维吾尔族男性血清性激素结合球蛋白与2型糖尿病及其危险因素的相关性分析

目的 探讨维族男性血清性激素结合球蛋白、性激素与2型糖尿病及其危险因素的关系.方法 用随机对照方法纳入维族男性2型糖尿病患者81例和正常对照组65例,分别测量血压,检测空腹血糖、胰岛素、糖化血红蛋白、血脂、性激素、性激素结合球蛋白,计算体重指数和胰岛素抵抗指数,比较2型糖尿病组和对照组的上述指标水平,并探讨性激素、性激素结合球蛋白与2型糖尿病相关指标及其危险因素的关系.结果 2型糖尿病组空腹血糖、空腹胰岛素、糖化血红蛋白均高于正常对照组,而性激素结合球蛋白、睾酮低于正常对照组,P均小于0.05.应用Pearson相关以及Spearman秩相关作相关分析,维族男性2型糖尿病患者血清性激素结合球蛋白、血清睾酮均分别与体重指数（r=-0.485,r=-0.543）、空腹胰岛素（r=-0.467,r=-0.423）、甘油三酯（r=-0.442,r=-0.351）呈负相关,血清睾酮与高密度脂蛋白（r=0.317）呈正相关,P均小于0.05.结论 在维族男性中,血清性激素结合球蛋白、血清睾酮可能是2型糖尿病的保护因素.     

2型糖尿病患者血清瘦素水平及影响因素

目的:回顾性分析2型糖尿病(T2DM)患者血清瘦素(Leptin)水平及其影响因素。方法:收集整理35例T2DM患者Leptin水平和体重指数(BMI)、性别、年龄等数据,分性别比较其与正常对照人群的差异,分析T2DM患者Leptin水平与相关因素的关系。结果:T2DM患者血清Leptin浓度为9.72±5.01ng/ml,与正常对照组12.85±6.06ng/ml比较无显著性差异(P>0.05);但正常女性与女性T2DM患者Leptin水平均显著高于男性(P<0.01)。T2DM组患者血清Leptin水平与其年龄、性别和BMI呈显著正相关性(P<0.05～0.01)。结论:女性Leptin水平显著高于男性,且受到年龄、BMI的明显影响。     

2型糖尿病患者血清瘦素水平分析

目的：探讨２型糖尿病患者血清瘦素（Ｌｅｐｔｉｎ）水平的变化及意义。方法：采用放射免疫法测定１０９例２型糖尿病患者及８４例非糖尿病对照者的血清瘦素水平,观察其与性别、年龄、体重指数（ＢＭＩ）、腰臀比率（ＷＨＲ）、空腹血糖（ＦＰＧ）、糖化血红蛋白（ＨｂＡｌｃ）、空腹血浆胰岛素（ＦＩＮＳ）等指标的关系。结果：２型糖尿病组与对照组之间血清瘦素水平无显著性差异,但无论是在２型糖尿病患者还是对照者中,女性血清     

瘦素(Leptin)与Ⅱ型糖尿病的关系

目的研究不同年龄组Ⅱ型糖尿病患者瘦素水平与性别、体脂及胰岛素的关系.方法77名Ⅱ型糖尿病患者按年龄分为三组,计算BMI、WHR,ELISA法测定空腹瘦素浓度,放免法测定空腹胰岛素、C肽.结果Ⅱ型糖尿病人瘦素浓度男性为10.89±9.27ug/L,女性为19.04±11.59ug/L,两者有显著性差异.均与BMI、C肽显著相关,男性还与WHR相关.不同年龄组受试者或同性别不同年龄组受试者瘦素浓度均无显著性意义.结论瘦素水平在Ⅱ型糖尿病患者中女性高于男性,随年龄增长而逐渐下降的趋势消失,体脂总量是影响女性瘦素水平的主要因素,除总体脂外,局部体脂也是男性瘦素的影响因素.     

男性2型糖尿病患者睾酮及性激素结合球蛋白水平分析

目的探讨男性2型糖尿病患者睾酮及性激素结合球蛋白(SHBG)水平与非糖尿病人群的差异及意义。方法以化学发光法测定60名男性2型糖尿病患者及51名非糖尿病男性血清SHBG及总睾酮水平。结果男性2型糖尿病患者SHBG及总睾酮水平显著低于对照组(P<0.01);与对照组相比,糖尿病患者随年龄增加游离睾酮水平下降明显;多元逐步回归分析发现糖尿病患者游离睾酮水平与年龄、糖化血红蛋白呈负相关(r=-0.483、P<0.01,r=-0.257、P<0.05)。结论2型糖尿病患者SHBG及睾酮水平的降低是独立年龄、体重指数(BMI)因素之外的,游离睾酮水平同血糖控制有关,其原因尚待进一步探讨。     

多囊卵巢综合征患者的月经改变与血激素水平相关分析

目的探讨多囊卵巢综合征(PCOS)患者月经周期改变与血中睾酮、雄烯二酮和胰岛素水平的关系。方法选择临床诊断为PCOS的患者112例,包括继发闭经组(56例)和月经稀发组(56例),采用放射免疫法测定其血清性激素及空腹胰岛素水平,对比两组患者早卵泡期或闭经状态下各项性激素、空腹胰岛素水平及体重指数。结果继发闭经组患者的睾酮、雄烯二酮、空腹胰岛素水平显著高于月经稀发组(P=0.00,P=0.016,P=0.024)结论(1)继发闭经的PCOS患者体内的血清睾酮、雄烯二酮和空腹胰岛素水平明显高于月经稀发的PCOS患者,提示在育龄期继发闭经的P-COS患者有更严重的内分泌代谢失调。(2)育龄期妇女PCOS月经异常程度与体重无直接相关性,但体重指数与高胰岛素血症/高睾酮直接相关,而高胰岛素/高睾酮水平与月经异常程度相干,提示体重对月经异常可能有间接影响。     

初诊DM2患者脂联素、炎性因子与胰岛素抵抗的相关分析

目的：分析初诊2型糖尿病（DM2）患者脂联素、IL-6、TNF-α水平变化及其与胰岛素抵抗（IR）、肥胖的相关性。方法：选择初诊DM292例,分为肥胖组（体重指数BMI≥25kg/m^2）42例、非肥胖组（BMI〈25kg/m^2）50例、正常对照组40例,测定血清脂联素、IL-6、TNF-α、体重、身高、血脂、空腹血糖（fPG）、餐后2h血糖（2hPG）、空腹胰岛素（fINS）、餐后2h胰岛素（2hINS）、计算胰岛素抵抗指数（HOMA-IR）,做相关性分析。结果：肥胖组脂联素低于非肥胖组（P〈0.05）及正常对照组（P〈0.01）,非肥胖组又低于正常对照组（P〈0.05）。而肥胖组IL-6、TNF-α高于非肥胖组（P〈0.05）及正常对照组（P〈0.01）,非肥胖组又高于正常对照组（P〈0.05）。脂联素与BMI、HOMA-IR呈负相关,IL-6、TNF-α与BMI、HOMA-IR呈正相关。结论：脂联素、IL-6、TNF-α与IR密切相关,参与了糖脂代谢紊乱。     

吡格列酮和二甲双胍治疗对2型糖尿病患者血清抵抗素的影响

探讨吡格列酮和二甲双胍治疗对2型糖尿病患者血清抵抗素和胰岛素抵抗的不同影响。将48例初诊肥胖2型糖尿病患者随机分两组,分别给予二甲双胍（M组）和二甲双胍联合吡格列酮（MP组）治疗12周,于治疗前后测定受试者空腹血清抵抗素、血糖（FBS）、血脂、胰岛素（FINS）,测量身高、体重,计算体重指数（BMI）、胰岛素抵抗指数（HOMA-IR）。结果显示,与治疗前相比,MP组FBS、FINS、HOMA-IR、抵抗素水平明显降低（P〈0.01）;M组抵抗素水平没有明显改变（P〉0.05）,BMI、FINS、HOMA-IR水平明显降低（P〈0.01）。结论：吡格列酮治疗能有效降低肥胖2型糖尿病患者血清抵抗素水平。     

瘦素、抵抗素、2型糖尿病间的相关性研究

目的：研究血浆瘦素与抵抗素、体重指数、腰围、腰臀比、血脂、胰岛素敏感性指数等的关系。方法：对43例新诊断2型糖尿病患者及37例糖耐量正常者，测定空腹血浆瘦素、胰岛素、血糖、血脂及抵抗素浓度。结果：相关分析显示性别、体重指数（BMI）、腰围、腰臀比、胰岛素与瘦素呈显著正相关（r分别为0.623,0.534，0.516，0.302，0.354，均P<0.01），IAI与瘦素呈显著负相关(r=-0.373,P<0.01),甘油三酯、胆固醇空腹血糖与瘦素无明显相关。瘦素与抵抗素无相关性（r=0.101,P>0.05）结论：空腹血浆瘦素水平与肥胖程度、胰岛素抵抗呈显著正相关，与抵抗素无关。瘦素可能与2型糖尿病的发病有关。     

PCOS患者不良妊娠结局的相关因素分析

目的 探讨多囊卵巢综合征(PCOS)患者不良妊娠结局的相关因素.方法 回顾性分析我院2009年1月至2017年1月收治的82例PCOS患者的临床资料及妊娠结局,根据妊娠结局分组,比较各组临床资料,且通过Logistic多因素回归分析影响PCOS患者妊娠结局的危险因素.结果 不良妊娠结局发生率15.85％;不良妊娠结局组与非不良妊娠结局组在体重指数(BMI)≥25kg/m2、腰臀比≥0.8、妊娠期糖尿病(GDM)发生率、血清卵泡刺激素(FSH)、黄体生成素(LH)、总睾酮(T)、性激素结合蛋白(SHBG)、空腹胰岛素(INS)、游离睾酮指数(FTI)上比较差异均有统计学意义(P＜0.05);Logistic多因素回归分析显示PCOS患者不良妊娠结局发生的危险因素包括BMI、腰臀比、GDM、INS、FTI,保护因子为SHBG(均P＜0.05).结论 PCOS不良妊娠结局主要包括早产、流产等,其发生与患者高BMI、大腰臀比、GDM、FTI等密切相关,需根据相关因素积极纠正,以改善患者妊娠结局.     

Prostate size correlates with fasting blood glucose in non-diabetic benign prostatic hyperplasia patients with normal testosterone levels

We evaluated the correlations between BMI, fasting glucose, insulin, testosterone level, insulin resistance, and prostate size in non-diabetic benign prostatic hyperplasia (BPH) patients with normal testosterone levels. Data from 212 non-diabetic BPH patients with normal testosterone levels, who underwent transurethral resection of the prostate (TURP) due to medical treatment failure, were evaluated retrospectively. Patients with prostate specific antigen (PSA) levels of ≥ 3 ng/mL underwent multicore transrectal prostate biopsy before TURP to rule out prostate cancer. Patients with diabetes mellitus (DM) or serum testosterone levels of < 3.50 ng/mL were excluded from analysis. Correlations between clinical and laboratory parameters were determined. Prostate size correlated positively with age (r = 0.227, P < 0.001), PSA (r = 0.510, P < 0.001), and fasting glucose level (r = 0.186, P = 0.007), but not with BMI, testosterone, insulin level, or insulin resistance (each P > 0.05). Testosterone level inversely correlated with BMI (r = -0.327, P < 0.001), insulin level (r = -0.207, P = 0.003), and insulin resistance (r = -0.221, P = 0.001), but not with age, prostate size, PSA, or fasting glucose level (each P > 0.05). Upon multiple adjusted linear regression analysis, prostate size correlated with elevated PSA (P < 0.001) and increased fasting glucose levels (P = 0.023). In non-DM BPH patients with normal testosterone levels, fasting glucose level is an independent risk factor for prostate hyperplasia.     

2型糖尿病患者C反应蛋白、脂联素和瘦素水平与胰岛素抵抗的相关性

目的探讨C反应蛋白(CRP)、脂联素(APN)、瘦素(Leptin)水平、胰岛素抵抗指数(HOMA-IR)与2型糖尿病(T2DM)病变易患因素的关系。方法用RIA法测定2型糖尿病患者血浆leptin和胰岛素(FINS),用ELSIA法测定血清ANP,用全自动生化分析仪常规测定血清CRP、空腹血糖(FPG),计算胰岛素抵抗指数(HOMA-IR,FPG×FINS/22.5),以正常健康体检者为对照组,进行对比分析。结果 CRP、leptin、HOMA-IR在2型糖尿病组显著高于对照组(P<0.01),ANP显著低于对照组(P<0.01);线性相关显示2型糖尿病HOMA-IR与CRP(r=0.36,P<0.05)、leptin(r=0.39,P<0.05)呈正相关,2型糖尿病HOMA-IR与APN(r=-0.32,P<0.05)呈负相关。结论低APN和高CRP、leptin血症可能是糖尿病的发病因子,它们的代谢紊乱与胰岛素抵抗有密切关系。     

肥胖患者血清瘦素、C-肽和外周脂肪组织中瘦素受体水平的变化分析

目的 :通过对肥胖及伴有 2型糖尿病患者瘦素、C -肽及外周脂肪组织leptin受体表达的研究 ,进一步探讨肥胖及肥胖伴 2型糖尿病患者发生发展的机制。方法 :用放射免疫分析和放射配基结合实验的方法 ,对 91例受检者 (其中肥胖 38例 ,超重 2 3例 ,正常对照 30例 )外周脂肪组织leptin受体的密度及血清中的瘦素、C -肽水平进行检测。结果 :随着BMI的增加 ,瘦素受体密度肥胖组和超重组与正常组比较差异十分显著(p <0 0 1) ,肥胖组与超重组比较有显著性差异 (p <0 0 1) ;而受体与瘦素结合的能力 (Kd值 )没有显著性差异(p >0 0 5 )。三组间的Kd值无差异。从散点分布图可以看出体重指数越大其leptin受体的密度就越小 ,BMI与Bmax相关性 (r=- 0 70 ,p<0 0 1) ;在超重和肥胖伴有 2型糖尿病患者 ,血清中的瘦素和C -肽水平肥胖组比超重组明显升高 ,二者的比值有明显差异 (p <0 0 1) ;血清C -肽增高幅度比瘦素明显 ;血清C -肽水平与体重指数呈正相关。结论 :单纯性肥胖及肥胖伴 2型糖尿病患者血清瘦素、C -肽水平及外周脂肪组织中leptin受体的密度的变化与BMI密切相关 ,肥胖病人所并发的 2型糖尿病与瘦素抵抗和胰岛素抵抗密切相关     

2型糖尿病患者血清瘦素水平及临床意义

目的：观察2型糖尿病（DM2）患者血清瘦素（leptin）水平及其与肥胖、血糖、血脂的关系。方法：采用放射免疫分析（RIA）测定42例DM2患者和38例正常对照组的血清leptin水平。结果：DM2组血清leptin水平明显高于对照组（P〈0．01）;血清leptin与体重指数（BMI）、血清胰岛素（INS）、总胆固醇（TC）、甘油三酯（TG）、脂蛋白LDL-C呈正相关。结论：DM2患者的高leptin血症与肥胖、血脂异常及胰岛素抵抗（IR）密切相关。     

Regulation of leptin synthesis in white adipose tissue of the female fruit bat, Cynopterus sphinx: role of melatonin with or without insulin

Factors regulating leptin synthesis during adipogenesis in wild species are not well known. Studies in the female Cynopterus sphinx bat have shown that it undergoes seasonal changes in its fat deposition and serum leptin and melatonin levels. The aim of the present study was to investigate the hormonal regulation of leptin synthesis by the white adipose tissue during the period of fat deposition in female C. sphinx. This study showed a significant correlation between the seasonal changes in serum melatonin level with the circulating leptin level (r = 0.78; P < 0.05) and with the changes in body fat mass (r = 0.88; P < 0.05) in C. sphinx. A significant correlation between circulating insulin and leptin levels (r = 0.65; P < 0.05) was also found in this species. This in vivo finding suggests that melatonin together with insulin may enhance leptin synthesis by increasing adipose tissue accumulation. The in vitro study showed that melatonin interacts synergistically with insulin in stimulating leptin synthesis by adipose tissue in C. sphinx. The study showed MT(2) receptors in adipose tissue and a stimulatory effect of melatonin on leptin synthesis, which was blocked by treatment with an MT(2) receptor antagonist, suggesting that the effect of melatonin on leptin synthesis by adipose tissue is mediated through the MT(2) receptor in C. sphinx. The in vitro study showed that the synthesis of leptin is directly proportional to the amount of glucose uptake by the adipose tissue. It further showed that melatonin together with insulin synergistically enhanced the leptin synthesis by adipose tissue through phosphorylation of mitogen-activated protein kinase in C. sphinx.     

The relationship between plasma leptin and nutritional status in chronic hemodialysis patients

Leptin serves an important role in suppressing appetite in mice and is known to be elevated in chronic renal failure (CRF) patients. But clinical significance of leptin as an appetite-reducing uremic toxin, remains to be determined. So we studied the relationship between plasma leptin and nutritional status in 46 chronic hemodialysis (HD) patients. Pre HD leptin was measured and divided by body mass index (BMI) to give adjusted leptin levels. KT/Vurea (K, dialyzer urea clearance; T, duration of HD; V, volume of distribution of urea), C-reactive protein (CRP), plasma insulin and nutritional parameters such as serum albumin, normalized protein catabolic rate (nPCR), subjective global assessment (SGA), BMI and mid-arm muscle circumference (MAMC) were also measured. Mean plasma leptin levels were 8.13+/-2.91 ng/mL (male 3.15+/-0.70; female 14.07+/-6.14, p<0.05). Adjusted leptin levels were positively correlated with nPCR (male r=0.47, p<0.05; female r=0.46, p<0.05), SGA (male r=0.43, p<0.05; female r=0.51, p<0.05) and MAMC (male r=0.60, p<0.005; female r=0.61, p<0.05). They did not correlate with KT/Vurea, serum albumin, hematocrit, bicarbonate, insulin and CRP. Presence of DM and erythropoietin therapy had no effect on leptin levels. These results suggest that leptin is a marker of good nutritional status rather than a cause of protein energy malnutrition in chronic HD patients.     

Baseline non-fasting serum leptin concentration to body mass index ratio is predictive of IVF outcomes

BACKGROUND: The present study was designed to determine whether circulating leptin concentrations and/or body mass index (BMI) in women undergoing IVF are predictive of outcomes. METHODS: IVF cycle outcomes, e.g. fertilization, embryo development, implantation, pregnancy, were analysed relative to baseline (i.e. day gonadotrophin stimulation was initiated) non-fasting serum leptin concentrations and BMI. RESULTS: Serum leptin concentrations correlated with BMI (r = 0.739, P < 0.0001) as expected. Multiple logistic regression analyses showed correlation between serum leptin and pregnancy success (likelihood ratio = 5.198, P < 0.05), but there was no association between pregnancy and BMI. However, the serum leptin to BMI ratio was more strongly correlated (likelihood ratio = 7.258, P < 0.01) with pregnancy success than was leptin alone. Moreover, women with a low leptin:BMI ratio (< or =0.3) had significantly more superior quality embryos on day 3 post-retrieval (2.5 versus 1.4, P < 0.05, Kruskal-Wallis) and a greater implantation rate (26.7 versus 13.2%, P < 0.025, chi(2)) than women with a high leptin:BMI ratio (> or =0.7). CONCLUSIONS: The leptin:BMI ratio appears to be highly predictive of IVF success. Elevated leptin concentrations, particularly relative to BMI, may negatively impact fertility by assisted reproduction, possibly through direct ovarian actions resulting in impaired oocyte quality and/or early embryo development.     

C-peptide and insulin, but not C19-steroids, support the predictive value of body mass index on leptin in serum of premenopausal women

Hyperleptinaemia is known to be positively associated with obesity in females. Therefore, circulating leptin concentrations are predicted by body mass index (BMI). Additional effects of endogenous C19-steroids, sex hormone binding globulin (SHBG), luteinizing hormone (LH), follicle stimulating hormone (FSH), C-peptide and insulin on the predictive value of BMI on serum leptin were investigated in 56 hyperandrogenaemic and/or hyperinsulinaemic and/or obese premenopausal women. Serum concentrations (after an overnight 12 h fast) of leptin, total testosterone, free testosterone, SHBG, dehydroepiandrosterone sulphate (DHEAS), LH, FSH, and oestradiol as well as serum concentrations of C- peptide and insulin prior to, and 1 h after, an oral 100 mg glucose load (1 h values) were determined by immunoassays. Subjects with regular menstrual cycles were studied in the mid-follicular phase while the remainder were studied at random. Nineteen normotestosteronaemic, normoinsulinaemic, lean and ovulatory volunteers served as controls; in order to determine the effect of different stages of the menstrual cylce, serum concentrations of leptin (and of oestradiol in 12 out of the 19 individuals) were determined at the preovulatory, the mid-luteal and the following mid-follicular phase. Significant differences between the patients versus control were not found possibly because of the heterogeneity in the patient group. Multiple regression indicated a hyperbolic correlation between BMI and leptin concentrations. As expected, BMI was the major determinant responsible for >50% (R2=0.51) of the elevation of leptin concentrations. The combination of BMI with fasting C-peptide or fasting insulin enhanced the R2 up to 0.59. The multiple regression with two explaining parameters showed a significant regression coefficient for BMI at the 0.001 level, and for fasting C- peptide and fasting insulin at the 0.01 level, which was as statistically significant as the combination of BMI with the 1 h values of C-peptide and of insulin. In contrast, total testosterone, free testosterone, SHBG, free testosterone/SHBG ratio, DHEAS and LH/FSH ratio had no effect. Similarly, models with more than two variables did not measurably improve the explained variation. In the control group, leptin concentrations were significantly higher in preovulatory and mid- luteal phases than the two mid-follicular phases (P < or = 0.05) and must be considered when determining sampling time. In conclusion, hyperandrogenaemia does not have a predictive value on leptin concentrations in premenopausal subjects but hyperinsulinaemia exerts an effect independent of obesity that is the strongest predictor for elevation of leptin concentrations. Hyperinsulinaemia might contribute to the hyperbolic correlation of circulating leptin in obese patients.      

二甲双胍对奥氮平致体重增加的精神分裂症患者血清瘦素水平的影响

目的观察并分析二甲双胍对奥氮平治疗后体重增加的精神分裂症患者血清瘦素的影响。方法单一接受奥氮平治疗并出现有临床意义体重显著增加(≥7%)的精神分裂症患者,随机分组后分别加用(二甲双胍组,n=35)或不加用(对照组,n=35)二甲双胍(750mg/d)辅助治疗,于治疗前及治疗后4、8周末分别测定体质量指数(BMI)、血清瘦素、稳态模型评估的胰岛素抵抗指数(HOMA-IR)。结果①二甲双胍组治疗后4、8周时,瘦素、HOMA-IR均较治疗前显著下降(P0.05~0.01);治疗8周时BMI较治疗前显著下降(P0.05)。对照组治疗4、8周时,BMI、瘦素、HOMA-IR与治疗前比较无显著差异;②两组治疗前及治疗后4、8周时,血清瘦素水平与BMI、HOMA-IR均有显著相关(r=0.356~0.463,P=0.036~0.004);二甲双胍组治疗后4、8周时,血清瘦素治疗前后的变化值与BMI、HOMA-IR治疗前后的变化值均有显著相关(r=0.341~0.404,P=0.042~0.015)。结论二甲双胍辅助治疗可显著降低奥氮平所致体重增加的精神分裂症患者血清瘦素水平,并与其对体重、胰岛素抵抗的改善有关。