不同糖耐量个体血清瘦素水平与特异胰岛素、胰岛素原及胰岛素敏感性的关系探讨

目的　研究不同糖耐量人群空腹瘦素水平与特异胰岛素、胰岛素原及胰岛素敏感性之间的关系。方法　用放射免疫法测量 5 4例正常糖耐量 (NGT)、33例糖耐量低减 (IGT)、4 7例新发 2型糖尿病 (DM )的空腹瘦素水平、口服葡萄糖耐量试验 (OGTT) 0、1/2、1、2h的特异胰岛素 (SI)和胰岛素原 (PI)。结果　 (1)多元逐步回归分析显示 ,性别、体重指数 (BMI)、胰岛素敏感性指数是影响空腹瘦素水平最重要的因素 (校正的R2 分别为 0 .2 5 1、0 .4 19、0 .4 38,P值分别为 <0 .0 0 1、<0 .0 0 1、<0 .0 5 ) ;空腹血清瘦素水平与OGTT各时间点PI、SI、PI/SI值无相关性。 (2 )在校正性别、BMI等影响因素后 ,空腹血清瘦素水平在不同糖耐量组差异无显著性 ;DM组OGTT各时间点PI/SI值明显高于IGT组和NGT组 (P <0 .0 1) ;胰岛素敏感性 (ISI)为NGT组 >IGT组 >DM组 (P <0 .0 0 1)。结论　在测定特异胰岛素、胰岛素原时 ,血清瘦素水平除了与性别、BMI相关外 ,尚与胰岛素敏感性 (按SI水平计算 )相关 ;不同糖耐量状态对血清瘦素水平无明显影响 ;DM组存在胰岛素不敏感、PI/SI失调

The association between fasting serum leptin and specific insulin, proinsulin and insulin sensitivity in different glucose tolerance individuals

Objective To investigate the relationship between fasting serum leptin and specific insulin (SI), proinsulin (PI) and insulin sensitivity. Methods This study included 54 normal glucose tolerance (NGT) subjects, 33 impaired glucose tolerance (IGT) subjects and 47 newly diagnosed patients with type 2 diabetes mellitus (DM). Specific insulin and proinsulin during oral glucose tolerlance test (OGTT) at 0, 1/2, 1 and 2h and fasting serum leptin were measured by radioimmunoassay. Results (1) Sex, body mass index (BMI) and insulin sensitivity index (ISI) were three major factors related to the concentration of serum leptin, while serum leptin level did not relate to SI, PI and PI/SI during OGTT at 0, 1/2, 1 and 2h. (2) After adjusted by sex and BMI, there was no significant difference of serum leptin levels among three groups; while PI/SI was higher and ISI was lower in DM group than those in NGT and IGT groups (P<0.01). Conclusion Sex, BMI and ISI are the major factors that affect the concentration of serum leptin; There is no significant difference of serum leptin level in different glucose torlerant states; DM group shows higher PI/SI and lower insulin sensitivity (calculated from SI levels).