瘦素、脂联素在肝源性糖尿病患者发病机制中的作用

目的 探讨瘦素、脂联素在肝源性糖尿病中的作用。方法对25例肝源性糖尿病患者、23例肝硬化患者、20例2型糖尿病患者及20例健康体检者进行血浆瘦素（LPT）、脂联素（ADPN）、空腹胰岛素（FINS）水平测定，计算胰岛素抵抗指数（HOMAIR）、胰岛素敏感指数（ISI），分析LPT、ADPN与其他影响糖代谢紊乱因素的相关性。结果肝源性糖尿病组的LPT水平显著高于肝硬化和健康体检组，（2．77±0．11）μg／L，（2．69±0．11μg／LVS（2．91±0．15）μg／L（P〈0．05），肝源性糖尿病组的ADPN水平显著高于2型糖尿病和健康体检组，（5．03±1．63）mg／L，（11．94±2．55）mg／Lvs（16．79±3．36）mg／L（P〈0．05）。相关分析显示，LPT与HOM艮IR呈正相关（r=0．613，P=0．000），与ISI呈负相关（r=-0．613，P=0．000），ADPN与各指标未表现出明显相关性（P〉0．05）。结论肝源性糖尿病组与肝硬化组均存在胰岛素抵抗，LPT、ADPN参与了肝病患者的糖代谢紊乱，LPT可能通过胰岛素抵抗诱发或加重肝病患者的糖代谢异常，肝源性糖尿病患者的ADPN水平显著高于2型糖尿病患者。

Leptin and adiponectin effects in hepatic diabetes mellitus development

Objective To explore the role of Ieptin and adiponectin effects in hepatic diabetes rnellitus development. Methods Twenty-five patients with hepatic diabetes mellitus,23 patients with cirrhosis,20 patients with type 2 diabetes mellitas and 20 normal control subjects were investigated of the expression of plasma leptin and adiponectin,to evaluate insulin sensitivity and insulin resistance, and analyze the relations between serum leptin, adiponectin and other factors. Results The serum leptin level was significantly increased in hepatic diabetes group compared with that in liver cirrhosis group and normal control group, （2.77 ± 0.11） μg/L, （2.69±0.11 ）μg/L vs （2.91±0.15） μg/L（ P 〈0.05）. The serum adiponectin level was significantly increased in hepatic diabetes group compared with that in type 2 diabetes mellitus group and normal control group, （5.03 ± 1.63 ） mg/L, （11.94 ± 2.55 ） mg/L vs （16.79± 3.36） mg/L（ P 〈0.05）. Significant positive correlation was observed between the serum leptin level and HOMA-IR（ r=0. 613, P =0. 000）. Significant negative correlation was observed between the serum leptin level and ISI （ r = -0.613, P = 0. 000）. Adiponectin had no significant correlation with all indexes. Conclusion Leptin and adiponectin play important roles in hepatic diabetes mellitus development.