Studies On The Changes Of Serum Adiponectin, Resistin And Adipocyte Fatty Acid-binding Protein In Metabolic Syndrome And Their Clinical Significance

Background Metabolic symdrome(MS) is a cluster of conditions that could be potentially explained by a common pathophysiologic link insulin resistance (IR), including obesity, hypertension, dyslipidemia and glucose intolerance,all of which are risk factors for coronary heart disease. Adiponectin(ADPN), Resistin(RETN) and Adipocyte fatty acid binding protein(A-FABP) are recently described adipokine which produced by adipose tissue. They have been recognized as a key regulator of obesity, insulin sensitivity, MS and atherosclerosis. The role and mechanism of circulation ADPN, RETN and A-FABP in preventing and treatment of obesity and MS are still to remain to research.Objective To investigate the serum ADPN, RETN and A-FABP concentration in healthy people , obese subjects and patiens with MS, and the relationship between ADPN, RETN and A-FABP with sex, body mass index(BMI), waist-to-hip ratio (WHR), blood pressure, fasting plasma glucose (FPG), fasting plasma insulin (FINS), insulin resistance(IR) and lipid profile. Make basic investigations for further understanding the roles of ADPN, RETN and A-FABP in the onset of MS and obesity and to provide the theory to prevent and treat MS.Methods According to standard of MS of CDS in 2004, Select MS subjects, normal subjects and obese subjects in the same ages, the number of three groups respectively are 121, 120 and 55. All subjects have history-taking, physical examination followed by collection of fasting blood samples. Serum ADPN, RETN and A-FABP were detected by ELISA method, FPG, FINS and lipid profile of these people were measured at the same time in order to study the relationship between the serum ADPN, RETN and A-FABP levels with these data. Insulin resistance index was calculated by Homeostasis model assessment (HOMA).Results1. The incidence of MS in people whose age from 40 to 59 121 cases (11.8%) had MS in all 1027 cases, obesity were found in 315 cases(30.7%), hyperglycaemia in 116 cases (11.3%), hyperlipemia in 477 cases(46.4%), Hypertension in 243 cases(23.7%), abdominal obesity in 295(28.7%). metabolic syndrome subjects with abdominal obesity is 79(65.3%).2. BMI, WC, WHR were significantly higher in MS subjects and obese subjects than in normal subjects. SBP, DBP, ABPm, FINS, HOMA-IR increased gradually from group of normal subjects, obese subjects to MS subects(P<0.01 ); while HDL-C was decreased step by step. FPG, TC, TG were significantly higher in MS subjects than in normal subjects.3. Serum ADPN was significantly lower in MS subjects(3.4±2.5μg/ml ) than in obese subjects(5.8±4.4μg/ml ) and normal subjects(5.7±3.9μg/ml). Serum RETN and A-FABP were significantly higher in MS subjects and obese subjects than in normal subjects (P<0.05).4. serum ADPN concentrations in men were lower than those in women, especially analyzed in normal and MS group (P<0.05). serum RETN concentrations in women were lower than those in men in normal group, while inversely in MS group.5. The relationship between ADPN, RETN, A-FABP with central obesity: Serum RETN and A-FABP levels in the metabolic syndrome subjects with abdominal obesity were higher than metabolic syndrome subjects without abdominal obesity(P<0.001). 6. ADPN levels were positively correlated with HDL-C in obese and MS subjects. ADPN levels were also positively correlated with TC/A-FABP respectively in normal/MS subjects. ADPN levels were negatively correlated with WC, WHR, FINS, HOMA-IR in normal and MS subjects and also negatively correlated with BMI/TG/WHR, SBP respectively in normal/MS/obese subjects.RETN levels were positively correlated with BMI, WC, SBP, FPG, A-FABP/ WC, WHR, SBP, DBP, ABPm, A-FABP respectively in MS/obese subjects.A-FABP levels were positively correlated with FINS, HOMA-IR/ADPN, RETN/SBP, DBP, ABPm, RETN respectively in normal/MS/obese subjects.7. Multiple regression analysis showed that HDL-C was the independent factor to ADPN in normal and MS subjects, and WHR was the independent factor to ADPN in normal and obese subjects, while A-FABP and WC were the ones in MS subjects. A-FABP was the independent factor to RETN in obese and MS subjects, while FPG and WC were the independent factors to RETN respectively in MS subjects and obese subjects. RETN was the independent factor to A-FABP in obese and MS subjects, while FINS and TC were the independent factors to A-FABP respectively in normal subjects and MS subjects.Conclusions1. High incidence of MS in people whose age from 40 to 59; Metabolic Syndrome usually have abdominal obesity.2. Serum ADPN and RETN concentrations was different between male and female, the levels were significantly higher in women than those in men.3. It is usually hyperresistinemia and high A-FABP level in metabolic syndrome subjects with abdominal obesity.4. Serum ADPN, RETN and A-FABP concentrations were close related with MS. Hypoadiponectinemia, hyperresistinemia and high A-FABP level are usually in MS subjects.This study show that the close relationship in ADPN,RETN and A-FABP,maybe integrate them can predict the development of MS.