阻塞性睡眠呼吸暂停低通气综合症患者血清瘦素水平的研究

目的研究瘦素（Leptin）在健康人、单纯性肥胖和阻塞性睡眠呼吸暂停低通气综合症（OSAHS）患者血清中平均水平,探讨血清瘦素检测在OSAHS中的临床意义。方法用ELISA法检测30例OSAHS患者、10例单纯性肥胖患者及10名健康对照者的血清瘦素水平,并测定全部受试者身高、体重,计算体重指数（BMI）。结果其血清瘦素水平非肥胖OSAHS患者组（184.1200±81.90162）ng/ml、肥胖OSAHS患者组（197.1006±107.61821）ng/ml比单纯肥胖组（61.0270±22.29194）ng/ml和健康人组（59.4610±14.87509）ng/ml均高,差异有统计学意义（P〈0.05）;单纯肥胖组比健康人组略高,但无统计学意义（P〉0.05）;肥胖OSAHS患者组比非肥胖OSAHS患者组略高,亦也无统计学意义（P〉0.05）。结论瘦素在健康人和单纯肥胖者与OSAHS患者相比血清中的水平有显著性差异,瘦素与OSAHS有关。     

特发性血小板减少性紫癜患者激素敏感性与糖皮质激素受体亚型的关系研究

目的探究特发性血小板减少性紫癜（ITP）患者对糖皮质激素敏感性与其外周血单个核细胞内激素受体亚型表达的关系。方法采用实时定量RT—PCR和免疫组化技术检测不同激素敏感性ITP患者（包括糖皮质激素抵抗和敏感病人）外周血单个核细胞内α和β亚型糖皮质激素受体（GRα和GRβ）mRNA和蛋白表达，并将检测结果与正常对照组进行比较。结果糖皮质激素抵抗组患者外周血单个核细胞GRβmRNA表达量和GRβ蛋白表达阳性的单个核细胞比率明显高于激素敏感组及正常对照组（P〈0．01），而GRα mRNA和蛋白表达水平，各组之间无显著差异。结论ITP患者糖皮质激素敏感性与其GRβ表达水平密切相关。     

三种不同体重指数慢性阻塞性肺疾病患者炎性因子的研究

目的探讨3种不同体重指数（BMI）稳定期慢性阻塞性肺疾病（简称慢阻肺）患者血清瘦素、肿瘤坏死因子仅（TNF-α）、白细胞介素8（IL-8）及超敏C反应蛋白（hs-CRP）水平是否有差异。方法将稳定期慢阻肺患者105例按BMI进行分组：BMI〈18．5kg／m^2的32例为低BMI组,BMI18．5～23．9kg／m^2的48例为正常BMI组,BMI≥23．9kg／m^2的25例为高BMI组。同时将BMI为18．5～23．9kg／m^2的健康体检者30例作为健康对照组。用放免法检测各组受试者血清中瘦素、TNF-α、IL-8水平;全自动生化分析仪测定hs-CRP。结果慢阻肺患者瘦素水平[（10．19±4．63）ng／L]低于健康对照组[（14．12±4．86）ng／L（P〈0．05）],其中低BMI组及高BMI组患者瘦素水平[（7．89±3．16）ng／L,（10．52±5．98）ng／L]低于正常BMI组[（13．04±5．73）ng／L,P〈0．05],低BMI组较高BMI组下降更显著（P〈0．05）。慢阻肺患者TNF．d水平[（192．37±83．65）μg/L]较健康对照组[（178．59±60．38）μg／L]增高（P〈0.05）,其中低BMI组TNF-α水平[（229．39±89．57）μg/L]高于高BMI组[（189．46±82．41）μg／L]及正常BMI组[（180．06±74．24）μg／L,P〈0．01]。3组慢阻肺患者之间IL-8水平无明显差异。高BMI组hs-CRP水平较低BMI组（P〈0．01）及正常BMI组明显升高（P〈0．05）。结论不同BMI的慢阻肺患者瘦素水平有不同程度的降低,瘦素、TNF-α参与了稳定期慢阻肺患者低体重的发生。     

超重人群脂肪组织脂联素受体的表达与血清瘦素、游离脂肪酸的关系

目的 了解两种脂联素受体在人白色脂肪组织中的表达水平及其与血清瘦素（LEPTIN）、游离脂肪酸（FFA）的关系。方法 选取19例超重或肥胖（BMI≥25kg／m^2）和29例正常体重（BMI〈25kg／m^2）人群,用RT-PCR技术检测腹部皮下与大网膜脂肪组织中脂联素受体的表达水平,并测空腹血浆胰岛素（FINS）、血脂和血清LEPTIN、FFA等指标。结果 ①两种脂联素受体mRNA的表达水平在肥胖组和对照组、皮下和网膜脂肪组织之间均无差异;但超重或肥胖患者的血浆甘油三酯（TG）、极低密度脂蛋白胆固醇（VLDL-C）、FINS、LEPTIN、FFA均高于正常对照（P〈0．05）。②总体观察对象中,腹部皮下脂肪组织的脂联素受体mRNA表达水平与LEPTIN、FFA、FINS、胰岛素抵抗指数（HOMA-IR）水平负相关（P〈0．05）;与胰岛素敏感指数（ISI）正相关（P〈0．05）。③超重或肥胖组中FFA与血浆TG、总胆固醇（Teh）、低密度脂蛋白（LDL）、FINS正相关（P〈0．05）;LEP-TIN与BMI、FINS正相关（P〈0．01）。结论、超重人群的血清LEPTIN、FFA水平显著高于正常人群;脂联素受体、空腹胰岛素、FFA是很好的评估胰岛素敏感性的指标。     

单个核细胞内长型和短型瘦素受体的表达

目的:探讨肥胖者和瘦者单个核细胞内长型瘦素受体(OB—RL)和最短的膜结合瘦素受体(OB—Rs)的表达。方法:从50例健康个体(30例肥胖者,BMI 25～18.9 k/m2;20例瘦者,BMI 25～47.2 kg/m2)中获取末稍血,用淋巴细胞分离液从血样中分离单个核细胞,用逆转录-聚合酶链反应(RT—PCR)定量研究OB—Rs和OB—RL的表达水平,所有PCR产物经琼脂糖凝胶电泳检测。结     

肥胖与非肥胖糖耐量受损患者血清C反应蛋白表达水平的研究

目的：探讨肥胖和非肥胖糖耐量受损（IGT）患者血清CRP表达的差异和临床意义。方法：117例IGT患者和68例正常糖耐量（NGT）对照组按BMI≥25kg／m^2和BMI〈23kg／m^2分为肥胖组与非肥胖组,以免疫散射比浊法测定CRP并加以比较。结果：CRP水平IGT组和NGT组各自组内比较,肥胖者均较非肥胖者高（P〈0．05）;组间比较,IGT组较NGT组CRP水平在肥胖者和非肥胖者均增高,差异显著（P〈0．01）。结论：IGT患者较NGT患者,肥胖较非肥胖者的炎症因子表达更显著。     

冠心病患者血清瘦素水平的检测及意义

目的瘦素是肥胖基因的产物,它对于研究人类肥胖及与肥胖有关的疾病具有重大的意义。本实验检测冠心病患者的瘦素水平,研究瘦素与冠心病的关系。方法选择冠心病患者44例及与之年龄、性别比例、吸烟史及体重指数(BMI)相匹配的健康体检人员44例。分别测试受试者的身高、体重、血压、总胆固醇、甘油三脂、血糖及血清瘦素水平。分析瘦素与其它各项参数的相关性,组间采用t检验。结果88例受试者血清瘦素水平为(7.782±7.288)ng/ml。瘦素与BMI呈显著正相关(r=0.3854,P<0.01)。女性血清瘦素水平比男性高(冠心病组:P<0.05,对照组:P<0.01)。男性受试者中,冠心病组血清瘦素水平高于对照组(P<0.05)。结论所有受试者的血清瘦素水平与BMI呈显著正相关,肥胖者体内存在内源性瘦素抵抗。、女性血清瘦素水平比男性高,性激素参与瘦素的代谢。冠心病组血清瘦素水平高于对照组,提示瘦素是预示冠心病的危险因素之一。     

绝经期妇女激素替代治疗前后血清瘦素水平

目的　检测绝经期妇女激素替代治疗前后血清瘦素（leptin）水平并初步探讨激素替代治疗对瘦素的调节作用。方法　采用双抗夹心ELISA方法检测了27位绝经期妇女激素替代治疗前后的血清瘦素水平并与月经周期正常者比较。结果27位绝经期妇女激素替代治疗前血清瘦素水平平均为（20.75±2.80）ng/ml,显著高于月经周期正常妇女[（17.11±1.24）ng/ml,P<0.01];接受治疗后平均为（1.46±1.71）ng/ml,与月经周期正常妇女血清瘦素水平元显著差异,与治疗前相比显著降低（P<0.05）。结论　绝经期妇女血清瘦素水平较月经周期正常妇女增高,经一定时期的激素替代治疗后可以降至正常水平,提示血清瘦素水平也许可以应用于临床作为一个监测与评估疗效的检测指标。     

老年代谢综合征与瘦素水平的相关性分析

目的：本研究通过分析瘦素（Lep）与老年代谢综合征（MS）各构成组分的相关性，了解Lep在老年MS发生、发展中的作用。方法：入选符合国际糖尿病联盟（IDF）2005年MS诊断标准的老年MS患者76例。选与研究组年龄相匹配的正常对照组20剜。通过全自动生化分析仪获取入选者血糖和血日旨的指标；对入选者进行身高、体重、腰围及血压的测量；采用双抗体夹心ABC—EHSA法对入选者的血清Lep进行检测；采用BECKMAN ACCESS全自动化学发光仪测定胰岛素水平。结果：老年MS组血清Lep水平明显高于老年对照组[（5．23±2．15）ng／ml vs（2．24±1．95）ng／ml，P〈0．01]；老年MS肥胖组（BMI≥25kg／m^2）血清Lep水平明显高于MS非肥胖组（BMI〈25kg／m^2）[（5．67±2．25）ng/ml vs（4．58±1．85）ng／ml，P〈0．05]；老年MS患者血清Lep水平与BMI、SBP、FINS、及WC呈显著正相关，与HDL—C、ISI呈显著负相关；随着MS构成组分的增加，Lep及FINS水平显著升高，而ISI显著下降；结论：老年MS患者存在脂肪-胰岛内分泌轴的功能紊乱，老年MS患者同时存在胰岛素抵抗和Lep抵抗；高血压、肥胖及HDL-C下降在老年MS中占有重要地位．府强调对老年人进行毕活方式的干预并促讲血压、血脂的达标．     

以地高辛标记探针检测瘦素基因的表达

【目的】以地高辛（DIG）标记探针检测汉族肥胖者瘦素（leptin）基因的表达。【方法】以DIG用随机引物法标记瘦素cDNA片段,以此探针,采用斑点杂交方法检测11例汉族正常体重者(体重指数,MBI为21.0kg/m     

Influence of catgut implantation at acupoints on leptin and insulin resistance in simple obesity rats

OBJECTIVES:To investigate the influence of catgut implantation at acupoints on leptin resistance(LR) and insulin resistance(IR) in the simple obesity rat.METHODS:Rats were made obese with high-fat diets,after which surgical catgut was implanted at Zusanli(ST 36) and Neiting(ST 44) acupoints once a week for 4 weeks(implantation group).Rats from the implantation group were compared with normal rats and unoperated obese rats(control group).Gene expression of the leptin receptor(OB-R) was evaluated using RT-PCR and northern blot.Serum and hypothalamus leptin and insulin(INS) levels were determined by radioimmunoassay.Body weight,Lee’s index,body fat,serum and hypothalamus leptin and INS levels,and hypothalamic OB-R gene expression were determined before and after treatment.RESULTS:Body weights,Lee’s index,body fat,and serum leptin and INS levels were significantly higher in obese than in normal rats.Hypothalamic leptin and INS levels and OB-R gene expression were significantly lower in obese rats.Catgut implantation at acupoint promoted weight loss and decreased serum leptin and INS levels.Hypothalamic leptin and INS levels and OB-R gene expression increased significantly.CONCLUSIONS:Catgut implantation at acupoint adjusts central and peripheral leptin and promotes hypothalamic OB-R gene expression.This may be an important method for regulation of LR,IR and abnormal endocrinology and metabolism.     

Serum leptin levels and adiposity in adult Chinese: a preliminary observation

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Changes in serum leptin levels during r-hGH treatment in growth hormone-deficient children

Leptin isa protein hormone which consistsof1 6 7amino acids,which is synthesized and secreted byadipocytes under the modulation and control of obgenes.Its main function is to balance the energyintake againstexpenditure of body.Recently,a directhormonal modulation of circulating leptin levels hasbeen suggested.Hormoneswith metaboliceffects suchas insulin,cortisol and thyroxine have been identifiedas possible regulators of leptin expression and thecomplex interplay of them in the modulation of l…     

Expression of Leptin Long-form Receptor mRNA in Luteinized Granulosa Cells of Obese Women with Polycystic Ovary Syndrome

To investigate the expression of mRNA of leptin long-form receptor(OB-Rb) in lu-teinized granulosa cells of obese women with polycystic ovary syndrome(PCOS),and to determine the role of leptin in the physiopathology of PCOS,luteinized granulosa cells were collected from the follicle fluid of 10 obese women who met the diagnostic criteria for PCOS and their BMI was equal to or greater than 25 kg/m2,and at the same time,granulosa cells were collected from 10 normal women undergoing IVF-ET who served as the control group.Some luteinized granulosa cells were taken from normal women for in-vitro culture,into which human leptin of different concentrations was added(0,10,100 and 1000 ng/mL).After stimulation with leptin for 48 h,RT-PCR was em-ployed for the detection of the expression of OB-RLmRNA in the luteinized granulosa cells.Our re-sults showed that the level of OB-RLmRNA in luteinized granulosa cells of obese PCOS women was higher than those in the control(P<0.05).In luteinized granulosa cells cultured in vitro and stimulated by human leptin for 48 h,the level of OB-RLmRNA was higher than those without leptin stimulation(P<0.01),and when leptin concentration was at 100 ng/mL,and the level of OB-RLmRNA reached a peak.It is concluded that in obese PCOS women,the level of serum leptin is increased,which pro-motes the expression of OB-RL in luteinized granulosa cells and increases the sensitivity of the granulosa cells to leptin.Leptin may contribute to anovulation in obese women with PCOS     

益肾导痰调冲汤对多囊卵巢综合征大鼠瘦素及其受体和IGF-IR表达的影响

目的:观察益肾导痰调冲汤对多囊卵巢综合征(PCOS)大鼠瘦素及其受体和胰岛素样生长因子I受体(IGF-IR)表达的影响。方法:SD大鼠,采用"T+HCG"造模法建立PCOS大鼠模型。随机分为正常对照组、空白模型组、益肾导痰调冲汤等效剂量组(以下简称中药组)、西药达英-35组、达英加中药组、桂枝茯苓丸组各10只。观察卵巢组织形态学改变;放射免疫法测定血清内分泌水平;ELISA法测定瘦素(Lep);免疫组化法测定卵巢组织瘦素受体(OB-R)及IGF-IR表达。结果:益肾导痰调冲汤可改善PCOS大鼠卵巢组织结构,缩小卵巢体积,减少囊状卵泡及闭锁卵泡数目。降低LH、LH/FSH、T、Lep,增高E2水平,降低OB-R、IGF-IR阳性表达(P<0.05或P<0.01)。结论:益肾导痰调冲汤可改善PCOS大鼠lep与OB-R的结合障碍,调节OB-R、IGF-IR的生物利用度,从而改善PCOS大鼠的高雄激素血症及排卵障碍。     

模拟失重对大鼠胃黏膜瘦素及其受体表达的影响

目的：观察模拟失重条件下大鼠胃黏膜瘦素及其受体（OB-R）表达的变化,探讨失重对消化系统功能的影响.方法：将22只SD大鼠分为模拟失重组（n=12）和正常对照组（n=10）,采用尾悬吊模拟失重28d,用免疫组化ABC方法,观察大鼠胃黏膜瘦素及其受体的定位与表达,并比较两组动物胃黏膜瘦素及其受体免疫反应阳性细胞密度的差异.结果：瘦素及其受体免疫反应阳性细胞均分布于胃底腺的中下部区域、阳性物质主要定位于主细胞和壁细胞.与正常对照组相比,模拟失重组大鼠胃黏膜瘦素免疫反应阳性细胞密度显著增加（P＜0.01）;而瘦素受体免疫反应阳性细胞密度虽有增加趋势,但无显著差异（P＞0.05）. 结论：28 d的悬吊模拟失重可致大鼠胃黏膜瘦素及其受体表达增加,提示瘦素可能参与失重过程中消化道功能紊乱的调节.     

肥胖儿童食欲素、瘦素和神经肽Y水平及其相互关系

目的分析肥胖儿童血中食欲素(O rex ins)、瘦素(L eptin、LEP)和神经肽Y(neuropeptide Y,NPY)水平及其相互关系,探讨O rex ins,LEP和NPY在儿童肥胖发生中的作用及三者存在的相互作用关系。方法以放射免疫法测定98名肥胖〔BM I男(29.24±1.87)kg/m2,女(28.12±2.30)kg/m2〕和104名正常对照〔BM I男(20.49±1.95)kg/m2,女(19.59±1.51)kg/m2〕儿童血中的LEP、O rex ins和NPY浓度。结果肥胖儿童血中LEP浓度〔男(26.00±14.66)ng/mL;女(33.59±14.63)ng/mL〕高于对照组儿童〔男(6.65±4.49)ng/mL;女(10.48±5.52)ng/mL,P<0.01〕;肥胖儿童血中O rex inA浓度〔男(3.23±1.86)pg/mL;女(3.38±1.80)pg/mL〕低于对照组〔男(4.52±1.52)pg/mL;女(4.71±1.53)pg/mL,P<0.05〕;两组间LEP与NPY皆呈负相关关系(对照组r=-0.310;肥胖组r=-0.302,P均<0.01),但斜率不同(对照组-2.969;肥胖组-0.809);NPY与O rex inA为正相关关系r=0.207 P<0.05,肥胖组儿童相对于对照组O rex inA的波动范围明显变小。结论肥胖儿童与对照组相比血中LEP与O rex inA浓度水平相反,儿童肥胖的发生与LEP、O rex inA、NPY和它们之间的相互作用有关。     

非肥胖多囊卵巢综合征不孕患者瘦素mRNA和蛋白表达的对照研究

目的探讨非肥胖多囊卵巢综合征(PCOS)不孕患者黄素化颗粒细胞瘦素mRNA的表达和血清、卵泡液瘦素水平。方法对超促排卵条件下16例非肥胖PCOS不孕患者和24名正常对照进行研究。采用逆转录聚合酶链反应(RTPCR)半定量测定卵巢黄素化颗粒细胞瘦素mRNA的表达,用酶联免疫吸附法(ELISA)测定血清和卵泡液中瘦素蛋白水平的表达。结果(1)两组对象的卵巢黄素化颗粒细胞上均有瘦素mRNA的表达,但表达量差异无统计学意义(P>005)。(2)两组对象血清瘦素、卵泡液瘦素水平比较,差异均无统计学意义(均P>005)。(3)PCOS组患者血清瘦素与卵泡液瘦素水平比较,差异无统计学意义(P>005);对照组血清瘦素与卵泡液瘦素水平比较,差异也无统计学意义(P>005)。(4)两组对象中卵泡液瘦素水平均与血清瘦素水平显著正相关(PCOS组rs=0838,P=0000;对照组rs=0837,P=0000),血清瘦素水平均与体重指数显著正相关(PCOS组rs=0665,P=0005;对照组rs=0712,P=0000);(5)两组对象中卵巢黄素化颗粒细胞瘦素mRNA表达与卵泡液瘦素水平均无相关性(均P>005)。结论非肥胖PCOS患者卵巢黄素化颗粒细胞有瘦素mRNA的表达,其表达量无异常;非肥胖PCOS患者血清、卵泡液瘦素水平与正常妇女类似,血清瘦素主要来源于脂肪组织,卵泡液瘦素水平主要取决于循环瘦素水平。     

孕妇血清羊水和新生儿脐血瘦素水平的测定

目的　探讨正常妊娠妇女血清、羊水和新生儿脐血的瘦素水平及其临床意义。方法　采用放射免疫法测定 45例正常妊娠妇女 (其中早孕 15例 ,中孕 15例 ,晚孕 15例 )的血清瘦素水平和 2 0例足月孕妇的产前、产后三天血及其羊水、脐血瘦素水平。将测定结果与体重指数 (BMI)、血压和新生儿出生体重进行相关分析。结果　①血清瘦素水平在正常未妊娠妇女为 (7.84± 1.5 1)ng/ml;早期妊娠妇女为 (7.2 3± 2 .36 )ng/ml,中期妊娠妇女为(15 .6 1± 4.5 2 )ng/ml,晚期妊娠妇女为 (19.46± 4.5 9)ng/ml;产前妇女为 (18.92± 6 .0 3)ng/ml;产后三天妇女为(11.46± 3.17)ng/ml。妊娠中、晚期及足月产前血瘦素水平较正常未孕妇女明显升高。产后三天恢复正常。妊娠期间血瘦水平与BMI及血压无关。未孕及产后妇女的血瘦素水平与BMI正相关。②羊水瘦素水平为 (4 .84±1.2 4)ng/ml,新生儿脐血的瘦素水平为 (7.83± 1.95 )ng/ml。母血瘦素水平与羊水瘦素水平正相关 ,与脐血瘦素水平、血压及产前BMI无关 ;新生儿出生体重 (3714± 45 7) g与脐血瘦素水平正相关 ,与母血及羊水瘦素水平无关。结论　妊娠期间瘦素抵抗状态 ,瘦素抵抗有助于孕妇体脂增加及促进胎儿生长发育。     

Circulating leptin and osteoprotegerin levels affect insulin resistance in healthy premenopausal obese women

We investigated the relationship between circulating leptin and osteoprotegerin (OPG) levels and insulin resistance assessed by HOMA-IR in premenopausal obese and normal weight women. Thirty four obese women (age 31 +/- 8 years) (BMI 35 +/- 4 kg/m(2)) with 19 healthy controls (age 31 +/- 7 years) (BMI <25 kg/m(2)) (BMI 21 +/- 2 kg/m(2)) were included in the study. Women were healthy and had no osteoporosis. Circulating leptin levels were significantly higher in obese women (17.11 +/- 2.05 ng/mL vs. 8.38 +/- 4.71 ng/mL, p <0.0001) and decreased OPG levels were found (14.7 +/- 7.15 pg/mL vs. 19.17 +/- 6.37 pg/mL, p = 0.03). Leptin showed a positive correlation with BMI (r = 0.851, p <0.0001), waist-to-hip ratio (r = 0.692, p <0.0001), fasting insulin (r = 0.441, p <0.001), HOMA-IR (r = 0.412, p = 0.002), fibrinogen (r = 0.387, p = 0.004), uric acid (r = 0.293, p = 0.033), hematocrit (r = 0.394, p = 0.003), systolic (r = 0.504, p <0.0001), and diastolic blood pressure (r = 0.363, p = 0.008). OPG showed a negative correlation with insulin (r = -0.341, p = 0.013) and HOMA-IR (r = -0.324, p = 0.018). In obese women group, the regression equation of HOMA-IR was (HOMA-IR = [0.095 x leptin]-[0.051 x OPG] + 1.71). However, there was no relation between leptin and OPG levels. In conclusion, circulating leptin and OPG levels were related to insulin resistance in premenopausal obese women. However, leptin had no interference in OPG in premenopausal women.