肥胖症和初诊的2型糖尿病患者血清瘦素水平的意义

目的　研究口服糖耐量 (OGTT)试验正常组 (NGT)和新发 2型糖尿病组 ( 2 -DM )人群中血清瘦素水平的变化及其临床意义 ,探讨瘦素在糖尿病发病中的地位。方法　从我院健康体检的人中选取口服糖耐量试验正常组 2 3例和新发 2型糖尿病组 2 5例 ,并根据体重指数分为肥胖和非肥胖组 ;采用RIA方法检测真胰岛素 (TI)和瘦素 (SS)水平。分别测定入选对象的体重指数 (BMI)、腰臀比值 (WHR)、空腹及餐后 2小时瘦素和真胰岛素 ,并计算胰岛素敏感指数和胰岛B细胞分泌功能指数。结果　空腹血清瘦素水平、12 0分瘦素水平、瘦素曲线下面积有性别显著差异。各组间血清瘦素水平无显著差异。多元线性相关分析表明空腹瘦素与性别、体重指数、腰臀比、空腹胰岛素、餐后 2小时胰岛素、胰岛素分泌功能指数显著正相关 ;而与胰岛素敏感指数显著负相关 ;与空腹血糖、餐后 2小时血糖不相关。逐步多元回归分析中 ,影响血清瘦素水平最终进入方程的变量有体重指数、胰岛素分泌功能指数。结论　血清瘦素水平与性别、肥胖、胰岛素敏感性、胰岛B细胞的分泌功能有关 ;瘦素参与胰岛素抵抗的形成 ,为影响 2型糖尿病发病的又一重要因素

The significance of the serum leptin level in obese and type 2 diabetic patients

Objective To study the change of leptin andits significance in obese and 2 diabetic (2-DM) patients. Methods 23 cases with normal glucose tolerance (NGT) and 25 cases with newlydiagnosed type 2 diabetic patients were subdivided into obese and non-obese groups. Their body mass index (BMI), waist-hip ratio (WHR), the level of the fastingand 2 h postprandial leptin and special insulin were measured, then the insulinsecretion index and the insulin sensitive index were calculated. Results The level of the fasting leptin has significantly difference between male and female, so were the 2 h postprandial leptin and the areas under the curve of the leptin. Fasting serum leptin was independently correlated with gender, BMI, WHR, fasting special insulin, 2 h postprandial true insulin, insulinsecretion index. There was significant negative correlation between the fastingleptin and the insulin sensitivity index. There was no relation between the fasting leptin and the serum glucose. The results of stepwise regressionship analyses showed that BMI and insulin secretion index entered the regression equation in the final phase. Conclusion Serum leptin level is related to the gender, BMI, WHR, fasting special insulin, 2 h postprandial special insulin, insulin secretion index, insulin sensitivity. In some extent, leptin maycontribute to the development of the insulin resistance and type 2 diabetes.