胰岛素动态变化对成人隐匿性自身免疫性糖尿病患者血浆瘦素水平的影响

目的 探讨口服葡萄糖耐量试验（OGTT）各时相的血胰岛素水平变化对瘦素的短时效应。方法 同步测定32例LADSA患者胰岛素治疗前后OGTT各时相的血胰岛素和瘦素水平，32例性别、年龄、体重指数等与之相匹配的健康者作为对照组。结果 （1）LADA患者基础血胰岛素和基础血瘦素水平均显著低于对照组，且两者呈正相关（P＜0．05）。（2）糖负荷后血胰岛素水平明显增高，但同时相的血瘦素水平无显著变化，两者无相关关系（P＞0．05）。结论 （1）LADA患者内源性胰岛素分泌不足致白瘦素水平低于正常；（2）胰岛素对血瘦素水平无短时效应（≤3小时）。

Dynamic Effects of Insulin on Plasma Leptin Levels in Patients with Latent Autoimmune Diabetes in Adults

Objective:To evaluate the short term effects of insulin on plasma leptin levels in patients with latent autoimmune diabetes in adults(LADA) and in normal subjects during oral glucose tolerance test (OGTT).Methods:The plasma insulin and leptin levels at each phase of OGTT were investigated simultaneously in 32 LADA subjects,and 32 normal subjects matched for sex,age,and body mass index(BMI) were selected as controls.Results:(1)Both basic plasma insulin and leptin levels in LADA were significantly lower than those in controls and basic plasma insulin levels correlated positively with basic leptin levels(P<0 05).(2)The insulin levels of each phase after the glucose loading increased significantly with no significant change of the leptin levels at the same phase.The insulin levels at each phase of OGTT were not related to the leptin levels of the same phase(P>0 05).Conclusion:(1)The endogenous insulin deficiency resulted in hypoleptinemia in LADA subjects.(2)The insulin had no short term effect on the plasma leptin levels.