血清瘦素与2型糖尿病下肢大血管病变的关系探讨

RELATIONSHIP BETWEEN SERUM LEPTIN AND LOWER EXTREMITY ARTERIAL DISEASE IN PATIENTS WITH TYPE-2 DIABETES MELLITUS

目的探讨瘦素(leptin)与2型糖尿病(T2DM)下肢大血管病变的相关性。方法所有病例均行双下肢动脉彩色多谱勒超声检查,按有无下肢血管病变分为病变组(A组)、对照组(B组),每组再按有无高血压病、冠心病、脑血管病分为病变组并发其他血管疾病组(A1组)和病变组无并发其他血管疾病组(A2组);对照组并发其他血管疾病组(B1组),对照组无并发其他血管疾病组(B2组)。比较病变组与对照组leptin及其他指标差异。结果A1组与B1组比较(二组男女构成、体重指数、腰臀比值、有无微血管病变比较无显著性差异)。Apo-B(1.306±0.217;1.193±0.169)mmol/L,P<0.05(校正年龄后),leptin(16.453±2.061;11.845±3.173)ng/ml,P<0.05;A2组与B2组比较,LDL-C(3.878±1.151;3.258±0.721)mmol/L,P<0.05(校正年龄后);以有无下肢血管病变为应变量进行多因素logistic回归分析。结论下肢血管病变与瘦素无相关性,而与年龄、LDL-C有相关性。瘦素与性别及BMI有一定的关系。女性瘦素水平高于男性,BMI值越大瘦素水平越高,瘦素与HDL-C呈显著负相关,与apoB呈显著正相关。

Objective To study the relationship between the serum leptin level and the trunk complications in type 2 diabetic patients. Methods The arteries of bilateral lower extremities in all subjects were detected by color Doppler to determine the pathology of low extremity artery,all patients were classed into case group with/without the other trunk complications(A1 group,A2 group) and control group with/without the other trunk complications(B1 group,B2 group) on the base of the other complications such as hypertension,coronary heart disease,brain vessel disease.Leptin and other indexes were compared between two groups. Results There were significant difference between A1 group and B1 group in sex ratio BMI,WHR microvessel complication.Fasting apo B in A1 group was significantly higher than that in B1 group(1.306±0.217;1.193±0.169g/L,P< 0.05 )after adjusting age.Leptin in A1 group was significantly higher than that in B1 group (16.453± 2.061 ;11.845±3.173 ng/ml,P<0.05).There were significant difference between A2 group and B2 group in sex ratio BMI,WHR microvessel complication. Fasting LDL-C was significantly higher in A2 group than that in B2 group(3.878±1.151;3.258±0.72mmol/L,P<0.05) after adjusting age. Conclusion There is no significant relationship between arterial disease of lower extremity and leptin level; but there are some relationship with age and LDL-C level.Leptin level is related to sex and BMI.The leptin levels in femals are higher than those in males. The bigger BMI value is, the higher leptin level is.There are negative relationship between leptin level and HDL-C level,and positive relationship between leptin level and apo-B level.