不同人群血清脂联素、瘦素水平与胰岛素抵抗的关系

【目的】研究不同人群（健康人群、肥胖和2型糖尿病患者）血清脂联素（APN）、瘦素（LEP）水平及其与肥胖、胰岛素抵抗的关系。【方法】采用病例对照研究，2型糖尿病（T2DM）伴有肥胖组（DO）42例，T2DM不伴肥胖组（NDO）42例，单纯性肥胖组（OB）37例，正常对照组（NC）28名。检测了4组研究对象血脂、血糖、空腹胰岛素（Fins）、APN、LEP水平，用HOMA模型公式计算胰岛素抵抗指数（HOMAIR）。结果]NC组的APN水平明显高于其他3组（均P〈0．05）。DO组、OB组的LEP水平明显高于NDO组及NC组（P〈0．05）。相关分析显示：APN与HOMAIR、体质指数（BMI）、腰围（WC）、腰臀比（WHR）、空腹血糖（FBG）、甘油三脂（TG）和Fins呈显著负相关（P〈0．01）；LEP与BMI和体脂百分含量（BFC）呈显著正相关（P〈0．01），与WC和Fins呈正相关（P〈0．05）；APN与LEP无相关性。多元逐步回归分析显示：APN与Fins呈显著负相关（P〈0．01），与WHR、FBG呈负相关（P〈0．05）；LEP与BFC呈显著正相关（P〈0．01）。【结论】血清APN水平与2型糖尿病及肥胖相关。血清瘦素水平与2型糖尿病无关，但与肥胖有关。APN与瘦素之间无相关性，APN对于胰岛素抵抗的影响程度明显大于瘦素。

Relationship Among Serum Adiponectin, Leptin and Insulin Resistance in Different People

Objective] To investigate the level of serum adiponectin（APN） and leptin（LEP） in different people（normal subjects, obese subjects and type 2 diabetes mellitus patients）, and the relationship among APN, LEP and insulin resistance（IR）. Methods] The investigation used a case control study. Serum lipids, fasting glucose（FBG）, fasting insulin（Fins）, APN and LEP were measured in patients of 42 type 2 diabetes with obesity（DO）, 42 type 2 diabetes without obesity（NDO）, 37 obese subjects（OB） and 28 control subjects （NC）. According to the typical HOMA model, insulin resistance index was calculated. Results] The result showed that serum APN level was significantly higher in group NC than that in other three groups （ P 〈 0.05）, while serum LEP level was significantly higher in group OB and DO than that in group NDO and NC （ P 〈0.05）. Correlation analysis showed that serum APN was significantly negatively correlated with HOMA IR, body mass index （BMI）, waist circumference （WC）, waist-hip ratio （WHR）, FBG, serum triglyceride （TG） and Fins（ P 〈0.01）. The serum LEP levelpositively correlated with BMI and body fat content（BFC） （ P 〈0.01）, and positively correlated with WC and Fins （ P 〈0.05）. There was no correlation between APN and LEP. The multiple stepwise regression analysis indicated that serum APN level negatively correlated with Fins （ P 〈0.01）, and negatively correlated with WHR and FBG （ P 〈0.05）. The serum LEP level positively correlated with BFC （ P 〈0.01）. Conclusion] The serum APN is relevant to type 2 diabetes mellitus and obesity. The serum LEP is not relevant to type 2 diabetes mellitus, while it is relevant to obesity. There is irrelevant between APN and LEP. The serum APN level is more closely related to IR than LEP.