 Joint Committee for Developing Chinese Guidelines.Results: A total of 2,692 individuals with an average age of 57.24 ± 8.35 years were enrolled in the present study. The prevalence of MS in FDRs (36.44%) was significantly higher than that in non-FDRs (25.28%; P<.001). FDRs accounted for 13.37%, 14.32%, 16.67%, 22.47%, 23.53%, and 25.58% of subjects with 0 to 5 MS components, showing an increasing trend (P for trend <.001). After adjusting for gender and age, partial correlation analyses showed significant associations of first-degree family history of diabetes with MS-related indexes (all P<.05). After adjusting for gender, age, lifestyle habits, and total metabolic traits, the first-degree family history of diabetes remained an independent factor that was positively associated with MS (odds ratio, 1.765; P<.001).Conclusion: A first-degree family history of diabetes predisposes individuals to developing MS and stands out as an independent risk factor for MS even without considering the subsequent effects of hyperglycemia.Abbreviations: BMI = body mass index; DBP = diastolic blood pressure; FDR = first-degree relative; FPG = fasting plasma glucose; HbA1c = glycated hemoglobin A1c; HDL-c = high-density-lipoprotein cholesterol; LDL-c = low-density-lipoprotein cholesterol; MAP = mean arterial pressure; MS = metabolic syndrome; OR = odds ratio; SBP = systolic blood pressure; TC = total cholesterol; TG = triglyceride; WC = waist circumference; WHR = waist-to-hip ratio; 2hPG = 2-hour plasma glucose     

Relationship Between Serum Calcium and Magnesium Concentrations and Metabolic Syndrome Diagnostic Components in Middle-Aged Korean Men

It is thought that calcium and magnesium may be related to metabolic disorders such as obesity and metabolic syndrome; however, to date, there have been few studies investigating the association between serum calcium and magnesium levels and metabolic syndrome in middle-aged male adults. We aimed to investigate the association between serum calcium and magnesium levels and metabolic syndrome in Korean middle-aged male adults. Study subjects included 213 men aged 30∼60 years. MetS risk score is determined by adding the number of risk factors, waist circumference, triacylglyceride (TG), HDL cholesterol, glucose, and blood pressure (BP). The study population was divided into three groups according to the MetS risk score: group I (MetS risk score ≤1; n = 106), group II (MetS risk score = 2; n = 51), and group III (MetS risk score ≥3; n = 56). The serum Ca, according to increase of MetS risk score, was significantly higher (p < 0.001), and there was no significant difference in serum Mg concentration among the three groups. Subjects with high TG and high BP had higher serum calcium levels than those without such abnormalities. Subjects with higher glucose had lower serum magnesium levels than those without such abnormality. The correlation analysis indicated that the serum Ca had positive correlations with the MetS risk score (r = 0.1769, p < 0.01), serum TG (r = 0.2516, p < 0.001), and DBP (r = 0.2246, p < 0.01). The correlation analysis indicated that the serum Mg had an inverse relationship with serum glucose (r = −0.2404, p < 0.001). In conclusion, serum Ca had positive association with TG and BP, while serum Mg had negative association with serum glucose after adjusting age and BMI among the middle-aged Korean male adults.     

良性前列腺增生与代谢综合征相关性研究

目的:探讨代谢综合征在老年良性前列腺患者病程中的作用.方法:选择湖南师范大学第二附属医院老年病科2010年1月至2012年1月门诊及住院的男性良性前列腺增生合并代谢综合征患者88例,同时选择同期的单纯良性前列腺增生患者90例,分析体重指数、血压、腰围、空腹血糖、胰岛素抵抗指数、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、前列腺特异性抗原等对及前列腺体积的影响.结果:BPH合并MS组PV为(39.7±21.1)mL,明显高于单纯BPH组,且PV与BMI、收缩压、空腹血糖、PSA呈正相关,与高密度脂蛋白呈负相关.结论:BPH与MS具有相关性,BMI、收缩压、PSA、FBG、低密度脂蛋白是BPH发生发展的危险因素.     

植物中赤霉素代谢酶与株高的关系

赤霉素是高等植物体内调控植物发育的重要激素.介绍了赤霉素的生物合成过程及赤霉素代谢酶与株高关系的研究概况.     

Relationship Between Metabolic Syndrome,Circadian Treatment Time,and Blood Pressure Non-Dipping Profile in Essential Hypertension

There is a strong association between metabolic syndrome (MS) and increased cardiovascular risk. Moreover, elevated nighttime blood pressure (BP) and non-dipping (subjects with <10% decline in the asleep relative to the awake BP mean) have been also linked to increased cardiovascular morbidity and mortality. We investigated the relation between MS, circadian time of hypertension treatment, and impaired nighttime BP decline in a cross-sectional study on 3352 (1576 men/1776 women) non-diabetic hypertensive subjects, 53.7?±?13.1 (mean?±?SD) yrs of age. Among them, 2056 were ingesting all their prescribed hypertension medication upon awakening, and 1296 were ingesting at least one of their BP medications at bedtime. BP was measured by ambulatory monitoring for 48 consecutive hours to substantiate reproducibility of the dipping pattern. Physical activity was simultaneously monitored every minute by wrist actigraphy to accurately calculate mean BP when awake and asleep for each subject. MS was present in 52.6% of the subjects. The prevalence of an altered non-dipper BP profile was significantly higher among subjects with MS (52.0% vs. 39.5% in subjects without MS, p < .001). Non-dipping was significantly more prevalent among subjects ingesting all BP-lowering medications upon awakening (56.8%) than among those ingesting at least one of their BP medications at bedtime (29.1%; p < .001). Subjects with MS had significantly higher values of uric acid (6.0 vs. 5.3?mg/dL, p < .001), plasma fibrinogen (331 vs. 315?mg/dL, p < .001), and erythrocyte sedimentation rate (14.8 vs. 12.4?mm, p < .001). Non-dipping was significantly associated with the presence of MS and treatment upon awakening in a multiple logistic regression model adjusted by significant confounding factors, including age, creatinine, erythrocyte sedimentation rate, and cigarette smoking. This cross-sectional study documents a significant increase of a blunted sleep-time BP decline in treated hypertensive subjects with MS. Even in the presence of MS, treatment at bedtime is significantly associated with lower prevalence of a high-risk non-dipper BP profile. (Author correspondence: rhermida@uvigo.es)     

Hair Tissue Mineral Analysis and Metabolic Syndrome

Deficiency of minerals causes functional abnormality of enzymes, frequently resulting in metabolic disturbance. We investigated possible relationship between minerals and metabolic syndrome by analysis of hair tissue minerals. We selected 848 subjects older than 20 years of age at Ajou University Hospital from May 2004 to February 2007. We excluded the subjects who had cancers, steroid and thyroid medication, and incomplete record from the study. Finally, 343 subjects were eligible. We performed cross-sectional analysis for the relationship between minerals and metabolic syndrome. The contents of calcium, magnesium, and copper in the metabolic syndrome group were significantly lower than those of the normal group, whereas the amounts of sodium, potassium, and mercury in the metabolic syndrome group were significantly higher than those of the normal group. By dividing the subjects into quartile with the level of calcium, magnesium, and mercury concentrations, we carried out logistic regression analysis to study the subjects and found that the subjects in the third quartile of calcium and magnesium concentrations had significantly lower odds ratio (OR) of the metabolic syndrome compared with that of the lowest quartile group [OR = 0.30, confidence interval (CI) = 0.10–0.89; OR = 0.189, CI = 0.063–0.566] and that the subjects in the highest mercury quartile had significantly higher OR of the metabolic syndrome compared with that of the lowest mercury quartile group (OR = 7.35, CI = 1.73–31.1). As part of the metabolic syndrome, the optimal calcium and magnesium concentrations in hair tissue may reflect decreased risk of metabolic syndrome, whereas high mercury concentration in hair tissue may indicate increased risk of metabolic syndrome.     

Alanine Aminotransferase and Risk of the Metabolic Syndrome: A Linear Dose-Response Relationship

Background

Elevated baseline circulating alanine aminotransferase (ALT) level has been demonstrated to be associated with an increased risk of the metabolic syndrome (MetS), but the nature of the dose-response relationship is uncertain.

Methods

We performed a systematic review and meta-analysis of published prospective cohort studies to characterize in detail the nature of the dose-response relationship between baseline ALT level and risk of incident MetS in the general population. Relevant studies were identified in a literature search of MEDLINE, EMBASE, and Web of Science up to December 2013. Prospective studies in which investigators reported relative risks (RRs) of MetS for 3 or more categories of ALT levels were eligible. A potential nonlinear relationship between ALT levels and MetS was examined using restricted cubic splines.

Results

Of the 489 studies reviewed, relevant data were available on 29,815 non-overlapping participants comprising 2,125 incident MetS events from five prospective cohort studies. There was evidence of a linear association (P for nonlinearity = 0.38) between ALT level and risk of MetS, characterised by a graded increase in MetS risk at ALT levels 6–40 U/L. The risk of MetS increased by 14% for every 5 U/L increment in circulating ALT level (95% CI: 12–17%). Evidence was lacking of heterogeneity and publication bias among the contributing studies.

Conclusions

Baseline ALT level is associated with risk of the MetS in a linear dose-response manner. Studies are needed to determine whether the association represents a causal relationship.     

微量白蛋白尿与2型糖尿病合并代谢综合征的相关性

目的:探讨2型糖尿病(T2DM)患者微量白蛋白尿与代谢综合征(MS)的相关性。方法:282例T2DM患者根据是否合并MS分为MS组(163例)和非MS组(119例),测定24h尿白蛋白(UAlb)及相关生化指标,比较两组UAlb水平及糖尿病肾病(DN)患病率,采用多元Logistic回归方法分析T2DM患者微量白蛋白尿的危险因素。结果:MS组的UAlb及DN患病率明显高于非MS组,且随着MS组分增加,UAlb水平显著升高。多元Logistic回归分析表明甘油三酯、糖化血红蛋白、收缩压为影响UAlb的独立危险因素。结论:T2DM患者微量白蛋白尿与MS密切相关,需采取综合干预措施避免或延缓DN的发生发展。     

微量白蛋白尿与2型糖尿病合并代谢综合征的相关性

目的:探讨2型糖尿病(T2DM)患者微量白蛋白尿与代谢综合征(MS)的相关性.方法:282例T2DM患者根据是否合并MS分为MS组(163例)和非MS组(119例),测定24h尿白蛋白(UAlb)及相关生化指标,比较两组UAlb水平及糖尿病肾病(DN)患病率,采用多元Logistic回归方法分析T2DM患者微量白蛋白尿的危险因素.结果:MS组的UAlb及DN患病率明显高于非MS组,且随着MS组分增加,UAlb水平显著升高.多元Logistic回归分析表明甘油三酯、糖化血红蛋白、收缩压为影响UAlb的独立危险因素.结论:T2DM患者微量白蛋白尿与MS密切相关,需采取综合干预措施避免或延缓DN的发生发展.     

Alcohol Consumption in the Severely Obese: Relationship with the Metabolic Syndrome

Objective: The aim of this study was to examine the association between the clinical and biochemical features of the metabolic syndrome and quantity and type of alcohol intake in the severely obese. Research Methods and Procedures: A cross‐sectional study was performed in 486 consecutive severely obese subjects. Data on alcohol consumption was collected by serial clinical interviews and a questionnaire. The relationship between alcohol intake and the clinical and serum chemistry features of the metabolic syndrome was analyzed by multiple statistical techniques. Laboratory measures included lipid profile, fasting blood glucose, hemoglobin A1c, and fasting serum insulin. An indirect index of insulin resistance was calculated using the log‐transformed fasting insulin and glucose product. Results: There were 486 subjects, 84% women, with a mean age of 40.6 ± 10 years (range, 16 to 71 years) and a body mass index of 45.3 ± 7 kg/m² (range, 34 to 77 kg/m²). Alcohol consumers (N = 276) showed a marked reduction in the adjusted odds ratio of type 2 diabetes (odds ratio = 0.29; 95% confidence interval, 0.16 to 0.55) compared with rare or nonconsumers (N = 210). There was a U‐shaped relationship between the amount and frequency of alcohol consumption and fasting triglyceride, fasting glucose, hemoglobin A1c, and index of insulin resistance measurements. Consumers of <100 g/wk had more favorable measures. The effect was attenuated when diabetics were excluded from the analysis. Timing of alcohol consumption did not influence outcome measures. Discussion: Light‐to‐moderate alcohol consumption is associated with a lower prevalence of type 2 diabetes, reduced insulin resistance, and more favorable vascular risk profile in the severely obese. We would propose that light to moderate alcohol consumption should not be discouraged in the severely obese.     

代谢综合征患者血液流变学及多因素相关分析

目的:探讨代谢综合征(MS)患者血液流变学及多因素的相关性。方法:检测49例2型糖尿病(T2DM)和40例MS患者的肥胖指标、血脂、血黏度,并进行比较和相关性分析。结果:(1)MS组的BMI(体重指数),FAT%(体脂百分率),W(腰围),LP(脂蛋白),TG(甘油三酯),TC(总胆固醇),血浆黏度均显著高于T2DM组(p＜0．05);(2)T2DM组的血浆黏度与TC及MS组的W与BMI,FAT%正相关(p＜0．05)。结论:(1)MS较T2DM存在更高的血浆黏度,可能是多因素综合作用的结果。(2)FAT%的测定对中心性肥胖的评估具有一定意义。     

产甲烷常温古细菌和嗜热古细菌代谢网络拓扑结构与功能间的关联性研究

根据从KEGG数据库获得的产甲烷的常温古细菌Methanosarcina acetivorans(MAC)和嗜热古细菌Methanopyrus kandleri(MKA)的代谢网络,通过不同的网络属性特征的比较,发现常温古细菌MAC的代谢网络比嗜热古细菌MKA有更长的平均路径长度,更大的直径,这表明常温古细菌MAC的总体结构是相对低密度、松散的网络结构.同时为了从系统水平上分析这些特征蕴含的功能意义,采用了Grivan和Newman提出的模块算法(简称GN算法)分析这两个生物体的功能模块,并将所得的结果与KEGG数据库中的途径信息进行比较研究,发现大部分模块对应2~4个KEGG途径,表明这些网络模块均具有一定功能意义.     

冠心病患者血清CRP的变化及其临床意义

目的:探讨冠心病(CAD)患者血清C-反应蛋白(CRP)的变化及其临床意义.方法:运用全自动生化分析仪检测97例CAD患者和28例对照组人群的血清CRP,将CAD患者进一步分为稳定性心绞痛组(SAP)、不稳定心绞痛(UAP)、心肌梗死组(AMI)三组.另外,将97例CAD惠者分为1支病变组、2支病变组和3支病变组.所有研究对象均行选择性冠状动脉造影检查.结果:(1)与对照组比较,CAD患者血清CRP显著升高(P<0.05);(2)与对照组比较,SAP组、UAP组和AMI组患者血清CRP均显著升高(P<0.05);与SAP组比较,UAP组和AMI组患者血清CRP亦显著升高(P<0.05);(3)与对照组比较,1支病变组、2支病变组和3支病变组患者血清CRP均显著升高(P<0.05);与1支病变组比较,2支病变组和3支病变组患者血清CRP亦显著升高(P<0.05);与2支病变组比较,3支病变组患者血清CRP亦显著升高(P<0.05).结论:(1)CRP可能与CAD有关;(2)CRP异常升高可能反映冠状动脉斑块的不稳定和CAD的严重程度.     

驻某地武警机关干部体质指数与代谢性疾病的关系

目的:探讨健康体检的驻某地武警机关干部体质指数(BMI)与代谢性疾病的关系。方法:采用横断面调查方法对健康体检的1920名驻某地武警机关干部和270名地方机关干部的体质指数情况进行比较分析,探讨超重肥胖与代谢性疾病的关系。结果:1.军人组超重率及肥胖率均低于地方组(P<0.01)。2.<50岁人群组随年龄增加,超重及肥胖检出率有增高趋势(P<0.01),40~49岁人群超重率和肥胖率最高;50~65岁人群超重与肥胖率最低。3.两组机关干部随BMI升高,高总胆固醇、高甘油三酯、高尿酸血症、脂肪肝检出率增高(P<0.01);军人组高尿酸血症发病率明显高于地方组(P<0.05);高血压、高血脂发病率明显降低(P<0.05);与地方超重组比较,军人超重组脂肪肝发病率明显升高(P<0.05)。4.在30~50岁的军人中,随着年龄升高,高血压、高血糖、高血脂、高尿酸,脂肪肝发病率明显升高(P<0.01)。结论:健康体检人群超重、肥胖率较高,控制体重对高血压、高血糖、高血脂及脂肪肝等慢性病的防治具有重要意义。军人组超重与肥胖率均低于地方,但高尿酸血症和高脂肪肝发病率升高,故建议有代谢性疾病的军人限制饮酒可能会受益。