摘要目的:探讨代谢综合征(MS)患者血清成纤维细胞生长因子19(FGF19)水平的变化及其在诊断MS中的意义。方法:将175例门诊及住院MS患者按代谢指标异常个数分为3个代谢指标异常组(Ⅲ组)、4个代谢指标异常组(Ⅳ组)、5个代谢指标异常组(Ⅴ组)，分别为68、57、50例。40例体检正常人群作为正常对照组(NC组)。采用酶联免疫法测定各组血清FGF19浓度，同时测量身高、体重、腰围、血压，测定血脂、空腹及餐后2 h血糖、空腹胰岛素、血清C反应蛋白含量。采用多元逐步回归法分析FGF19相关影响因素，通过绘制ROC曲线确定FGF19在诊断MS中的阈值。结果:NC、Ⅲ、Ⅳ、Ⅴ组受试者血清FGF19水平逐渐降低，差异均有统计学意义( P<0.05)。多元逐步回归分析显示，体重指数、血清总胆固醇、糖化血红蛋白、腰围是MS患者FGF19水平变化的独立影响因素( P<0.05)。ROC曲线分析显示，FGF19诊断代谢综合征的曲线面积为0.849( P<0.01)，阈值为115.4 pg/ml，灵敏度为0.875，特异度为0.667。 结论:随着MS代谢异常指标个数的增多，FGF19水平降低，且与肥胖、糖脂代谢紊乱相关，可能是预测及诊断MS发病的指标。

abstractsObjective:To investigate the change of fibroblast growth factor 19 (FGF19) in patients with metabolic syndrome (MS) and its diagnostic significance.Methods:According to the number of abnormal metabolic indexes, 175 outpatients and inpatients with MS were divided into Group Ⅲ, Group Ⅳ and Group Ⅴ, with 68 cases, 57 cases and 50 cases, respectively. 40 healthy people were served as normal control group (NC group). Serum FGF19 concentration was measured by enzyme-linked immunosorbent assay (ELISA). The height, weight, waist circumference, blood pressure, blood lipid, fasting and 2-hour postprandial blood glucose, fasting insulin and serum C-reactive protein were measured. Multiple stepwise regression was used to analyze the related influencing factors of FGF19, and the threshold value of FGF19 in the diagnosis of MS was determined by drawing receiver operating characteristic (ROC) curve.Results:The levels of serum FGF19 in NC, Ⅲ, Ⅳ and Ⅴ groups decreased gradually, and the differences were statistically significant ( P<0.05). Multiple stepwise regression analysis showed that BMI, serum total cholesterol, glycosylated hemoglobin and waist circumference were independent influencing factors of FGF19 ( P<0.05). ROC curve analysis showed that the ROC area of FGF19 was 0.849, the threshold was 115.4 pg/ml, with sensitivity 0.875 and specificity 0.667. Conclusions:With the increase of metabolic abnormalities in MS, the level of FGF19 decreased, which was related to obesity and glucose and lipid metabolism disorder. It may be an index to predict and diagnose MS.