肥胖患者血清瘦素、C-肽和外周脂肪组织中瘦素受体水平的变化分析

目的 :通过对肥胖及伴有 2型糖尿病患者瘦素、C -肽及外周脂肪组织leptin受体表达的研究 ,进一步探讨肥胖及肥胖伴 2型糖尿病患者发生发展的机制。方法 :用放射免疫分析和放射配基结合实验的方法 ,对 91例受检者 (其中肥胖 38例 ,超重 2 3例 ,正常对照 30例 )外周脂肪组织leptin受体的密度及血清中的瘦素、C -肽水平进行检测。结果 :随着BMI的增加 ,瘦素受体密度肥胖组和超重组与正常组比较差异十分显著(p <0 0 1) ,肥胖组与超重组比较有显著性差异 (p <0 0 1) ;而受体与瘦素结合的能力 (Kd值 )没有显著性差异(p >0 0 5 )。三组间的Kd值无差异。从散点分布图可以看出体重指数越大其leptin受体的密度就越小 ,BMI与Bmax相关性 (r=- 0 70 ,p<0 0 1) ;在超重和肥胖伴有 2型糖尿病患者 ,血清中的瘦素和C -肽水平肥胖组比超重组明显升高 ,二者的比值有明显差异 (p <0 0 1) ;血清C -肽增高幅度比瘦素明显 ;血清C -肽水平与体重指数呈正相关。结论 :单纯性肥胖及肥胖伴 2型糖尿病患者血清瘦素、C -肽水平及外周脂肪组织中leptin受体的密度的变化与BMI密切相关 ,肥胖病人所并发的 2型糖尿病与瘦素抵抗和胰岛素抵抗密切相关

Analysis of Changes of Serum Leptin, C-peptide Levels and Peripheral Fat Tissue Leptin Receptor Expression in Obesity

Objective To explore the mechanism of obesity and obesity accompanied type two diabetes mellitus by investigating changes of serum leptin, C-peptide (C-P) levels and leptin receptor expression in peripheral adipose tissues. Methods Peripheral leptin receptor density was measured via radio-ligand binding method, serum leptin and C-P levels were measurd via radioimmunoassay in 91 cases (38 in obesity goup, 23 in over weight, and 30 in normal controls). Results With the inerease of body mass index (BMI), the peripheral leptin receptor density of the over weight and obese cases decreased and was mash less than that of normal cases (both p <0 01, respectively). There was no statistical differences for Kd value among the three groups, suggesting no associated change between the binding ability of leptin receptor to its ligand.. There was a negative correlation between BMI and leptin receptor density ( r=-0 70, p<0 01 ). The serum leptin and C-P levels in weight excess and obese Subjects with type two DM were both increased, but significantly higher in obese group than those in weight excess group ( p <0 01). The increase of C-P was much marked than that of leptin. Serum C-P level was positively correlated with BMI. Conclusion Changes of serum leptin, C-P levels and peripheral leptin receptor expression in cases with simple obesity and obesity accompanied with type two DM were related closely with BMI. Type 2 DM in obese subjects was related with leptin resistance and insulin resistance.