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目的:探讨抵抗素与代谢综合征(MS)患者内皮功能障碍的相关性。方法:入选2006年3月～2008年9月于我院门诊或住院的MS初诊患者48例为MS组,以门诊健康体检者48例为对照组。采用酶联免疫吸附测定(ELISA)法检测两组的血清抵抗素水平,同时应用高频超声探头分别测量两组的肱动脉基础内径、反应性充血内径、含服硝酸甘油(NTG)后内径,计算血流介导的肱动脉舒张反应(FMD),并运用多普勒技术测定血流速度峰值。应用第95百分位数法确定MS组的血清抵抗素水平界值点(65μg/L),根据该值将患者再分为两亚组:较高组和较低组。比较组间及组内上述参数的差别。结果:MS组的血清抵抗素水平较对照组明显升高[(83±6)μg/L∶(16±5)μg/L,P<0.001],并且其FMD显著恶化[(4.80±0.60)%∶(6.00±0.50)%,P=0.006];在MS组中,与抵抗素水平较低组比较,较高组患者的肱动脉FMD显著恶化[(5.63±0.12)%∶(3.68±0.20)%,P<0.001],然而,两组间NTG介导的肱动脉舒张反应及反应性充血时峰值血流速度没有显著差别(P均>0.05)。偏相关分析显示,控制混杂因素以后,MS患者的血清抵抗素水平与内皮功能障碍仍存在负相关性(rs=-0.373,P<0.001)。结论:代谢综合征患者的血清抵抗素水平明显升高,与其内皮功能障碍有一定相关性,可作为代谢综合征患者的内皮功能障碍的预测指标。
Objective: To investigate the relationship between resistin and endothelial dysfunction in patients with metabolic syndrome (MS). Methods: Forty-eight newly diagnosed MS patients were selected as MS group from March 2006 to September 2008 in outpatient department or inpatient department of our hospital, and 48 healthy subjects were selected as the control group. The levels of serum resistin in the two groups were measured by enzyme-linked immunosorbent assay (ELISA). The basal diameter of brachial artery, the diameter of reactive hyperemia, the inner diameter of NTG, Flow-mediated brachial artery vasodilation (FMD) was calculated and peak blood flow velocity was measured using Doppler technique. The 95th percentile method was used to determine the cutoff point (65 μg / L) of serum resistin levels in the MS group, which was subdivided into two subgroups: the upper and lower groups. Compare the difference between the above parameters in groups and groups. Results: Serum resistin level in MS group was significantly higher than that in control group [(83 ± 6) μg / L: (16 ± 5) μg / L, P <0.001] (6.00 ± 0.50)%, P = 0.006]. In MS group, brachial artery FMD was significantly worse in the higher group compared with the lower resistin group [(5.63 ± 0.12)%: (3.68 ± 0.20 )%, P <0.001]. However, there was no significant difference between NTG-mediated brachial artery diastolic response and peak blood flow velocity during reactive hyperemia (P> 0.05). Partial correlation analysis showed that there was negative correlation between serum resistin levels and endothelial dysfunction in MS patients (rs = -0.373, P <0.001) after control of confounders. Conclusion: Serum resistin levels in patients with metabolic syndrome are significantly increased, which may be related to endothelial dysfunction and may be used as predictors of endothelial dysfunction in patients with metabolic syndrome.