2型糖尿病患者一级亲属血清瘦素与胰岛素抵抗关系的探讨  

Study of the relationship of serum leptin level with insulin resistance in nondaiabetic firstdegree

作　　者：阚卫军[1] 王霞[1] 孙体[1] 杨静 张建平[2] 

机构地区：[1]武警山西总队医院,030006 [2]山西医科大学第一医院

出　　处：《山西医药杂志》2007年第3期207-209,共3页Shanxi Medical Journal

摘　　要：目的检测2型糖尿病一级亲属正常糖耐量患者血清瘦素(Lep)水平,以及与胰岛素抵抗的关系,探讨其在糖尿病发生发展中的作用。方法①抽取有糖尿病家族史的正常糖耐量一级亲属30名和无糖尿病家族史的正常糖耐量者30名为研究对象。②检测体重、血压、血脂、空腹血糖(FPG)、血浆胰岛素(FINS)。③用放射免疫法检测血清瘦素水平。④结合口服葡萄糖耐量试验,用胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗;用胰岛β细胞功能指数(HOMA-β)评估基础胰岛素分泌;用口服葡萄糖耐量试验(OGTT)空腹和30 min胰岛素血糖差值的比值(ΔI30/ΔG30)评价胰岛素早期分泌。⑤分析瘦素水平和胰岛素抵抗的关系。结果①有糖尿病家族史的一级亲属的甘油三酯(TG)、总胆固醇(TC)、空腹胰岛素(INS)、HOMA-IR、Lep均高于正常对照组,差异有统计学意义(P<0.05),高密度脂蛋白(HDL)低于正常组,差异无统计学意义。②以对数HOMA-IR为因变量,体重指数(BMI)、瘦素、TG、TC、HDL为自变量,进行多元线性逐步回归分析,显示TG和瘦素进入回归方程,当TG不变的情况下,对数HOMA-IR仍与瘦素显著正相关。③以对数HOMA-β为因变量同上做多元线性逐步回归分析,仅瘦素进入回归方程,显示对数HOMA-β与瘦素呈负相关。结论2型糖尿病的一级亲属与正常对照组相比存在瘦素高表达,且瘦素水平与HOMA-IR呈正相关,而与HOMA-β呈负相关,提示瘦素与胰岛素抵抗密切相关。Objective, To investigate the relationship of serum leptin level with insulin resistance （IR） in the nondiabetic first-degree relatives of type 2 diabetic mellitus （T2DM） through measuring serum leptin level. Methods Thirty normal glucose tolerance subjects with parental T2DM history and 30 normal glucose tolerance control subjects without T2DM family history were enrolled, The levels of body weight, blood pressure, lipid, fasting blood glucose; blood plasma insulin were measured in two groups. Serum leptin level was measured by radioimmunoassay （RIA）. All subjects underwent an oral glucose tolerance test （OGTT）, for determinations of 0, 30, 60, 120,180 minutes glucose and insulin. Insulin resistance and baseline insulin secretion were estimated using the homeostasis assessment （HOMA- IR） and β-cell function index （HOMA-β） by HOMA model respectively, and accounted/x ΔI30/ΔG30 to evaluate early insulin secretion. The relationship between HOMA-IR and the level of leptin was assessed. Results ①The group of the first-relatives of type 2 diabetes had the higher levels of serum leptin,TG, TC, FINS and HOMA-IR than that in control （P〈0.05）; lower HDL than that in control, but there was no significant difference between the two groups. ②LnHOMA- IR and leptin were get into multielement gradual regressive equation. Remaining TG invariant, serum leptin level is obviously positively correlated with LnHOMA-IR. ③LnHOMA-β and leptin were get into rnultielement gradual regressive equation. Leptin level is obviously negatively correlated with LnHOMA-β. Conclusion The degree of Serum leptin level in first-degree relatives of type 2 diabetes was significantly higher than that in control. Serum leptin level is obviously positive correlated with HOMA-IR and negative correlated with HOMA-β. Leptin level is closely correlated with insulin resistance.

关 键 词：2型糖尿病 一级亲属 瘦素 

分 类 号：R587.1[医药卫生—内分泌]