充血性心力衰竭患者血浆瘦素水平与胰岛素抵抗相关性研究

目的　探讨充血性心力衰竭 (CHF)患者血浆瘦素 (leptin)水平与胰岛素抵抗的相关性。 方法　 4 5例男性CHF患者为研究对象 ,30例男性健康查体者作为对照组 ;应用ELISA法测定血浆leptin、空腹胰岛素 (FINS) ;空腹血糖 (FPG)采用氧化酶法测定 ;并计算胰岛素抵抗指数 (Homa -IR) ,测定体重指数(BMI)、腰围 /臀围比 (WHR)等人体测量指标。结果　 (1)CHF组血浆Leptin、FINS、Homa -IR水平高于对照组 (均P <0 0 0 1) ;两组FPG水平无差异 (P >0 0 5 ) ;Pearson相关分析CHF组血浆Leptin水平与FINS、Homa -IR呈正相关 (均P <0 0 0 1) ;Stepwise回归分析显示 :CHF组与血浆leptin水平独立相关的指标为BMI、Homa -IR。结论　CHF患者血浆Leptin水平升高与胰岛素抵抗相关 ;胰岛素抵抗为独立影响CHF患者血浆Leptin水平的因素 ;CHF患者高Leptin血症、胰岛素抵抗可能共同参与了CHF分解代谢、神经内分泌激活等病理生理过程。

THE CHANGE OF PLASMA LEPTIN LEVEL AND ITS CORRELATIVE STAUDY WITH INSULIN RESISTANCE IN PATIENTS WITH CONGESTIVE HEART FAILURE

Objective To determine the change of plasma leptin levels and the correlation between hyperleptinaemia and insulin resistance in patients with congestive heart failure(CHF).Methods The levels of plasma leptin of fasting plasma insulin(FINS)in 45 male patients with CHF and of 30 healthy male people were measured by ELISA,Body mass index(BMI),waist/hip ratio(WHR)and insulin resistance index(Homa-IR)were calculated respectively.Results The plasma levels of leptin,FINS,Homa-IR in the CHF group were higher than those in the control group(all P<0.001);in the CHF group plasma leptin levels correlated with FINS (r=0.638,P<0.001),Homa-IR (r=0.568,P<0.001);in multiple stepwise regression analysis BMI,Homa-IR were isolated factors affecting plasma leptin levels in the CHF group.Conclusion plasma leptin levels were raised and correlated with BMI,WHR, FINS and Homa-IR in patients with CHF;Insulin resistance was isolated factors affecting plasma leptin levels in CHF patients;both hyperleptinaemia and Insulin resistance may play a role in the pathophysiology of CHF such as catabolic process and activation of neurohormone.