初发2型糖尿病患者血清瘦素水平变化及OGTT对其影响

Changes of Serum Leptin Levels in Type 2 Diabetics and The Effect of OGTT on Them

目的 观察初发 2型糖尿病患者血清瘦素水平变化及糖负荷对瘦素分泌的影响 ,进而探讨瘦素与肥胖、2型糖尿病间的关系。方法 测定 4 0例正常对照者 (肥胖与非肥胖各为 2 0例 )及 5 0例初发 2型糖尿病者(肥胖者 2 0例 ,非肥胖者 30例 )空腹及口服葡萄糖耐量试验 (OGTT)后血清瘦素、胰岛素、血糖水平 ,同时测定糖化血红蛋白、三酰甘油及胆固醇水平。结果 ( 1)对照组和初发 2型糖尿病组肥胖者血清瘦素水平均高于非肥胖者 (均P <0 .0 0 1) ,但 2型糖尿病患者血清瘦素水平与对照组差异无显著意义 (P >0 .0 5 ) ;( 2 )不论是对照组 ,还是 2型糖尿病组 ,糖负荷后血清胰岛素水平升高 ,而瘦素水平呈下降趋势 ,但无统计学意义 (P >0 .0 5 ) ;( 3)相关分析显示 ,空腹血清瘦素水平与性别、体重指数和胰岛素水平具有相关性。结论 初发 2型糖尿病患者血清瘦素水平无显著变化 ;短期血胰岛素水平升高对血清瘦素水平无明显影响。

Purpose: To observe the changes of leptin levels in newly diagnosed type 2 diabetic patients and the effect of oral glucose tolerance test (OGTT) on leptin levels, so as to investigate the relationship between leptin, obesity and type 2 diabetes. Methods: Fasting serum levels of leptin, insulin, glucose, hemoglobinA1c(HbA1c), triglycerides and cholesterol were analyzed in 40 normal controls(including 20 non-obese and 20 obese subjects) and 50 newly diagnosed type 2 diabetic patients (30 non-obese and 20 obese subjects). All subjects received 75 g glucose orally and blood samples were taken for the determination of serum leptin, insulin and plasma glucose levels at 0, 60, 120, 180 min. Results (1) In both control group and type 2 diabetic group, leptin levels of obese subjects were higher than those of non-obese subjects (P 0.05). (2) During OGTT, serum insulin levels rose significantly. The leptin release curve showed a decrease pattern during OGTT in both normal group and type 2 diabetic group, although no statistical difference was revealed (P > 0.05). (3) Serum leptin levels were correlated to sex, BMI and insulin levels. Conclusions: Levels of leptin in newly diagnosed type 2 diabetic patients were not different from those in control subjects. It is likely that short-term hyperinsulinemia has no effect on serum leptin levels.