2型糖尿病患者瘦素水平测定及临床意义的研究  

Leptin level measures and their clinical significance in type 2 diabetic patients

作　　者：程瑞迎[1] 柳洁[1] 柳湘[1] 康文娟[1] 秦洁[1] 胡玲[1] 王彩萍[1] 邵晋康[1] 薛雪花[1] 高应[2] 

机构地区：[1]山西省人民医院内分泌科,030012 [2]山西医科大学研究生实验室

出　　处：《中国药物与临床》2005年第8期585-587,共3页Chinese Remedies & Clinics

基　　金：山西省自然科学基金资助项目(991088)

摘　　要：目的探讨2型糖尿病患者的血清瘦素水平、瘦素与胰岛素抵抗的关系及临床意义。方法糖尿病组100例,分为糖尿病非肥胖组[体重指数(BMI)<25kg/m2)]与肥胖组(BMI≥25kg/m2),计算BMI、腰臀围比值(WHR),用酶联免疫吸附试验(ELISA)测定人血清瘦素,同时测定空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素原(PI)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、游离脂肪酸(FFA)、睾酮。胰岛素敏感性以HOMA模型中胰岛素抵抗指数(HOMA-R)评价。对照组:健康人60名与糖尿病组相匹配,分组和观察指标也相同。结果山西地区人血清瘦素正常值女性为(7.6±3.6)μg/L,男性为(2.1±1.0)μg/L;糖尿病组与对照组肥胖者瘦素水平均明显高于非肥胖者,瘦素水平与性别、体重、BMI、FINS、PI、HOMA-R、FFA显著相关,男性瘦素水平与男性睾酮呈显著负相关。肥胖者多数存在高胰岛素血症,胰岛素不敏感者较胰岛素敏感者瘦素水平增高。多元回归结果显示,糖尿病组性别、BMI、FINS、HOMA-R是瘦素水平的影响因素。结论2型糖尿病患者瘦素水平与非糖尿病无明显差异,瘦素水平与肥胖和胰岛素抵抗关系密切,并对糖尿病患者的防治有一定的临床意义。Objective The aim of the study was to investigate type 2 diabetics＇ serum leptin levels,and their relationship with insulin resistance,as well as the clinical significance. Methods A total of 100 type 2 diabetic patients, whose serum leptin level, BMI, glycosylated hemoglobin（HbA1e）, plasma glucose, serum insulin and proinsulin, lipids （triglycerides, total cholesterol ）, free fatty acid （FFA） and testosterone were measured. Insulin sensitivity was evaluated by homeostatic model assessment （HOMA-R）. Results Multiple regression analyses showed the serum leptin levels positively correlated to sex, BMI, serum insulin, HOMA-R .There was, however, no relationship between serum leptin levels and measures of variables including total cholesterol, fasting blood glucose,HbA1c .Conclusion No significant difference of serum leptin levels existed between type 2 diabetics and non-diabeties：however,leptin levels had close relation with obesity and/or insulin resistance,and showed a certain clinical value for diabetic prevention and cure.

关 键 词：2型糖尿病 瘦素 含量测定 酶联免疫吸附试验 体重指数 肥胖 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]