血清瘦素和可溶性瘦素受体与代谢综合征的关系

The relationship bwtween serum leptin,soluble leptin receptor and metabolic syndrome in healthy subjects and the patients with type two diabetes mellitus and/or coronary heart disease

目的 探讨血清瘦素和可溶性瘦素受体水平与代谢综合征的关系。方法 检测 1 1 0例住院健康体检者、2型糖尿病 (2 DM)及合并冠心病患者血清瘦素 (Lp)、可溶性瘦素受体 (sLR)水平并分析其与血糖 (BG)、总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白 (HDL)、低密度脂蛋白 (LDL)、载脂蛋白ApoA、ApoB、ApoA/B、胰岛素(Ins)、C 肽 (C p)、HOMA胰岛素抵抗指数 (HOMA IR)、体质指数 (BMI)、腰臀比 (WHR)等临床指标的相关性。 结果 疾病组Lp水平明显高于对照组 ,sLR水平明显降低 ,有极显著性差异 (P <0 .0 0 1 )。相关分析显示Lp与BMI、Ins、C p、HOMA IR、TC、ApoB呈正相关 ,与sLR、ApoA、ApoA/B呈负相关 ;sLR与Lp、C p、BMI呈负相关 ,与ApoA/B呈正相关 ,有显著性差异或极显著性差异 (P <0 .0 5或 0 .0 0 1 ) ,与Ins、HOMA IR、TC、ApoB、ApoA无显著性差异(P >0 .0 5 )。结论 疾病组Lp升高、sLR降低 ,提示Lp抵抗可能是 2 DM及冠心病的重要发病因素。Lp、sLR水平与BMI、血脂、Ins、C p、HOMA IR等临床指标相关性分析显示 ,代谢综合征的发生可能与Lp、sLR的变化有关 。

Objective To study the relationship between serum leptin (Lp)/soluble leptin receptor (sLR) and metabolic syndrome (obesity combined with diabetes,coronary heart disease,dyslipidemia etc.).Methods 110 cases from 48 healthy subjects and 62 patients with type two diabetes mellitus (2 DM) and/or coronary heart disease (CHD) were studied.Lp and sLR levels were detected and an analysis was carried out on their co relationship with the clinic indices of blood glucose (BG),total cholesterol(TC),triglyceride(TG),high density lipoprotein (HDL),low density lipoprotein (LDL),apolipoprotein A(ApoA),apolipoprotein B(ApoB),ApoA/B,insulin (Ins),C peptide (C p),homeostasis modelassessment index for insulin resistance (HOMA IR),body mass index (BMI),waist to hip ratio(WHR),etc.Results The patients had significantly higher Lp and lower sLR values ( P <0.001).Correlation analysis indicated that Lp levels were significantly correlated with BMI,Ins,C p,HOMA IR,TC and ApoB,but inversely correlated with sLR,ApoA,ApoA/B.It also suggested that sLR levels were correlated with ApoA/B but inversely correlated with Lp,C p,and BMI ( P <0.05 or P <0.001).Conclusions The higher Lp levels and lower sLR levels of the patients suggest the existence of a leptin resistance that might be the cause of 2 DM and CHD.The correlation of Lp and sLR with above mentioned clinic indices suggests a close relationship between metabolic syndrome and the changes of Lp and sLR.The cause and effect between the leptin resistance and metabolic syndrome requires further study.