代谢综合征患者血清磷脂脂肪酸谱与胰岛素抵抗

代谢综合征患者血清磷脂脂肪酸谱与胰岛素抵抗

朱麒钱楼大钧茅小燕张爱珍李铎

［摘要］目的研究代谢综合征患者血清磷脂脂肪酸谱与胰岛素抵抗的关系。方法41例代谢综合征患者和50例健康对照者用高效气相色谱法测定血清磷脂脂肪酸谱，HOMA－IR评价IR。结果代谢综合征组的C16:0、C16:1、C18:0、饱和脂肪酸（SFA）、n-6多不饱和脂肪酸（PUFA）/n-3 PUFA较健康对照组显著升高(P＜0.05),C18:2n-6、C18:3n-3、C22:2n-6、C24:1、C22:6n-3、PUFA、PUFA/SFA、n-6 PUFA、n-3PUFA较健康对照组显著降低(P＜0.05)。Spearman相关性分析显示FBG、HbA1c与C20:3n-6呈显著负相关，FINS与C18:0、BMI 呈显著正相关，与C20:4n-6、PUFA、PUFA/SFA呈显著负相关，HOMA-IR与BMI、n-6PUFA /n-3PUFA呈显著正相关，与C20:4n-6、C20:5n-3、n-3PUFA呈显著负相关，BMI与C16:1、SFA、n-6PUFA /n-3PUF呈显著正相关，与C20:5n-3、C20:6n-3、PUFA、n-3PUFA、PUFA/SFA 呈显著负相关。结论代谢综合征患者SFA明显高于健康对照，PUFA则明显低于健康对照。PUFA与胰岛素抵抗负相关。代谢综合征患者应减少SFA的摄入，注意补充PUFA。Serum phospholipid fatty acid and insulin resistance in patients with metabolic syndrome ZHU Qi-qian*, LOU Da-jun MAO Xiao-yan, ZHANG Ai-zhen, LI Duo.

* Department of Endocrinology, Shaoxin People’s Hospital, Shaoxin 312000 【Abstract】Objective To investigate the serum phospholipid fatty acid and its relationship with insulin resistance in patients with metabolic syndrome (MS). Methods Serum phospholipid fatty acid profile was analyzed with capillary gas chromatography. Insulin resistance was assessed by homeostasis model assessment(HOMA-IR). Results The percentage of fatty acids (C16:0, C16:1, C18:0), saturated fatty acid (SFA) and the ratio of n-6 polyunsaturated fatty acid (PUFA) to

n-3 PUFA were higher in MS than those in normal control group (NC). But the percentage of fatty acids (C18:2n-6, C18:3n-3、C22:2n-6、C24:1、C22:6n-3、PUFA、n-6 PUFA、n-3PUFA) and the ratio of PUFA to SFA were lower in MS group than those in NC group.There were negative correlations between FBG、HbA1c andC20:3n-6; FINS were positively correlated with C18:0、BMI, but negatively correlated with C20:4n-6、PUFA、PUFA/SFA; HOMA-IR were positively correlated with BMI、n-6PUFA /n-3PUFA, but negatively correlated with C20:4n-6、C20:5n-3、n-3PUFA; BMI were positively correlated with C16:1、SFA、n-6PUFA /n-3PUF，but negatively correlated with C20:5n-3、C20:6n-3、PUFA、n-3PUFA、PUFA/SFA. Conclusion Serum phospholipid SFA in MS group were significantly higher than those of normal control group, but polyunsaturated fatty acid in MS group were significantly lower than those of normal control group. PUFA were negatively correlated insulin resistance in MS. 【Keywords】phospholipid fatty acid, Metabolic syndrome, Insulin resistance 代谢综合征（+MS）是多种代谢异常同时发生于同一个体的临床现象，可明显增加心血管疾病的危险性，胰岛素抵抗是多种代谢异常的共同发病基础。研究发现膳食脂肪是影响代谢综合征的重要危险因素，但不同种类的脂肪酸对胰岛素敏感性的影响不同［1，2］。因血清、血浆磷脂脂肪酸是反映膳食脂肪酸类型和量的稳定而可靠的指标［3］。本实验对代谢综合征患____________________

作者单位：312000 绍兴市人民医院内分泌代谢科（朱麒钱楼大钧）浙江大学医学院（茅小燕张爱珍）浙江大学食品科学与营养系（李铎）

者和健康人的血清磷脂脂肪酸谱进行比较，并分析其与胰岛素抵抗（IR）之间的相关性，研究脂肪酸与代谢综合征和胰岛素抵抗之间的关系。