肥胖患者中瘦素与胰岛素抵抗的关系

目的　探讨血清瘦素水平在不同糖代谢水平的肥胖患者中的变化及其与胰岛素抵抗的关系。方法　选择肥胖患者 15 2例 ,其中包括糖耐量正常者 6 8例 ,糖耐量异常者 46例和糖尿病患者 38例 ,以及正常对照者 47例 ,测定并比较他们的空腹血清瘦素水平。采用HOMA指数评价胰岛素抵抗程度 ,分析肥胖患者中瘦素与胰岛素抵抗的关系。结果　肥胖者体重指数 (BMI)和瘦素水平均高于对照者 (P <0 .0 0 1) ;空腹血糖糖尿病患者 >糖耐量异常者 >糖耐量正常者 (P <0 .0 0 1) ,体重指数和瘦素水平三组间的差别无显著性。肥胖者HOMA值与瘦素呈正相关 (r=0 .2 0 ,P <0 .0 5 ) ,但性别分层后 ,男性肥胖者的HOMA值与瘦素仍呈正相关 (r =0 .5 1,P <0 .0 0 1) ,而女性肥胖者的HOMA值与瘦素无显著相关 (P >0 .0 5 )。逐步回归分析显示 ,肥胖者男性瘦素水平是HOMA值的主要相关因素。结论　体脂水平相同情况下 ,不同的糖代谢水平的肥胖者的空腹血清瘦素水平相同 ;肥胖者空腹血清瘦素水平与胰岛素抵抗密切相关 ,是胰岛素抵抗的主要相关因素 ,而这一关系仅在男性中存在

Association of Serum Leptin with Insulin Resistance in Obese Subjects

Purpose To investigate the changes of serum leptin level in obese subjects with different glucose metabolism states and its relationship to insulin resistance. Methods Fasting serum leptin was measured and compared in obese subjects,which included subjects of 68 normal glucose tolerance,46 impaired glucose tolerance and 38 diabetes,and 47 controls.Insulin resistance was estimated by HOMA value and its relationship to leptin level in obese was analyzed. Results Body mass index(BMI) and serum leptin of obese were higher than controls (P<0.001),fasting glucose levle of diabetes>impaired glucose tolerance>normal glucose tolerance(P< 0.001),the three groups did not differ in BMI and leptin levels(P>0.05).HOMA value in obese subjects positively correlated with leptin(r=0.20,P<0.05).After stratified by sex,HOMA value of male still positively correlated with leptin(r=0.51,P<0.001),but that of female did not correlated with leptin(P>0.05). Conclusions Obese subjects with different glucose metabolism states had same fasting serum leptin level when their body fat was the same.Fasting serum leptin level closely correlated with insulin resistance in obese subjects and it was the main correlation factor of insulin resistance,but the relationship only existed in male.