脂联素与体脂分布、胰岛素敏感性及血浆脂蛋白的关系：年龄和性别的独立作用证据
Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex.
作者信息
Cnop M, Havel P J, Utzschneider K M, Carr D B, Sinha M K, Boyko E J, Retzlaff B M, Knopp R H, Brunzell J D, Kahn S E
机构信息
Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, Veterans Affairs Puget Sound Health Care System (151) and University of Washington, 1660 S. Columbian Way, Seattle, WA 98108, USA.
出版信息
Diabetologia. 2003 Apr;46(4):459-69. doi: 10.1007/s00125-003-1074-z. Epub 2003 Apr 10.
AIMS/HYPOTHESIS: Increased intra-abdominal fat is associated with insulin resistance and an atherogenic lipoprotein profile. Circulating concentrations of adiponectin, an adipocyte-derived protein, are decreased with insulin resistance. We investigated the relationships between adiponectin and leptin, body fat distribution, insulin sensitivity and lipoproteins.
METHODS
We measured plasma adiponectin, leptin and lipid concentrations, intra-abdominal and subcutaneous fat areas by CT scan, and insulin sensitivity index (S(I)) in 182 subjects (76 M/106F).
RESULTS
Adiponectin concentrations were higher in women than in men (7.4+/-2.9 vs 5.4+/-2.3 micro g/ml, p<0.0001) as were leptin concentrations (19.1+/-13.7 vs 6.9+/-5.1 ng/ml, p<0.0001). Women were more insulin sensitive (S(I): 6.8+/-3.9 vs 5.9+/-4.4 x 10(-5) min(-1)/(pmol/l), p<0.01) and had more subcutaneous (240+/-133 vs 187+/-90 cm(2), p<0.01), but less intra-abdominal fat (82+/-57 vs 124+/-68 cm(2), p<0.0001). By simple regression, adiponectin was positively correlated with age ( r=0.227, p<0.01) and S(I) ( r=0.375, p<0.0001), and negatively correlated with BMI ( r=-0.333, p<0.0001), subcutaneous ( r=-0.168, p<0.05) and intra-abdominal fat ( r=-0.35, p<0.0001). Adiponectin was negatively correlated with triglycerides ( r=-0.281, p<0.001) and positively correlated with HDL cholesterol ( r=0.605, p<0.0001) and Rf, a measure of LDL particle buoyancy ( r=0.474, p<0.0001). By multiple regression analysis, adiponectin was related to age ( p<0.0001), sex ( p<0.005) and intra-abdominal fat ( p<0.01). S(I) was related to intra-abdominal fat ( p<0.0001) and adiponectin ( p<0.0005). Both intra-abdominal fat and adiponectin contributed independently to triglycerides, HDL cholesterol and Rf.
CONCLUSION/INTERPRETATION: These data suggest that adiponectin concentrations are determined by intra-abdominal fat mass, with additional independent effects of age and sex. Adiponectin could link intra-abdominal fat with insulin resistance and an atherogenic lipoprotein profile.
目的/假设：腹内脂肪增加与胰岛素抵抗及致动脉粥样硬化脂蛋白谱相关。脂联素是一种脂肪细胞衍生蛋白，其循环浓度会随胰岛素抵抗而降低。我们研究了脂联素与瘦素、体脂分布、胰岛素敏感性及脂蛋白之间的关系。
方法
我们测量了182名受试者（76名男性/106名女性）的血浆脂联素、瘦素和脂质浓度、通过CT扫描测量腹内和皮下脂肪面积以及胰岛素敏感性指数（S(I)）。
结果
女性的脂联素浓度高于男性（7.4±2.9对5.4±2.3μg/ml，p<0.0001），瘦素浓度也是如此（19.1±13.7对6.9±5.1ng/ml，p<0.0001）。女性的胰岛素敏感性更高（S(I)：6.8±3.9对5.9±4.4×10(-5)min(-1)/(pmol/l)，p<0.01），皮下脂肪更多（240±133对187±90cm(2)，p<0.01），但腹内脂肪更少（82±57对124±68cm(²)，p<0.0001）。通过简单回归分析，脂联素与年龄呈正相关（r = 0.227，p<0.01）和S(I)呈正相关（r = 0.375，p<0.0001），与BMI呈负相关（r = -0.333，p<0.0001），与皮下脂肪（r = -0.168，p<0.05）和腹内脂肪（r = -0.35，p<0.0001）呈负相关。脂联素与甘油三酯呈负相关（r = -0.281，p<0.001），与高密度脂蛋白胆固醇呈正相关（r = 0.605，p<0.0001）以及与Rf（一种低密度脂蛋白颗粒浮力的测量指标）呈正相关（r = 0.474，p<0.0001）。通过多元回归分析，脂联素与年龄（p<0.0001）、性别（p<0.005）和腹内脂肪（p<0.01）有关。S(I)与腹内脂肪（p<0.0001）和脂联素（p<0.0005）有关。腹内脂肪和脂联素均独立地影响甘油三酯、高密度脂蛋白胆固醇和Rf。
结论/解读：这些数据表明脂联素浓度由腹内脂肪量决定，同时受年龄和性别的额外独立影响。脂联素可能将腹内脂肪与胰岛素抵抗及致动脉粥样硬化脂蛋白谱联系起来。
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