血清瘦素水平变化对围绝经期妇女脂类代谢的影响

探讨瘦素与围绝经期妇女肥胖及脂类代谢的关系.本文分别测量了110例围绝经期妇女(疾病组)血清瘦素(Leptin)、胰岛素(INS)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)、垂体促性腺激素(LH、FSH)、雌二醇(E2)、睾酮(T)、孕酮(P)及体重和身高.与60名正常育龄妇女(对照组)进行比较分析.结果表明围绝经期肥胖组、非肥胖组血清Leptin、INS水平增高与对照组比较其差异有显著意义(P＜0.01).肥胖组LDL-C 5.01mmol/L、TG 2.21mmol/L、apoB 0.89g/L与非肥胖组及对照组相比,其差异有显著意义(P＜0.01).研究组内LH、FSH、E2和T值,差异无显著意义(P＞0.05),但与对照组比较,差异有显著意义(P＜0.01).相关分析显示:围绝经期妇女Leptin与BMI、INS、LDL-C、apoB高度相关(r=0.762,P=0.002;r=0.382,P=0.01,r=0.430,P=0.002;r=0.545,P=0.001; r=0.454,P=0.001),且LDL-C与apoB同步升高在明显相关(r=0.796,P=0.001).围绝经期瘦素水平与HDL-C、apoA1分析未见相关(r=-0.222～-0.190,P＞0.05).围绝经期Leptin水平与脂类代谢异常相关,肥胖、Leptin增高围绝经期妇女更应重视脂类代谢异常.

Effect of Leptin Level upon Lipid Metabolism in Climacteric Women

To observe the relationship between leptin and obesity of climacteric women with their lipid metabolism, 110 cases of climacteric women were chosen as observation group, consisting of 69 cases obese subgroup and 45 cases non-obese group, and 60 cases of normal reproduction-age women were arranged as control group. Blood levels of leptin, INS, LDL-C, TG, HDL-C, apoA1, apoB, LH, FSH, E-2, T, and P were detected and BMI was calculated. The results showed that blood levels of leptin and INS of obese subgroup were significantly higher than those of non-obese sub-group and control group(P<0.01), and that LDL-C(5.01 mmol/L), TG(2.21mmal/L) and apoB(0.89g/L) levels in obese subgroup were significantly higher than those of control group. Furthermore, an important observation was that in climacteric women group, blood leptin level was positively and significantly correlated with insulin, BMI and several atherogenic blood lipid parameters, including LDL-C, TG and apoB. Thus, a preliminary conclusion might be reached as that the high climacteric level of leptin is associated with abnormal lipid metabolism related to atherogenity, and so leptin and lipid metabolism as a whole should be paid more attention in climateric women, especially those with obesity.