肥胖患者血清瘦素、TNF-α、游离脂肪酸水平与胰岛素敏感性的相关性研究

目的了解瘦素、TNF-α、游离脂肪酸在肥胖患者血清中的水平及与胰岛素敏感性的相互关系。方法选取19例肥胖症(BMI≥25 kg/m2)和29例非肥胖症(BMI<25 kg/m2)患者为研究对象,检测空腹血浆葡萄糖(FPG)、空腹血浆胰岛素(FINS)、血脂和血清瘦素(Leptin)、肿瘤坏死因子α(TNF-α)、游离脂肪酸(FFA)等指标,使用SPSS11. 0统计软件包统计分析瘦素、TNF-α、FFA在两组人群间的水平差异以及与反映胰岛素敏感性的指标间的相互关系。结果(1)肥胖患者的血浆TG、VLDL-C、FINS、瘦素、TNF-α、FFA均显著高于正常对照组(P<0.05-P<0.01)。(2)肥胖组中FFA与血浆TG、Tch、LDL、FINS、胰岛抵抗指数(HOMA-IR)呈正相关(γ分别为0.492、0.610、0.632、0.612、0. 607,均P<0.05),与胰岛素敏感指数(ISI)呈负相关(γ为-0.47,P<0.05);瘦素与BMI、FINS、HOMA-IR呈正相关(γ分别为0.673、0.831、0.823、P<0.01-P<0.001),与ISI呈负相关(γ为-0.578,P<0.05);TNF-α与ISI呈负相关(γ为-0.676,P<0.05)。结论肥胖患者的血清瘦素、TNF-α、FFA水平显著高于正常人群,且其水平与反映胰岛素敏感性的指标显著相关,血清瘦素、TNF-α、FFA是一组很好的评估胰岛素敏感性的指标。

Relationship between serum leptin, free fatty acid, TNF - α with insulin sensitivity in obesity

Objective To observe the changes of serum leptin, tumor necrosis factor - alpha (TNF -α) ,free fatty acid (FFA) and their relationships with insulin sensitivity. Methods 19 subjects with obesity( BMI≥25 kg/(b)) and 29 non - obese controls (BMI < 25 kg/(b)) were investigated. Fasting plasma insulin (FINS) , glucose (FPG),lipids, serum leptin, TNF - α, FFA were determined. Insulin sensitivity index (ISI) and HOMA insulin resistance index (HOMA -IR) were calculated. The relationships among these factors were analyzed by SPSS11. 0 software. Results (1)The plasma TG,VLDL - C,FINS, serum leptin, TNF -α and FFA levels in obese subjects were significantly higher than those of normal controls (P < 0.05 - P < 0.01). (2)In obese subjectsFFA was positively correlated with plasma TG,Tch,LDL, FINS (γ=0.492,0.610,0.632,0.612 respectively, all P<0.05) and negatively correlated with ISI (γ= -0.47,P<0.05);leptin was positively correlated with BMI, FINS and HOMA-IR (γ=0.673,0. 831 and 0. 823 respectively, P<0.01-P<0.001 respectively) and negatively correlated with ISI (γ= -0.578,P<0.05); TNF-α was negatively correlated with ISI (γ = -0. 676,P<0.05). Conclusion Serum leptin ,TNF-α and FFA levels in obese subjects are much higher than those of nomal controls. And they were correlated with insulin sensitivity. Serum leptin, TNF-α,FFA are good indexes in evaluating the insulin sensitivity.