2型糖尿病患者瘦素水平与胰岛素抵抗关系的研究

The association of serum leptin level with insulin resistance in type 2 diabetes

目的研究2型糖尿病（T2DM）患者血清瘦素与性别、体质指数（BMI）、腰臀比（WHa）、胰岛素、胰岛素抵抗、血糖、总胆固醇和甘油三酯的关系。方法随机选取56例2型糖尿病患者与22例非糖尿病者，分别测定体质指数、腰臀比、空腹瘦素、空腹和餐后2h血糖、空腹和餐后2h胰岛素、总胆固醇和甘油三酯。结果血清瘦素平均水平男性（8．5±0．9）μg／L，女性（17．2±1．1）μg/L，女性高于男性（P〈0．01）；血清瘦素与体质指数呈显著正相关（r=0．64，P〈0．01），与男性腰臀比显著正相关（r=0．05，P〈0．01），与胰岛素显著正相关（空腹：r=0．36，P〈0．01；餐后2h：r=0．36，P〈0．01），与2型糖尿病组胰岛素敏感指数（ISI）呈负相关（r=-0．31，P〈0．05），与血糖、血脂无相关性。结论血清瘦素水平与体质指数、男性腰臀比显著正相关，与胰岛素显著正相关，与2型糖尿病组胰岛素敏感指数（ISI）呈负相关。

Objective To investigate the relationship between serum leptin level in patients with type 2 diabetes and sex, serum glucose, serum insulin,insulin resistance, body mass index （BMI） , waist-hip ratio （WHR） and total cholesterol and triglyceride. Methods 56 cases of type 2 diabetes and 22 normal controls were entrolled in this study. Body mass index （BMI） ,waist-hip ratio （WHR） ,fasting serum leptin,fasting and 2h postprandial serum glucose and insulin,total cholesterol and triglyceride were detected. Results The average serum leptin level in women （ 17.2 ± 1.1 ） μg/L was significantly higher than that in men （ 8.5 ± 0. 9 ） μg/L（ P 〈 0. 01 ）. The serum leptin level was positively correlated with BMI （r =0.64,P〈0.01 ） and WHR （r=0. 05,P〈0. 01） ,serum insulin level （fasting r = 0. 36,r 〈 0. 01 ; 2h r = 0. 36,P 〈 0. 01 ） , but negatively correlated with insulin sensitivity index （ ISI ） in type 2 diabetic patients （ r = -0.31 ,P 〈 0. 05 ） , and correlated with neither blood glucose level nor total cholesterol and triglyceride. Conclusion Leptin resistance exists because serum leptin level is positively correlated with BMI and male WHR. There is a positive relationship between leptin and insulin, and serum leptin level is negatively correlated with insulin sensitivity index in type 2 diabetes.