Study Of The Relationship Between Adiponection, Lipid Levels, Insulin Resistant And Lipid-lowering Drug Intervention In Patients With Hyperlipidemia

Objective:To Study the relationship among adiponectin, lipid levels and insulin resistant and clarify the effect of lipid-lowering drug (Simvastatin and Gemfibrozil) on patients with hyperlipidemia. Method:1. 66 patients with hyperlipidemia , of them, 48 patients with hypercholesterolemia, 18 patients with hypertriglyceridemia, 30 healthy subjects as the control. 2. Height , weight, BMI, Waist circumference, hip circumference and Waist hip ratio were calculated, Total cholesterol(TC), triglyceride(TG) , LDL-C , HDL-C, the fasting blood glucose (FBG) , fasting serum insulin(FINS) and plasma adiponectin were measured. Insulin resistance index( HOMA- IR) and Insulin sensitivity index(ISI) were calculated. 3. Simvastatin 20mg QN, Gemfibrozil 300mg BID were administrated to HTC and HTG patients respectively for 8 weeks and the parameters above mentioned were reexamined. Result:1. The level of adiponectin was negatively correlated with height, weight, Waist circumference , BMI, TG ,. sex, age, VLDL-C and HOMA-IR was positively correlated with HDL- C (P<0.05) .The results of multi-factor stepwise regression analysis indicated that the weight , TG, sex, Homa- IR entered the regress equation, among them weight was prominent factor in male group, (Standardized Coefficients -0.580, and P, 0.000), but this was not obvious in female.2. The fasting blood glucose (FBG), Insulin resistance index in the two patients groups were higher than the one in healthy subjects but Insulin sensitivity index(ISI) waslower than that in healthy subjects (PO.05) .3. Plasma adiponectin levels in the two patients groups were lower than that in healthy subjects (P<0.05) .The levels in male was lower than the female one in the same group. The levels of adiponectin in N,HTC,HTG groups with same sex show the decending tendency,but the significant difference existed only in male ones, (male: 36.19+17.87, 16.88 + 17.13, 7.81+5.29,F=6.69,P=0.003;female: 43.68+20.01, 37.81+37.02, 14.76 ±8.23, F=2.343,P=0.106)o the adiponectin in patients with high BMI (BMI>25) was lower than that in the ones with nomal BMI (PO.05 )<, 4. The fasting blood glucose (FBG) n fasting serum insulin(FINS) -. Insulin resistance index( HOMA-IR) .. TC and LDL-C in the HTC group were significant decreased after 8 week treatment with Simvastatin .(T=5.35, PO.001;T=4.09, PO.001;T=5.69, P<0.00I;T=15.69, P<0.001 ■, T=l 1.84, PO.001;) Insulin sensitivity index(ISI) was increased obviously (T=-3.18, PO.05 )o 5. The TG > fasting serum insulin(FINS) and Insulin resistanse index( HOMA- IR) in HTG group were obviously decreased after Gemfibrozil treating, (T=4.13, PO.01;T=3.087, PO.05;T=2.987, PO.05), the levels of adiponectin was obviously increased (T=5.98, PO.01) .Conclusion:1. The levels of adiponectin in male is lower than that in female. It is lower in hyperlipidemia patients with same sex and high BMI in all subjects. 2. The levels of adiponectin is negatively correlated with height > weight, Waist circumference , BML TG, sex, age, VLDL- C and HOMA- IR, positively correlated with HDL- C. 3. Simvastatin and Gemfibrozil have the effects of decreasing FBG, FINS and could improve the insulin resistanse e 4. Gemfibrozil could increase the levels of adiponectin in patients who have the hypertriglyceridemia.