| PART 1 RELATIONS BETWEEN YOUTH SERUM LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 LEVELSAims:To observation serum lipoprotein phospholipase A2 levels(Lp-PLA2) in youth and to explore the correlation between Lp-PLA2 and insulin resistance and its clinical significance.Methods:One hundred and sixty subjects were from our hospital outpatient of obesity and the physical examination center, including 87 women and 73 men with an average age of 33.4±1.2 years. The anthropometric indicators of all the subjects such as height, weight and high sensitivity C-reactive protein, (hs-CRP), fasting plasma glucose(FPG), glycosylated hemoglobin(HbAlc), fasting insulin(Fins) were measured. Insulin resistance (IR) was assessed by the homeostasis model assessment-IR index (HOMA-IR). OGTT were detected in all subjects. At the same time, ELISA was used to detect serum lipoprotein-associated phospholipase A2(Lp-PLA2) levels. Based on the body mass index (BMI) and the results of oral glucose tolerance test (OGTT), as well as the overweight obesity and type 2 diabetes diagnostic criteria,the subjects were divided 3 group:65 cases of normal weight-normal glucose group (NW-NG),45 cases of overweight-obesity-normal glucose group (OB-NG) and overweight-obesity-type 2 diabetes (OB-T2DM) in total.Results:Compared with NW-NG group,the OB-NG group and OB-T2DM group had higher Lp-PLA2, HOMA-IR, BMI, LDL-C, Fins and hs-CRP levels (all p<0.05,with statistical difference). Also, as shown by Pearson correlation analysis, HOMA-IR had a significantly positive correlation with serum Lp-PLA2 level, BMI, hs-CRP and waistline. Meanwhile, multiple linear stepwise regression analysis statistics indicated that HOMA-IR was still positive correlated with serum Lp-PLA2 level independently(t=4.201 p=0.000). In addition, we used Youden’s index (YI) to determine the best threshold. YI got its maximum value, when Lp-PLA2 level was 21.0 ng/ml, which therefore was thought to be the best cut-off point for diagnosis of insulin resistance.Conclusion:This study shows that in young overweight obesity people with or without abnormal blood glucose, serum Lp-PLA2 level was increased and positively correlated with HOMA-IR, suggesting that serum Lp-PLA2 is an independent risk factor of insulin resistance, which provides a certain clinical value in predicting the occurrence of insulin resistance.PART 2 STUDY ON CORRELATION BETWEEN OBESE TYPE 2 DIABETES MELLITUS PATIENTS AFTERGASTRIC BYPASS ON SERUM LP-PLA2 AND INSULIN RESISTANCEAims:To investigate Lp-PLA2 of obese patients with type 2 diabetes mellitus after Gastric bypass surgery, and to explore the correlation between Lp-PLA2 and insulin resistance.Methods:We selected 12 subjects that under Gastric bypass surgery includ 6 women and 6 men. The average age was 33.4 years. The height, weight, lipid, glucose, insulin were measured and ELISA was used to detect serum lipoprotein-associated phospholipase A2(Lp-PLA2) levels.Results:3 months after the operation, FPG,HOMA-IR,BMI, waist circumference, blood pressure,Lp-PLA2 and were significantly decreased than before operation, at 12 months after operation, the level of Lp-PLA2, HOMA-IR, BMI, waist circumference, blood pressure, LDL-c were compared with the previous 6 months were decreased, P was<0.01.12 months after operation, the Pearson correlation analysis showed that:HOMA-IR was positively correlated with Lp-PLA2, BMI, waist circumference. The HOMA-IR as the dependent variable, Lp-PLA2, waist circumference and BMI as the independent variables, multiple linear stepwise regression analysis showed that:HOMA-IR and serum Lp-PLA2 levels were independently correlated (t=4.012, p=0.000)Conclusions:The Lp-PLA2 of obese patients with type 2 diabetes mellitus after Gastric bypass surgery one year were decreased significantly which validates that HOMA-IR is positively related. The Lp-PLA2 may have clinical significance as a marker of insulin sensitivity and inflammation. |
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