单纯性肥胖及肥胖伴2型糖尿病患者血清中瘦素水平的变化及其与胰岛素抵抗的关系

目的： 研究单纯性肥胖患者及肥胖伴2型糖尿病患者血清瘦素水平的变化，探讨瘦素与胰岛素抵抗的关系及瘦素在单纯性肥胖及肥胖伴2型糖尿病发病中的作用。 方法：选择单纯性肥胖患者60例，肥胖伴2型糖尿病患者60例，正常对照30例。 测定所有入选对象的空腹血清瘦素、空腹血清胰岛素、空腹血糖、血脂水平，计算体重指数（BMI）及胰岛素敏感指数（IAI）。 结果：单纯肥胖组及肥胖伴2型糖尿病组患者BMI、血清瘦素、空腹血清胰岛素及血脂水平均显著高于正常对照组（P<0.01）；IAI显著低于正常对照组（P<0.01）。肥胖伴2型糖尿病组血清瘦素、空腹血清胰岛素、空腹血糖及血脂水平均显著高于单纯肥胖组（P<0.01），IAI显著低于单纯肥胖组（P<0.01）。肥胖伴2型糖尿病组空腹瘦素水平与BMI呈正相关（r=0.48，P<0.05），与空腹胰岛素水平呈正相关（r=0.55，P<0.05），与IAI呈负相关（r=-0.47，P<0.05）。 结论：瘦素的过量表达参与了肥胖患者胰岛素抵抗和2型糖尿病的发生。

Changes of serum leptin and their relationships with insulin resistance in patients with simple obesity and patients with type 2 diabetes mellitus complicated with obesity

Objective To study the changes of serum leptin in patients with simple obesity and patients with type 2 diabetes mellitus complicated with obesity in order to explore the relationship of leptin and insulin resistance and the role of leptin in the occurrence of type 2 diabetes mellitus. Methods 60 cases of simple obesity, 60 cases of type 2 diabetes mellitus and 30 cases of normal control were included according to the diagnostic criteria of obesity and type 2 diabetes mellitus. The levels of fasting serum leptin, fasting serum insulin, fasting glucose, fasting blood lipid were measured in all cases.The body mass index (BMI) and insulin action index were calculated. Results The level of BMI, serum leptin, serum insulin, blood lipid were significantly higher in patients with simple obesity and with type 2 diabetes mellitus complicated with obesity than in normal control cases, whilel (IAI) was significantly lower. The levels of free serum leptin, serum insulin, free glucose, and blood lipid were significantly higher in patients with type 2 diabetes mellitus complicated with obesity than in patients with simple obesity, while IAI was significantly lower. The level of serum leptin was positively correlated with BMI(r=0.48,P<0.55) and fasting serum leptin(r=0.55,P<0.05) and negatively correlated with IAI(r=-0.47,P<0.05)in patients with type 2 diabetes complicated with obesity. Conclusion The overexpression of serum leptin may play an important role in the occurrence of in insulin resistance and type 2 diabetes mellitus in obesity patients.