肥胖症患者Leptin与胰岛素抵抗的关系

目的　研究肥胖症患者血清leptin水平与胰岛素抵抗的相关关系。方法　以稳态模型 (Homamodel)公式计算IR值作为评估胰岛素抵抗程度的指标 ,采用放射免疫分析法测定血清真胰岛素、1eptin水平。对两组BMI、WHR、胰岛素、1eptin水平及IR值进行比较分析。并通过相关分析确定 1eptin与各参数间相关性。 结果　leptin血清浓度有明显的性别差异 ,男 :女均约为 1∶4。肥胖组空腹胰岛素、IR值及leptin均明显高于正常对照组 (P <0 .0 1)。直线回归相关分析表明leptin值与BMI(r =0 .4 19,P <0 .0 1)相关。在校正性别及体重指数的影响后与空腹真胰岛素 (r =0 .4 2 7,P <0 .0 1)相关 ,与IR值 (r =0 .0 77,P >0 .0 5 )无相关。结论　肥胖症发病与胰岛素抵抗和高胰岛素血症有关 ,且leptin可能参与胰岛素抵抗和高胰岛素血症的发生进而导致肥胖的发生。

Investigation of Relationship between Leptin and Insulin Resistance in Obesity

Objective To explore the relationship between leptin and insulin resistance in obesity.Methods Homeostasis model assessment was applied to assess the status of insulin resistance(Homa IR).Serum leptin concentrations were determined in 49 healthy persons and 55 patients with obesity by radioimmunoassay.The correlation between leptin and other parameters were analyzed.Results Serum leptin concentrations were significantly higher in females than in males,the average female's leptin concentration being 4 times as that in male.Serum leptin concentrations were significantly higher in patients than in healthy persons(P<0.01).Fasting serum insulin and Homa IR were significantly higher in patients than in healthy persons(P<0.01).Peason analysis showed that fasting serum leptin concentrations were correlated with BMI(r=0.419,P<0.01).After adjustment of sex and BMI,partial correlation analysis showed that serum leptin concentrations were correlated with fasting serum true insulin(r=0.427,P<0.01),not with Homa IR(r=0.077,P>05).Serum leptin concentrations were not correlated with other parameters.Conclusion Insulin resistance and hyperinsulinemia play an important role in the pathogenesis of obesity,and leptin may play some role in it.