维持性血液透析患者瘦素与胰岛素抵抗的关系

目的 :探讨维持性血液透析患者瘦素与胰岛素抵抗的关系。方法 :选择终末期肾病维持血液透析 (MHD) 2 7例 (MHD组 )及健康对照组 (C组 ) 30例 ,应用放免分析法测定血清瘦素 ,同时检测空腹胰岛素 (FINS)、空腹血糖 (FBS)、体重指数 (BMI)及肾功能等指标 ,计算胰岛素敏感指数 (ISI)和稳态模型胰岛素抵抗指数 (Homa- IR)作为胰岛素抵抗指标 ,分析瘦素与各项参数的关系。结果 :MHD组 FINS、FBS、Hom a- IR明显高于对照组 (P均 <0 .0 1) ,ISI明显低于对照组 (P <0 .0 1)。校正 BMI差异后 ,MHD组的血清瘦素水平高于对照组 ,但差异无统计学意义 (P >0 .0 5 )。瘦素与 BMI、FINS、Homa- IR呈明显正相关 (P均 <0 .0 1) ,瘦素与 ISI呈明显负相关 (P <0 .0 1) ,但控制 BMI、FINS的影响后 ,瘦素与 Homa- IR及 ISI均无明显相关关系 (P>0 .0 5 )。结论 :瘦素与胰岛素抵抗的关系可能是通过对体脂和胰岛素的影响而间接发生联系

CORRELATION OF SERUM LEPTIN CONCENTRATION WITH INSULIN RESISTANCE IN HEMODIALYSIS PATIENTS

Objective:To explore correlation of serum leptin concentration with insulin resistance in hemodialysis patients.Methods:Serum leptin was measured by radioimmunoassay in hemodialysis patients (n=27) and healthy controls(n=30). Fasting insulin (FINS), Fasting blood sugar(FBS),Body mass index(BMI) and renal function indices were also determined.Insulin resistance was evaluated,using insulin sensitivity index(ISI) and Homa-IR. The relation between leptin and these parameters was analysed.Result:Leptin level was higher in the MHD group when BMI was corrected by covariance analysis,but not statistically significant. FINS ,FBS and Homa-IR in MHD group were significantly higher than control group(P<0.01 respectively),and ISI was lower (P<0.01).Serum leptin concentration in MHD was positively correlated to BMI ,FINS ,Homa-IR (P<0.01)and inversely to ISI(P<0.01). Partial correlation analysis showed that leptin concentration was not significantly correlated to Homa-IR or ISI after controlling for BMI or FINS (P>0.05).Conclusion:Relation between Leptin and insulin resistance may be mediated by body fat and insulin.