代谢综合征患者心脏损害与脂肪因子变化的临床研究

山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (9): 63-.

代谢综合征患者心脏损害与脂肪因子变化的临床研究

韩露1，王彬2，牟晓梅2，巩会平3，闫会敏1，王志浩1，张运1，张薇1，钟明1

1.山东大学齐鲁医院心内科，教育部和卫生部心血管重构和功能研究重点实验室，济南 250012；
2.淄博市张店区人民医院心内科，山东淄博 255003； 3.山东大学第二附属医院心内科，济南 250033

收稿日期:2011-04-18 出版日期:2011-09-10 发布日期:2011-09-10
通讯作者: 钟明(1968- )，女，博士，教授，主要从事代谢综合征和糖尿病心血管并发症的基础和临床研究。E-mail: zhongming2@medmail.com.cn
作者简介:韩露(1987- )，女，硕士研究生，主要从事代谢综合征和糖尿病心血管并发症的基础和临床研究
基金资助:
山东省科技攻关项目计划(2006GG2202020、2010G0020262)；山东省自然科学基金资助项目(ZR2009CM025、BS2009YY026)；国家自然科学基金资助项目(30971215)；教育部留学回国人员科研启动基金资助项目(2009ZRB019CQ)

Association of adipokines with cardiac abnormalities in patients with metabolic syndrome

HAN Lu1, WANG Bin2, MU Xiao-mei2, GONG Hui-ping3, YAN Hui-min1,
WANG Zhi-hao1, ZHANG Yun1, ZHANG Wei1, ZHONG Ming1

1. Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health; Department of Cardiology, Qilu Hospital, Shandong University, Jinan 250012, China;
2. Department of Cardiology, Zhangdian District People′s Hospital of Zibo City, Zibo, 255003, China;
3. Department of Cardiology, the Second Hospital of Shandong University, Jinan 250033, China

Received:2011-04-18 Online:2011-09-10 Published:2011-09-10

摘要/Abstract

摘要：

目的探讨代谢综合征(MS)患者心脏损害特点、脂肪因子的变化及其对左室收缩和舒张功能的影响。方法选择MS患者48例，正常对照组49例。应用组织多普勒成像技术测量二尖瓣瓣环整体运动速度指标，二尖瓣瓣环收缩期峰值运动速度(Sm)、二尖瓣瓣环舒张早期峰值运动速度(Em)、二尖瓣瓣环舒张晚期峰值运动速度(Am)，采用实时荧光定量RT-PCR技术检测单个核细胞中瘦素受体和胃饥素的mRNA表达。结果与正常对照组比较，MS组患者舒张晚期A波流速峰值(A)显著升高，舒张早期E波流速峰值与舒张晚期A波流速峰值比值(E/A)、Sm、Em、Em/Am显著减低(P<0.01～0.001)；外周血单核细胞瘦素受体和胃饥素的mRNA表达均显著减低(P均<0.05)。相关性分析显示，瘦素受体mRNA表达与A、E/A 、Sm、Em、Em/Am显著相关(P<0.05)；胃饥素mRNA 表达与Em和Sm显著相关(P<0.05～0.01)；进一步多元线性回归分析显示，E/A与瘦素受体mRNA表达具有数量依存关系，提示MS患者瘦素受体mRNA表达下调是心脏舒张功能减低的独立影响因素；多元线性回归分析显示，Sm与胃饥素mRNA表达具有数量依存关系，提示胃饥素mRNA表达下调是左室早期收缩功能异常的独立影响因素。结论瘦素受体和胃饥素mRNA表达下降可能是MS患者左室功能异常的机制之一。

关键词: 代谢综合征；心脏；收缩功能；舒张功能；脂肪因子

Abstract:

Objective To investigate the association of adipokine′s levels with left systolic and diastolic function in patients with metabolic syndrome (MS). Methods We enrolled 48 patients with MS and 49 gender-and age-matched healthy subjects who served as the control. Tissue Doppler imaging echocardiography was performed to measure systolic and diastolic mitral annular velocities, including the peak systolic mitral annulus velocity (Sm), the peak early diastolic mitral annulus velocity (Em) and the peak late diastolic mitral annulus velocity (Am). Real-time PCR assays were applied to detect expressions of leptin receptor and ghrelin mRNA expressions in peripheral blood mononuclear cells(PBMCs). Results Compared with the control, the MS group showed significant increases in the peak late diastolic velocity (A) but decreases in the ratio of early and late diastolic peak velocity (E/A), Sm, Em, and the ratio of Em and Am (Em/Am) (P<0.01～0.001). mRNA expressions of leptin receptor and ghrelin were significantly decreased in the MS group (all P<0.05). Expression of leptin receptor mRNA level was significantly correlated with A, E/A, Sm, Em and Em/Am (P<0.05～0.001), while the ghrelin mRNA level showed a significantly positive correlation with Em and Sm (P<0.05～0.01). Stepwise multiple linear regression analysis revealed a significant and independent association of E/A with decreases of leptin receptor mRNA level, as was the association of Sm with the decreases of ghrelin mRNA level. Decreases of leptin receptor mRNA level in PBMCs was an independent risk factor for left ventricular diastolic dysfunction，and the reduction of ghrelin mRNA expression was an independent risk factor for the early impairment of left ventricular systolic function. Conclusion The reduction of leptin receptor and ghrelin mRNA expression may contribute to impairments of left function in patients with metabolic syndrome.

Key words: Metabolic syndrome; Cardiac; Systolic function; Diastolic function; Adipokines

中图分类号:

R541.8

韩露1，王彬2，牟晓梅2，巩会平3，闫会敏1，王志浩1，张运1，张薇1，钟明1. 代谢综合征患者心脏损害与脂肪因子变化的临床研究[J]. 山东大学学报(医学版), 2011, 49(9): 63-.

HAN Lu1, WANG Bin2, MU Xiao-mei2, GONG Hui-ping3, YAN Hui-min1,WANG Zhi-hao1, ZHANG Yun1, ZHANG Wei1, ZHONG Ming1. Association of adipokines with cardiac abnormalities in patients with metabolic syndrome[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(9): 63-.

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