| Object:Now obesity is an important disease that threats public health, sharp increases in the prevalence of obesity have occurred worldwide, especially in China. Obese patients are at risk for developing coronary heart disease, hypertension, type2diabetes, dyslipidemia, sleep apnea et al. The aim of this study is to investigate the morbidity and the condition of complications of obesity.Method:We retrospectively analyze the clinical data of552patients who have been diagnosed simple obesity from2000to2013in the endocrinology department of Peking Union Medical Colledge Hospital. We design an access database, and then we analyze the association between the prevalence of hypertension, hyperlipidemia, impaired glucose tolerance, irregular menses et al with body mass index (BMI) of the obese patients using statistical methods.Results:1. The mean age of the552obese patients is26.3±13.0years of age, and the mean BMI is35.57±6.87kg/m2. Totally there are200male patients and352female patients.2. There are155minors among the552patients, with a mean age of14.1±2.4,76of which are male and79are female. One hundred and ten minors are brought into statistical analysis,45of which are male and65are female. The results of the statistical analysis are:In minor male, the prevalence of hypertension is44.2%, and is not correlated with BMI, with the P value=0.50. In minor female, the prevalence of hypertension is58.3%, and is positively correlated with body mass index (BMI), with the P value=0.008, OR=4.62and95%confidence interval [1.35-17.92]. Creatinine (Cr), hypersensitive C reactive protein (hsCRP) and homeostasis model assessment of insulin resistance index (HOMA-IR) are positively correlated with BMI, and free thyroxine (FT4) is negatively correlated with BMI.3. In all397adults are brought into statistical analysis, in which there are124male and273female. The results of the statistical analysis are:①In male adults, the incidence of hypertension is50.4%, and is correlated with BMI, with the P values<0.001. The prevalence of low HDL-C is52.7%, and is correlated with BMI, with the P value=0.02. And the prevalence of metabolic syndrome is60.3%, and is correlated with BMI, with the P value<0.001. However the incidence of hyperlipidemia, T2DM, fatty liver and OSAS are not correlated with BMI, with the P value=0.62,0.21,0.66and0.13, respectively.②In female adults, the incidence of hypertension is31.2%, and is correlated with BMI, with the P values=0.002. However the prevalence of low high density lipoprotein cholesterol (HDL-C) is23.2%, and is correlated with BMI, with the P value=0.005. The incidence of type2diabetes mellitus (T2DM) is14.3%, and is correlated with BMI, with the P value=0.03. And the incidence of fatty liver is correlated with BMI, with the P value=0.004. The prevalence of metabolic syndrome is69.9%, and is correlated with BMI, with the P value=0.04. The prevalence of obstructive sleep apnea syndrome (OSAS) is94.8%, and the BMI of the sick group of OSAS is markedly higher than normal group, with the P value=0.007.③For women between18and45years of reproductive age, BMI is positively correlated with irregular menses, with the P value=0.02.④In male and female adults, direct bilirubin (DBil), uric acid (UA), hsCRP, fasting blood glucose (FBG), fasting insulin (FINS) and HOMA-IR are positively correlated with BMI, and albumin (Alb), Cr, HDL-C, apolipoproteinB (ApoB) and testosterone (T) are negatively correlated with BMI. While in female adults, alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), total bilirubin (TBil), free fatty acid (FFA) and triiodothyronine (T3) are positively correlated with BMI.Conclusion:To sum up, we find that in simple obese minors, the prevalence of hypertension is higher and is positively correlated with BMI. In simple obese male adults, hypertension, low HDL-C and metabolic syndrome are positively correlated with BMI. And despite hypertension, low HDL-C and metabolic syndrome, type2diabetes mellitus, fatty liver are also positively correlated with BMI in simple obese female adults. Object:In obese patients, the prevalence of type2diabetes mellitus, impaired glucose tolerance and insulin resistance is sharp increased compared with normal weight people. The serum levels of certain adipokines and muscle factors may play an important role in it. Our study tries to investigate the relationship between changes of serum adipokines and muscle factor levels and obesity-related metabolic factors. The adipokines in our study include high-molecular-weight adiponectin, glypican-4, tumor necrosis factor-a and the muscle factor refers to irisin.Method:We select1146clinical cases from endocrinology department of Peking Union Medical College Hospital and do the statistical analysis. We analyze the relationship between the glucose metabolism status and several serum factors. All patients being analyzed are adults and have3hour oral glucose tolerance test (OGTT) results. All patients have exact diagnosis of their glucose metabolism status.413men and715women are included. Then we select208testees and divide them into5groups:normal control group (patients with normal glucose tolerance, normal insulin level and normal weight), OBI group (obese patients with normal glucose tolerance and normal insulin level), OB2group (obese patients with normal glucose tolerance but high insulin level), OB3group (obese patients with impaired glucose tolerance [IGT]) and OB4group (obese patients with type2diabetes mellitus [DM]). There are totally38patients in normal control group,40in OBI group,39in OB2group,50in OB4group and41in OB4group. Each one of the five groups has no statistical difference of age and sex composition with every other group. We use their fasting serum sample in the test. Since there are three reagent kits in total, for quality control’s sake, we select one37-years-old male control and add his serum sample on all three kits (once for each kit). So there are210samples in total and300μl for each. Then we use enzyme-linked immunosorbent assay (ELISA) to test the level of irisin, TNF-a, glypican-4and HMW-APN of the serum sample.Results:1. The results of the cases analysis:①Compared with normal glucose metabolism (NGM) people, patients in the impaired glucose tolerance (IGT) group and type2diabetes mellitus (DM) group are more likely to combine hypertension. Patients in the IGT, DM, and impaired fasting glucose (IFG)+IGT group are more likely to combine hyperlipidemia as compared with NGM people. Meanwhile the incidence of low HDL-C is not correlated with glucose metabolism status.②For the serum factors, the level of ALT and AST are markedly higher in IGT and DM patients compared with NGM people (elevated51.1%and38.5%for AST, and29.1%and23.0%for AST). Compared with NGM people and IFG patients, patients in DM group have markedly lower Cr level (decreased11.0%and13.0%, separately). Patients in IGT, DM, and IFG+IGT group have markedly higher TG level compared with NGM people(elevated25.7%,29.9%and73.6%, separately), and patients in DM group have markedly higher TG level compared with the patients in IGT group (elevated38.1%). At the same time, patients in IGT, DM, and IFG+IGT group have markedly higher TC serum level compared with NGM people (elevated9.5%,8.0%and14.3%, separately). Compared with NGM people, patients in IGT and DM group have markedly higher LDL-C level (elevated14.1%and14.4%, separately). Patients in IFG+IGT group have markedly higher HDL-C level compared with IGT group (elevated12.7%). Compared with NGM people, patients in DM group have markedly higher UA level (elevated9.1%). Meanwhile patients in IGT and DM group have markedly higher HOMA-IR level compared with NGM people (elevated32.6%and71.0%, separately).2. The results of the four serum factors:①The levels of HMW-APN trend down from normal control group (NOR) to OB4group, the level of HMW-APN in OB4group is only60.2%of that of NOR, and the level of HMW-APN is clearly higher in female than in male. In male and female, HDL-C is positively correlated with the level of HMW-APN, while body fat, BMI, ALT, FINS, LDL-C and HOMA-IR are negatively correlated with the level of HMW-APN. While in female, AST, TG and TC are negatively correlated with the level of HMW-APN.②From NOR to OB4group, the levels of GPC-4trend up. The level of GPC-4in OB4group is1.36fold larger than that of NOR. The levels of GPC-4are different in male and female; whereas it is a little bit lower in male than in female in group1(there is no statistical significance), the levels of GPC-4in male are higher than that in female in all the other groups. In male and female, BMI, ALT, AST, FINS and HOMA-IR are positively correlated with the level of GPC-4, while in male, body fat, TC and LDL-C are positively correlated with the level of GPC-4, and age is negatively correlated with the level of GPC-4.③There are no statistical differences between the levels of TNF-a in different groups. In male and female, BMI, FINS and HOMA-IR are positively correlated with the level of TNF-α, and the level of HDL-C is negatively correlated with the level of TNF-a. While in female, age is markedly positively correlated with the level of TNF-a.④The level of irisin is higher in patients of OB3and OB4groups than other groups, and in male age is markedly negatively correlated with the level of irisin (P<0.05).Conclusion:Compared with normal glucose metabolism people, patients with impaired glucose tolerance are more likely to combine hypertension and hyperlipidemia. As the glucose metabolism status goes worse, the level of the protective adipokine HMW-APN trends down, meanwhile there are no statistical significances between the levels of the inflammatory factor TNF-a. However the levels of the new adipokine GPC-4and the new muscle factor Irisin trends up, indicating that these new cytokines depress the secretion of inflammatory factors like TNF-a and try to delay the exacerbation process of glucose metabolism status. |
