2型糖尿病患者瘦素水平测定及临床意义的研究

目的探讨2型糖尿病患者的血清瘦素水平、瘦素与胰岛素抵抗的关系及临床意义。方法糖尿病组100例,分为糖尿病非肥胖组[体重指数(BMI)<25kg/m2)]与肥胖组(BMI≥25kg/m2),计算BMI、腰臀围比值(WHR),用酶联免疫吸附试验(ELISA)测定人血清瘦素,同时测定空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素原(PI)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、游离脂肪酸(FFA)、睾酮。胰岛素敏感性以HOMA模型中胰岛素抵抗指数(HOMA-R)评价。对照组:健康人60名与糖尿病组相匹配,分组和观察指标也相同。结果山西地区人血清瘦素正常值女性为(7.6±3.6)μg/L,男性为(2.1±1.0)μg/L;糖尿病组与对照组肥胖者瘦素水平均明显高于非肥胖者,瘦素水平与性别、体重、BMI、FINS、PI、HOMA-R、FFA显著相关,男性瘦素水平与男性睾酮呈显著负相关。肥胖者多数存在高胰岛素血症,胰岛素不敏感者较胰岛素敏感者瘦素水平增高。多元回归结果显示,糖尿病组性别、BMI、FINS、HOMA-R是瘦素水平的影响因素。结论2型糖尿病患者瘦素水平与非糖尿病无明显差异,瘦素水平与肥胖和胰岛素抵抗关系密切,并对糖尿病患者的防治有一定的临床意义。

Leptin level measures and their clinical significance in type 2 diabetic patients

Objective The aim of the study was to investigate type 2 diabetics' serum leptin levels,and their relationship with insulin resistance,as well as the clinical significance. Methods A total of 100 type 2 diabetic patients, whose serum leptin level, BMI, glycosylated hemoglobin(HbA1c), plasma glucose, serum insulin and proinsulin, lipids (triglycerides, total cholesterol ), free fatty acid ( FFA) and testosterone were measured. Insulin sensitivity was evaluated by homeostatic model assessment (HOMA-R). Results Multiple regression analyses showed the serum leptin levels positively correlated to sex, BMI, serum insulin, HOMA-R .There was, however, no relationship between serum leptin levels and measures of variables including total cholesterol, fasting blood glucose,HbA1c .Conclusion No significant difference of serum leptin levels existed between type 2 diabetics and non-diabetics;however,leptin levels had close relation with obesity and/or insulin resistance,and showed a certain clinical value for diabetic prevention and cure.