维持性血液透析患者瘦素与胰岛素抵抗的关系  

CORRELATION OF SERUM LEPTIN CONCENTRATION WITH INSULIN RESISTANCE IN HEMODIALYSIS PATIENTS

作　　者：谢恺庆[1] 孙安远[1] 周红卫[1] 杨海波[2] 罗佐杰[3] 

机构地区：[1]广西医科大学第一附属医院肾内科,南宁530021 [2]广西医科大学微生物与免疫学教研室 [3]广西医科大学第一附属医院内分泌科

出　　处：《广西医科大学学报》2004年第4期500-502,共3页Journal of Guangxi Medical University

基　　金：广西壮族自治区卫生厅医药卫生科研基金资助项目 (桂卫 Z2 0 0 10 2 1)

摘　　要：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.

关 键 词：维持性血液透析 瘦素 胰岛素抵抗 放免分析法 

分 类 号：R459.5[医药卫生—治疗学]