肥胖合并高脂血症患者血清食欲素A、25-羟维生素D3、瘦素水平与胰岛素抵抗、脂代谢紊乱和肥胖评价指标的相关性分析

摘要 目的：探讨肥胖合并高脂血症患者血清食欲素A（orexin A）、25-羟维生素D3[25-(OH)D3]、瘦素（Leptin）水平与胰岛素抵抗、脂代谢紊乱和肥胖评价指标的相关性。方法：选择2019年2月至2021年12月中国医科大学附属第四医院收治的105例肥胖合并高脂血症患者为研究组，另取同期在中国医科大学附属第四医院健康体检的73例志愿者为对照组。检测并对比两组血清orexin A、25-(OH)D3、Leptin、胰岛素抵抗相关指标、脂代谢指标及肥胖评价指标水平的差异。采用Pearson相关性分析血清orexin A、25-(OH)D3、Leptin水平与胰岛素抵抗相关指标、脂代谢指标及肥胖评价指标的相关性。结果：研究组血清orexin A、25-(OH)D3水平低于对照组，而Leptin水平高于对照组（P＜0.05）。研究组空腹血糖（FPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）水平均高于对照组（P＜0.05）。研究组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平高于对照组，而高密度脂蛋白胆固醇（HDL-C）水平低于对照组（P＜0.05）。研究组体质量指数（BMI）、腰臀比、腰高比均高于对照组（P＜0.05）。肥胖合并高脂血症患者的血清orexin A、25-(OH)D3水平与FPG、FINS、HOMA-IR、TC、TG、LDL-C水平、BMI、腰臀比、腰高比均呈负相关，与HDL-C水平呈正相关（P＜0.05）；Leptin水平与FPG、FINS、HOMA-IR、TC、TG、LDL-C水平、BMI、腰臀比、腰高比均呈正相关，与HDL-C水平呈负相关（P＜0.05）。结论：肥胖合并高脂血症患者血清orexin A、25-(OH)D3水平降低，Leptin水平升高，且与胰岛素抵抗、脂代谢紊乱及肥胖指标升高有关。

Correlation Analysis of Serum Orexin A, 25-Hydroxyvitamin D3 and Leptin Levels with Insulin Resistance, Lipid Metabolism Disorder and Obesity Evaluation Indexes in Patients with Obesity Complicated with Hyperlipidemia

ABSTRACT Objective: To investigate the correlation between serum orexin A (orexin A), 25-hydroxyvitamin D3[25-(OH)D3], Leptin and insulin resistance, lipid metabolism disorder and obesity in patients with obesity complicated with hyperlipidemia. Methods: 105 obese patients with hyperlipidemia who were treated in The Fourth Affiliated Hospital of China Medical University from February 2019 to December 2021 were selected as the study group, and 73 volunteers who underwent physical examination in The Fourth Affiliated Hospital of China Medical University in the same period were selected as the control group. The differences of serum orexin A, 25-(OH)D3, leptin, insulin resistance related indexes, lipid metabolism indexes and obesity evaluation indexes between the two groups were detected and compared. Pearson correlation was used to analyze the correlation between the levels of serum orexin A, 25-(OH) D3 and leptin and the indexes related to insulin resistance, lipid metabolism and obesity evaluation. Results: The levels of serum orexin A and 25-(OH) D3 in the study group were lower than those in the control group, while the level of leptin was higher than those in the control group (P<0.05). The levels of fasting blood glucose (FPG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) in the study group were higher than those in the control group(P<0.05). The levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol(LDL-C) in the study group were higher than those in the control group, while the levels of high density lipoprotein cholesterol (HDL-C) were lower than those in the control group(P<0.05). The body mass index (BMI), waist hip ratio and waist height ratio in the study group were higher than those in the control group(P<0.05). The levels of serum orexin A and 25-(OH) D3 in obese patients with hyperlipidemia were negatively correlated with the levels of FPG, fins, HOMA-IR, TC, TG, LDL-C, BMI, waist hip ratio and waist height ratio, and positively correlated with the level of HDL-C(P<0.05). Leptin level was positively correlated with FPG, fins, HOMA-IR, TC, TG, LDL-C level, BMI, waist hip ratio and waist height ratio, and negatively correlated with HDL-C level (P<0.05). Conclusion: The levels of serum orexin A and 25-(OH) D3 decreased and leptin increased in obese patients with hyperlipidemia, which was related to insulin resistance, lipid metabolism disorder and obesity index.