冠心病合并糖代谢异常患者血浆PPAR-γ、APN及胰岛素抵抗水平的变化  

The changes of the plasma levels of PPAR-γ and APN in coronary heart disease patients combined with abnormal glucose metabolism

作　　者：刘娟[1] 李晓燕[1] 孙青[1] 张红明[1] 韩淑芳[1] 高玉琪[1] 陈英剑[2] 

机构地区：[1]济南军区总医院心内科,山东省济南市250031 [2]济南军区总医院检验科,山东省济南市250031

出　　处：《中国心血管病研究》2014年第8期702-706,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 比较冠心病（CHD）合并糖代谢异常患者血浆PPAR-γ、APN及胰岛素抵抗水平的变化,并探讨相互的关系.方法 根据口服葡萄糖耐量试验（OGTT）,将160例CHD患者分为A组[CHD合并糖尿病（DM）组,51例]、B组（CHI）合并糖耐量受损（IGT）组,59例]和C组（单纯CHD组,50例）;选取50名健康体检者为D组（健康对照组,50例）.采用酶联免疫吸附法（E LISA法）检测受试者血浆PPAR-γ、APN及空腹胰岛素（FIN）水平.结果 ①A组、B组的FIN、HOMA-IR显著高于C组、D组（P＜0.01）,且A组显著高于B组（P＜0.01）,C组、D组之间差异无统计学意义（P＞0.05）.②A组、B组、C组、D组四组的血浆PPAR-γ、APN浓度逐渐升高,各组之间差异有统计学意义（P＜0.05）.③血浆PPAR-γ水平与APN水平呈显著正相关（r=0.579,P＜0.01）,与HOMA-IR呈显著负相关（r=-0.547,P＜0.01）. 结论 单纯CHD、CHD合并IGT、CHD合并DM患者血浆PPAR-γ、APN水平依次降低,胰岛素抵抗水平依次增高.CHD患者血浆PPAR-γ水平可能与APN、胰岛素抵抗水平及糖代谢异常的程度相关.Objective To compare the changes of the plasma peroxisome proliferator activated receptor-γ （PPAR-γ） and adiponectin （APN） levels in patients of coronary heart disease （CHD） combined with abnormal glucose metabolism, and to explore their relationship. Methods According to the oral glucose tolerance test （OGTr）, 160 patients with CHD were divided into group A （CHD combined with DM, n=51）, group B（CHD combined IGT group, n=59） and group C （simple CHD group, n=50）. 50 healthy volunteem were regarded as group D （normal control group, n=50）. Plasma PPAR-γ, APN and fasting insulin （FIN） levels of patients were tested by enzyme-linked immunosorbent assay （ELISA）. Results （1）The plasma FIN and HOMA-IR levels of group A, group B were higher than group C and group D （P〈0.05）, and the serum FIN and HOMA-IR levels of group A were higher than group B（P〈0.05）. （2）The plasma PPAR-γand APN concentration gradually increased in the group A, group B, group C, group D, there were significant differences among the groups. （3）The plasma lev- els of PPAR-γwere significantly positively correlated with plasma APN levels （r=0.579, P〈0.01 ）, and signifi- cantly negatively correlated with HOMA-IR （r=-0.547, P〈0.01 ）. Conclusion Plasma PPAR-γ levels and APN levels of the simple CHD, CHD combined with IGT, CHD combined with DM patients decrease, while the degree of insulin resistance increase, suggesting that the plasma levels of PPAR-γ in patients with CHD may be asseciat- ed with APN levels, the degree of insulin resistance and abnormal glucose metabolism.

关 键 词：冠状动脉疾病 糖代谢异常 过氧化物酶体增殖物激活受体-Γ 脂联素 胰岛素抵抗 

分 类 号：R541.4[医药卫生—心血管疾病]