| Objective By measuring the serum levels of adiponectin(APN)and lipocalin-2(LCN-2)in metabolically healthy obese(MHO) individuals, To explore its clinical significance in the MHO population.Methods Physical examination data of 10000 residents in a community of hefei from June 2011 to September were collected.Detailed medical history were inquired and all the subjects underwent measurements of height,weight,waist and blood pressures,serum levels of blood glucose and glycosylated hemoglobin(Hb A1c),blood lipids.The enzyme-linked immunosorbent assay(ELISA) was used to measure the concentrations of serum total adiponectin(APN),high-molecular-weight adiponectin(HMW-adp),lipocalin-2(LCN-2) respectively,and calculate the molecular ratio of adiponectin(HMW-adp/total APN,H/A).According to the relevant diagnostic criteria of obesity and metabolic syndrome(MS)and metabolically healthy obese,161 adults subjects were chosen, from which 52 subjects who were metabolically healthy but obese were selected as MHO group,52 subjects who had obesity with metabolic syndrome(MS) as obesity with MS group,57 subjects of healthy people who received physical health examination were selected as the control group.The general data,for example age,waist circumference, blood glucose, blood pressure, blood lipid of one group were compared with the other two groups,and at the same time to assess the variation and clinical value of adipocytokines in MHO individuals.Results 1 No significant differences of the levels of gender,age and low density lipoprotein cholesterol(LDL-C) could be drawn among the three groups(P>0.05).BMI and waist circumference were significantly higher(P<0.01) in the MHO group than the normal control group,and the two groups in systolic and diastolic blood pressure, FBG,2h PBG, Hb A1 c, total cholesterol(TCH), TG and high density lipoprotein cholesterol(HDL-C) showed no significant difference,but the diastolic blood pressure and TCH increased, HDL-C decreased.Obesity with MS group systolic blood pressure,diastolic blood pressure, BMI, waist circumference,FBG2, h PBG,Hb A1 c,TG were significantly higher than the normal control group(P<0.01), TCH increased(P<0.05).MHO group systolic and diastolic blood pressure, fasting blood-glucose(FBG), 2 hour postprandial blood glucose(2 h PBG), Hb A1 c and triglyceride(TG) were significantly lower than obesity with MS(P<0.05),and no significant differences of body mass index(BMI) and waist circumference between obesity with MS and MHO group.2 Both MHO group and obesity with MS group serum total APN and HMW-adp concentrations were significantly decreased compared with the normal control group(P<0.01),a comparison of total APN and HMW-adp between MHO group and obesity with MS group showed a significant increase(P<0.01) in MHO group.3 Compared with the normal control group, MHO group APN molecules increased(P<0.05),while obesity with MS group decreased(P<0.05),and MHO group APN molecules was significantly higher than obesity with MS(P<0.01).4 Compared with the normal control group,MHO group and obesity with MS group were significantly increased in serum LCN-2(P<0.01), MHO group LCN-2 was significantly decreased than obesity with MS group(P<0.01).5 In the normal control group,male total APN was lower than that of the female(P<0.05),compared with female, male HMW-adp and H/A were significantly decreased(P<0.01),LCN-2 was no significant difference between males and females,but there was an upward trend in males than in females;In the MHO group, there was no difference in gender between the total APN and LCN-2,Male HMW-adp and H/A were significantly lower(P<0.01) than that of female;In obese with MS group, the total APN of the male was significantly lower than that of the female(P<0.01),compared with female, male HMW-adp decreased(P<0.05),there was no significant difference in gender H/A,male LCN-2 was higher than that of female(P<0.05).6 Multiple linear regression analysis showed that BMI(β=-0.154,P<0.001),2 h PBG(β=-0.087,P<0.001)levels were important risk factors for serum total APN;waist circumference(β=-0.020,P<0.001),2 h PBG(β=-0.052,P<0.001)levels were negative predicting factors for HMW-adp,while HDL-C(β=0.58,P=0.003)was independent positive,however H/A was BMI(β=0.009,P=0.001),waist circumference(β=-0.002,P=0.021),HDL-C(β=0.069,P<0.001);BMI(β=1.436,P<0.001),2 h PBG(β=0.719,P<0.001) were positively correlated with LCN-2, however, HDL-C(β=-1.509,P<0.001)was negatively related with LCN-2.7 Total APN was positively correlated with HMW-adp(r=0.709, P<0.001),total APN(r=-0.571, P<0.001)and HMW-adp(r=-0.507, P<0.001) were negatively correlated with LCN-2,HMW-adp was positively correlated with H/A(r=0.691, P<0.001),and total APN, LCN-2 and H/A were not statistically related.Conclusion 1 Metabolically Healthy Obese(MHO)is a special subset of obesity and shows an intermediate clinical features between normal controls and obesity with MS.MHO is possible in a state of the transition between the two;2 The level of serum total APN, HMW-adp and LCN-2 in MHO were found in normal and obesity with MS crowd, but the variation of H/A in MHO individuals is at the high level.3 The expression of serum total APN, HMW-adp and LCN-2 in MHO showed significant gender difference.4 APN was related with LCN-2.5 It is possible that the metabolically healthy is correlated with the increase of total APN and HMW-adp and the decrease of LCN-2,especially HMW-adp. |
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