男性代谢综合征患者中组织缺氧与胰岛素抵抗的相关性研究  

A study on the correlation between hypoxia and insulin resistance in males with metabolic syndrome

作　　者：陈素峰[1] 夏骏[1] 单志明[3] 余细平 胡庆丰[1] 邱莲女[1] 周永列[1] 

机构地区：[1]浙江省人民医院检验中心,杭州310014 [2]浙江中医药大学医学技术学院 [3]浙江省临床检验中心

出　　处：《中华内分泌代谢杂志》2016年第8期652-656,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：浙江省医药卫生平台重点资助计划（2013ZDA005）

摘　　要：目的探讨男性代谢综合征（Ms）患者中组织缺氧与胰岛素抵抗的关系。方法295例中年男性健康体检者行身体基础和实验室指标（包括红细胞参数、糖代谢、脂代谢、胰岛素抵抗）的检查，按血红蛋白（hemoglobin，Hb）四分位法分组和Ms组分分组，比较糖代谢、脂代谢、胰岛素抵抗、组织缺氧相关指标的变化趋势，并分析组织缺氧和胰岛素抵抗的相关性。结果按Hb四分位法分组后，随着Hb的升高，MS的发生率、三酰甘油（TG）、胰岛素（INS）、稳态模型评估的胰岛素抵抗指数（HOMA-IR）显著升高（P〈0．05），高密度脂蛋白胆固醇（HDL-C）、稳态模型评估的胰岛素敏感指数（HOMA．IS）则有下降趋势（P〈0．05）；按MS组分分组后，红细胞参数[红细胞（RBC）、血红蛋白（Hb）、红细胞压积（Hct）]、INS、HOMA．IR随MS组分的增加有明显上升趋势（P〈0．05），而HOMA．IS则有下降趋势（P〈0．05）；缺氧相关指标[血乳酸（Lac）、缺氧诱导因子let（HIF-1α）]随着Hb的升高和MS组分的增加而显著增加（P〈0．05）；红细胞参数与Lac、HIF-1α成明显正相关，且红细胞参数、组织缺氧相关指标（Lac、HIF-1α）与HOMA-IR呈正相关，与胰岛素敏感指标（HOMA-IS）呈负相关。结论代谢综合征中可能存在慢性组织缺氧，其缺氧程度与胰岛素抵抗相关；红细胞参数（RBC、Hb、HCT）与胰岛素抵抗水平又具有显著相关性，可能是组织慢性缺氧的结果。Objective To investigate the relationship between hypoxia and insulin resistance in males with metabolic syndrome （MS）. Methods Parameters at physical, hematological, glucose metabolism, lipid metabolism, and insulin resistance were measured in 295 middle-aged men who took health examination. The trends of laboratory indexes grouped by hemoglobin quartile and MS components were compared. The correlation between hypoxia and insulin resistance was analyzed. Results With the increase of hemoglobin, the occurrence rates of MS, TG, INS, and HOMA-IR were also significantly increased （P 〈 0. 05 ）, while HDL-C and HOMA-IS reduced remarkably（ P〈0.05 ）. With the increase of MS components, hematological parameters（ RBC, Hb, Hct）, INS, and HOMA-IR were significantly increased （ P 〈 0.05 ） while HOMA-IS were significantly decreased （ P 〈 0.05 ）. Blood lactate and HIF-1 ctwere significantly increased with the increase of hemoglobin as well as MS components （ P〈0.05 ） ; Hematological parameters were positively correlated with blood lactate and HIF-lα, and Hypoxia related indicators including hematological parameters, Lac, HIF-lα showed a positive correlation with HOMA-IR and a negative correlation with HOMA-IS （ P 〈 0.05 ）. Conclusion Chronic hypoxia does exist in metabolic syndrome, and the degree of hypoxia is associated with insulin resistance. Hematological parameters are also significantly correlated with insulin resistance which could be as a result of chronic hypoxia.

关 键 词：代谢综合征 红细胞参数 组织缺氧 胰岛素抵抗 

分 类 号：R589[医药卫生—内分泌]