摘要
目的探讨急性冠脉综合征肥胖及非肥胖患者血清胰高血糖素水平变化及其临床意义。方法收集急性冠脉综合征患者119例,以体质量指数(BMI)≥28.0kg/m2,或腰臀比男性>0.9,女性>0.85为肥胖标准,分为急性冠脉综合征肥胖组(n=63)和急性冠脉综合征非肥胖组(n=56)。41例体检健康者作为对照组。根据1984年美国心脏病协会规定的冠脉血管图像分段评价标准和Gensini积分系统对每支血管狭窄程度进行定量分析。比较肥胖组、非肥胖组和对照组血清胰高血糖素水平;相关分析及多因素逐步回归分析胰高血糖素与肥胖指标及血糖、血脂等生化指标的相关性。结果急性冠脉综合征肥胖患者的胰高血糖素高于非肥胖患者及健康人群[(426.7±83.9)比(381.0±78.2)、(148.4±25.0)ng/L,P<0.05];低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素、稳态模式胰岛素抵抗指数(HOMA-IR)及冠状动脉Gensini积分也高于非肥胖患者(均P<0.05)。急性冠脉综合征肥胖患者胰高血糖素与腰臀比、LDL-C、HOMA-IR和Gensini积分呈正相关,与高密度脂蛋白胆固醇(HDL-C)呈负相关;非肥胖患者胰高血糖素与总胆固醇和空腹血糖呈正相关。结论急性冠脉综合征肥胖患者血清胰高血糖素高于非肥胖患者。HOMA-IR、LDL-C、HDL-C是影响肥胖患者血清胰高血糖素的因素;空腹血糖和总胆固醇水平是影响非肥胖患者血清胰高血糖素的因素。
Objective To investigate the changes and clinical implications of serum glucagon in obesity and non-obesity patients with acute coronary syndrome（ACS）.Methods One hundred and nineteen patients with ACS were divided into two groups：obesity with ACS [n=63,body mass index（BMI）≥28 kg/m2 or waist-to-hip ratio（WHR）0.9（male）or0.85（female）],and non-obesity with ACS（n=56）.Forty-one healthy individuals served as control group.The levels of serum glucagon were detected.The correlation of glucagon with obesity index and blood biochemical parameters were determined by linear correlation analysis and multivariate stepwise regression analysis.Results Serum glucagon concentration in obesity patients with ACS was significantly higher than that in non-obesity patients and controls[（426.7±83.9）vs（381.0±78.2）and（148.36±25.0）ng/L,P0.05].The levels of low-density lipoprotein cholesterol（LDL-C）,fasting insulin（FINS）,homeostasis model assessment of insulin resistance（HOMA-IR）and Gensini score were also significantly higher in obesity group than that in non-obesity group（all P0.05）.In obesity group,glucagon positively correlated with WHR,LDL-C,HOMA-IR and Gensini score,and negatively correlated with high-density lipoprotein cholesterol（HDL-C）.In non-obesity group,glucagon positively correlated with total cholesterol（TC）and fasting plasma glucose（FPG）.Conclusion The level of serum glucagon in obesity patients with ACS was significantly higher than that in non-obesity patients with ACS.Insulin resistance,higher LDL-C and lower HDL-C were factors affecting serum glucagon in obesity group.However,FPG and TC were factors determining serum glucagon in non-obesity group.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2010年第5期481-485,共5页
Chinese Journal of Hypertension
基金
国家自然科学基金资助项目(30871042)
