影响2型糖尿病合并高血压患者血清瘦素水平的因素分析

Factors that influencing the serum leptin level in type 2 diabetic patients with hypertension

目的:研究2型糖尿病合并高血压患者血清瘦素水平的变化。方法:随机选取2型糖尿病患者60例,肥胖者30例与非肥胖者30例,2型糖尿病患者合并高血压60例,肥胖者33例与非肥胖者27例,正常对照组30例。分别检测以上3组患者的空腹瘦素、空腹和餐后2h血糖、胰岛素和C肽、糖化血红蛋白(glucosylatedhemoglobin,HbA1c)、体质量指数(bodymassindexBMI)、血压、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白,并计算胰岛素敏感指数(insulinsensitivityindex,ISI)。结果:2型糖尿病患者血清瘦素水平与BMI、空腹胰岛素、C肽和餐后2h胰岛素、C肽水平、性别呈正相关(r=0.548,0353,0.391,0.332,0.362,0.373,P<0.01),高血压组高于其他两组(P<0.05或0.01),肥胖者犤高血压与非高血压组FINS分别为(24.62±0.83),(18.32±0.90)mIU/L犦高于非肥胖者犤(17.21±0.71),(15.24±0.62)mIU/L犦(P<0.05或0.01),与ISI呈负相关(r=0.33,P<0.01),血糖控制的差异对瘦素没有产生影响。结论:2型糖尿病合并高血压患者血清瘦素水平受到高胰岛素血症、胰岛素抵抗、肥胖和血脂等多因素的影响,但与血糖水平无关。

AIM:To investigate the changes of serum leptin level in type 2 diabetic hypertension patients with type 2 diabetes mellitus. METHODS:Sixty patients with type 2 diabetes mellitus(30 obesity,30 non obesity),type 2 diabetic patients with hypertension(33 obesity,27 non obesity) and 30 normal controls were enrolled in this study.Fasting leptin,fasting and 2 hour postprandial blood glucose,fasting insulin(FINS) and C peptide,glucosylated hemoglobin(HbA1C),body mass index(BMI),blood pressure,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL C) and low density lipoprotein cholesterol(LDL C) were measured in the three groups and insulin sensitivity index(ISI) was calculated. RESULTS:Serum leptin in the patients with type 2 diabetes was positively related with BMI,fasting insulin and C peptide,2 hour postprandial insulin and C peptide level and sex(r=0.548,0.353,0.391,0.332,0.362,r=0.373,P< 0.01);the serum lipids in the type 2 diabetic patients with hypertension was obviously higher than those in the other two groups(P< 0.05 or 0.01).In the obese group,the fasting insulin level of those with and without hypertension were(24.62±0.83) and(18.32±0.90) mIU/L respectively,higher than those in the non obese group[(17.21±0.71),(15.24±0.62) mIU/L](P< 0.05 or 0.01),and was negatively related with ISI(r=0.33,P< 0.01);the difference of glucose control did not affect the leptin level. CONCLUSION:The serum leptin level in type 2 diabetic patients with hypertension is influenced by multi factors,including hyperinsulinism,insulin resistance,obesity and serum lipids,but not correlated to the level of blood glucose.