患有代谢综合征前期和代谢综合征的儿童及青少年的促血栓形成因素与抗氧化防御能力降低
Prothrombogenic factors and reduced antioxidative defense in children and adolescents with pre-metabolic and metabolic syndrome.
作者信息
Dimitrijevic-Sreckovic Vesna, Colak Emina, Djordjevic Predrag, Gostiljac Drasko, Sreckovic Branko, Popovic Srdjan, Canovic Fadil, Ilic Miroljub, Obrenovic Radmila, Vukcevic Vladan, Nikolic Dragan, Nisic Tanja, Milic Gordana, Pejcic Gordana
机构信息
Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia.
出版信息
Clin Chem Lab Med. 2007;45(9):1140-4. doi: 10.1515/CCLM.2007.259.
BACKGROUND
The aim of this study was to examine prothrombogenic factors and antioxidative defense in obese children and adolescents with pre-metabolic and metabolic syndrome, and to analyze insulin secretion and resistance, early glycoregulation disorders and lipid status.
METHODS
Insulin sensitivity was determined using the homeostasis model assessment for insulin resistance (HOMA-IR), while insulin secretion was determined using the homeostasis model assessment beta (HOMA-beta). Prothrombogenic factors analyzed were plasma plasminogen activator inhibitor-1 (PAI-1) and fibrinogen. Superoxide dismutase and glutathione peroxidase were measured as markers of antioxidative defense.
RESULTS
Patients with metabolic syndrome were characterized with increased body mass index (BMI), waist circumference, and HOMA-IR and HOMA-beta levels, and all had increased blood pressure and triglyceride levels, low high-density lipoprotein cholesterol levels, increased PAI-1 levels and reduced antioxidative defense levels. Patients with pre-metabolic syndrome had higher levels of basal and mean insulinemia during an oral glucose tolerance test, higher levels of HOMA-beta and lower levels of antioxidative defense compared to patients with metabolic syndrome.
CONCLUSIONS
Negative correlations between antioxidative defense parameters and BMI, abdominal obesity, insulin secretion, systolic blood pressure and atherogenic lipid factors, as well as correlations between PAI-1 and insulin resistance and basal glycemia in the metabolic syndrome group contribute to accelerated atherosclerosis. Positive correlations between PAI-1 and waist circumference and BMI, and negative correlations between BMI and antioxidative defense in the pre-metabolic syndrome patients show that this early stage preceding the metabolic syndrome is also characterized by atherosclerotic complication risks and evident hyperinsulinism and insulin resistance.
背景
本研究旨在检测患有代谢综合征前期和代谢综合征的肥胖儿童及青少年的促血栓形成因子和抗氧化防御能力，并分析胰岛素分泌与抵抗、早期糖调节紊乱及血脂状况。
方法
采用稳态模型评估胰岛素抵抗（HOMA-IR）来测定胰岛素敏感性，采用稳态模型评估β细胞功能（HOMA-β）来测定胰岛素分泌。所分析的促血栓形成因子为血浆纤溶酶原激活物抑制剂-1（PAI-1）和纤维蛋白原。测定超氧化物歧化酶和谷胱甘肽过氧化物酶作为抗氧化防御的标志物。
结果
代谢综合征患者的特征为体重指数（BMI）、腰围、HOMA-IR和HOMA-β水平升高，且均有血压升高、甘油三酯水平升高、高密度脂蛋白胆固醇水平降低、PAI-1水平升高及抗氧化防御水平降低。与代谢综合征患者相比，代谢综合征前期患者在口服葡萄糖耐量试验期间的基础胰岛素血症和平均胰岛素血症水平更高，HOMA-β水平更高，抗氧化防御水平更低。
结论
抗氧化防御参数与BMI、腹型肥胖、胰岛素分泌、收缩压和致动脉粥样硬化脂质因子之间的负相关，以及代谢综合征组中PAI-1与胰岛素抵抗和基础血糖之间的相关性，均导致动脉粥样硬化加速。代谢综合征前期患者中PAI-1与腰围和BMI之间的正相关，以及BMI与抗氧化防御之间的负相关表明，代谢综合征之前的这个早期阶段也具有动脉粥样硬化并发症风险以及明显的高胰岛素血症和胰岛素抵抗的特征。
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