阿托伐他汀对冠心病合并肥胖患者网膜蛋白-1水平及胰岛素抵抗的影响

T. Maksymets
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摘要

脂肪组织是一种功能强大的内分泌器官,它能合成大量的生物活性物质——脂肪因子。由于脂肪因子功能障碍,出现了一系列与肥胖相关的疾病,即冠状动脉疾病、糖尿病、高血压和肿瘤。高胰岛素血症和胰岛素抵抗在肥胖患者心脏代谢并发症的发病机制中起重要作用。它们会引发一系列病理反应,导致心血管疾病。Omentin-1具有抗动脉粥样硬化作用,可调节胰岛素的外周效应。本研究的目的是分析冠状动脉疾病和肥胖患者在阿托伐他汀治疗期间omentin-1浓度的变化和胰岛素抵抗的状况。材料与方法:对55例肥胖患者进行检查。进行一般临床检查;血脂、尿酸水平和肝酶;测定糖化血红蛋白、葡萄糖、胰岛素,计算HOMA指数和网膜蛋白-1浓度。将患者分为两组:1 ~ 20例肥胖患者,无冠心病且不服用阿托伐他汀;2组冠心病合并肥胖患者,服用阿托伐他汀。2组患者在12个月内动态测定这些指标。结果和讨论。在冠心病和肥胖患者中,服用阿托伐他汀的患者血脂水平确实较低,但空腹血糖浓度、尿酸和肝酶水平高于未服用该药物的患者。冠心病合并肥胖患者12个月内血清网膜蛋白1升高,同时胰岛素水平升高,组织对其敏感性降低。结论。冠心病合并肥胖患者摄入阿托伐他汀后,胰岛素浓度升高,胰岛素抵抗加剧,网膜-1水平升高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
THE INFLUENCE OF ATORVASTATIN ON OMENTIN-1 LEVEL AND INSULIN RESISTANCE IN PATIENTS WITH CORONARY ARTERY DISEASE AND OBESITY
Adipose tissue is a powerful endocrine organ, which synthesizes significant amount of biologically active substances – adipokines. Due to adipokine dysfunction, a spectrum of diseases associated with obesity appears, namely, coronary artery disease, diabetes mellitus, hypertension and oncology. Hyperinsulinemia and insulin resistance play a significant role in pathogenesis of cardiometabolic complications in patients with obesity. They trigger a pathological cascade of reactions leading to cardiovascular diseases. Omentin-1 possesses anti-atherogenic action and it can modify peripheral effects of insulin. The aim of the study – to analyze changes in omentin-1 concentration and the condition of insulin resistance in patients with coronary artery disease and obesity during atorvastatin treatment. Materials and Methods. 55 patients with obesity were examined. They had general clinical examination; blood lipids, uric acid level and liver enzymes; glycated hemoglobin, glucose, insulin with the calculation of HOMA index and omentin-1 concentration was determined. Patients were divided into two groups: the group 1 – 20 patients with obesity, who did not suffer from CAD and did not take atorvastatin, and the group 2 – patients with CAD and obesity, who took atorvastatin. Determination of these indices was performed for patients of the group 2 in dynamics in 12 months. Results and Discussion. In the group of patients with CAD and obesity, who took atorvastatin, lipid levels were reliably lower, but levels of fasting glucose concentration, uric acid and liver enzymes were higher than in the patients who did not take the drug. Elevation of omentin-1 in blood serum was observed in 12 months in patients with CAD and obesity simultaneously with the increase in insulin level and the decrease in tissue sensitivity to it. Conclusions. Intake of atorvastatin by patients with coronary artery disease and obesity is accompanied by elevation of insulin concentration, intensification of insulin resistance and increase in omentin-1 level.
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