脂联素水平分泌的节律性及其与糖皮质激素、胰岛素、瘦素的关系  

The rhythmicity of adiponectin and its relation with glucocorticoids,insulin and leptin

作　　者：杨颖[1] 唐金凤[1] 汪启迪[1] 李凤英[1] 张一波[1] 周丽斌[1] 陈名道[1] 

机构地区：[1]上海第二医科大学附属瑞金医院上海市内分泌研究所,200025

出　　处：《中华内科杂志》2004年第7期515-518,共4页Chinese Journal of Internal Medicine

摘　　要：目的　观察库欣综合征患者、肥胖症者和正常人血清脂联素昼夜节律及糖皮质激素、胰岛素和瘦素对其影响。方法　 15例库欣综合征病人、10例单纯性肥胖症病人和 9例正常人 ,每 4h抽血 1次 ,测定 1d内的血清脂联素、皮质醇、胰岛素和瘦素的昼夜节律。同时观察地塞米松抑制试验对脂联素水平的影响。结果　库欣综合征病人、肥胖症者及正常人血清脂联素昼夜节律皆不明显 ,但肥胖症者 6个时间点脂联素水平显著低于正常人。脂联素曲线下面积与体重指数 (BMI)、腰围、腰臀围比和胰岛素曲线下面积呈显著负相关 (r值分别为 - 0 4 6、- 0 33、- 0 38、- 0 36 ,P值均 <0 0 5 ) ,而与瘦素的相关性尚未达到统计学差异 ,与皮质醇曲线下面积亦无相关性。 1、2、8mg地塞米松抑制试验对血清脂联素的影响皆不大 ,但库欣综合征病人术后第 1天脂联素水平明显低于术前。结论　血清脂联素水平与BMI、腰围呈负相关 ,既不受皮质醇昼高夜低的分泌节律影响 ,也不随餐后胰岛素释放的增加而变化 ,但术后的应激反应可能减少脂联素的分泌。ObjectiveTo investigate the circadian rhythmicity of adiponectin in patients with Cushing′s syndrome and obesity,as well as in normal subjects. The effects of glucocorticoids,insulin and leptin on the secretion of adiponectin were also explored. Methods15 patients with Cushing′s syndrome and 10 with obesity as well as 9 normal subjects were recruited and their serum adiponectin,glucocorticoids,insulin and leptin levels were determined 6 times a day (8:00,12:00,16:00,20:00,24:00,3:00). ResultsCircadian rhythmicity of adiponectin was not observed,but the adiponectin levels in patients with obesity were lower than those in the normal subjects at all 6 time spots. The area under curve (AUC) of serum adiponectin concentrations were significantly negatively correlated with body mass index (BMI, r =0.46,P <0.01),waist cricumfarence ( r =-0.33,P <0.05) and insulin AUC ( r =-0.36, P <0.05). A multiple linear regression analysis revealed that BMI and waist circumfarence were two significant independent parameters of the plasma adiponectin level. The adiponectin levels did not manifest any change after short term dexamethasone administration with both high and low doses,but were obviously decreased after surgery. ConclusionsNeither long-term endogenous hyperglucocorticoidism nor short-term dexamethasone administration affects the serum adiponectin levels and the serum adiponectin concentrations remain unchanged even with elevated postprandial insulin levels.

关 键 词：脂联素 糖皮质激素 胰岛素 瘦素 昼夜节律 库欣综合征 肥胖症 

分 类 号：R586[医药卫生—内分泌]