心室重塑患者瘦素抵抗与胰岛素抵抗及其相关性研究

目的:探讨不同基础病因的心室重塑患者血浆瘦素、可溶性瘦素受体水平的改变及其与胰岛素抵抗的关系.方法:选择心室重塑患者(心室重塑组,η=180)和体检正常者(对照组,η=60)采用酶联免疫吸附法测定血浆瘦素及可溶性瘦素受体、空腹胰岛素的浓度,同时常规测空腹血糖、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、体重指数、腰臀比等指标.采用彩色多普勒超声诊断仪测量心室重塑患者左心室舒张末期间隔厚度、左心室后壁厚度、左心室舒张末期内径及左心室射血分数值,计算左心室质量指数.结果:心室重塑组血浆瘦素、空腹胰岛素均高于对照组[(12.22±6.10)ng/ml vs(8.89±5.27)ng/ml,P<0.01];[(14.37±7.19)ng/ml vs(10.48±5.17)ng/ml,P<0.01],可溶性瘦素受体水平低于对照组[(124.08±62.12)ng/ml v8(164.23±69.60)ng/ml,P<0.01],差异均有统计学显著意义;其中缺血性心肌病患者血浆瘦素和空腹胰岛素水平最高,较高血压性心脏病和扩张型心肌病患者差异有统计学显著意义(P<0.01).可溶性瘦素受体呈现相反的变化,以对照组最高,其次为扩张型心肌病、高血压性心脏病和缺血性心肌病患者.结论:心室重塑患者存在高胰岛素血症和胰岛素抵抗.瘦素抵抗和胰岛素抵抗与心室重塑密切相关.

The Relationship Between Plasma Leptin Resistance and Insulin Resistance in Patients With Ventricular Remodeling

Objective:To explore the relationship between plasma leptin and soluble leptin receptor(SLR) with insulin resistance in patients with ventricular remodeling(VR).Methods: Our study consisted of two groups,VR group,n=180,the patients had ventricular remodeling caused by different diseases,and Control group,n=60 of healthy subjects.Fasting plasma leptin,SLR and insulin were examined by ELISA.Left ventricle diastasis interventricular septal thickness,posterior left ventricular wall thickness,left ventricle inne...