中老年高血压和2型糖尿病患者血清瘦素水平的初步研究

Preliminary study of serum leptin level in elderly patients with hypertension and type 2 diabetes

目的 研究中老年人群中原发性高血压和 2型糖尿病对血清瘦素水平的影响。方法 随机选取原发性高血压患者 30例 ,2型糖尿病 5 5例 ,正常对照组 15例 ,分别测定入选对象的体重指数 (BMI)、腰臀比值(WHR)、血压、空腹瘦素、空腹和餐后 2h血糖和胰岛素、糖化血红蛋白、总胆固醇和甘油三酯 ,并计算胰岛素敏感指数 (ISI)。结果 血清瘦素水平与性别、BMI、WHR、空腹和餐后 2h胰岛素和胰岛素敏感指数呈独立相关 ;性别、年龄、BMI、腰围、餐后 2h胰岛素和甘油三酯在逐步回归分析中最后进入方程。结论 老年人群中轻度血压增高和糖代谢受损时血清瘦素水平变化不大 ,而性别、体脂分布以及胰岛素的水平和敏感度是与瘦素水平变化的主要相关因素。

Objective To investigate the serum leptin level in elderly patients with essential hypertension and type 2 diabetes. Methods 30 cases of essential hypertension, 55 cases of type 2 diabetes and 15 normal controls were enrolled in this study. Body mass index (BMI), waist hip ratio(WHR), blood pressure, fasting serum leptin, fasting and 2 h postprandial serum glucose and insulin, glucosylated hemoglobin, total cholesterol and triglyceride were measured in all of them and insulin sensitivity index (ISI) was calculated. Results Serum leptin is independently correlated with gender, BMI, WHR, fasting and 2 h postprandial insulin and ISI; The results of stepwise regression analyses showed that gender, age, BMI, waist circumference, 2 h postprandial insulin and triglyceride entered the regression equation in the final phase. Conclusion There are no obvious changes of serum leptin in elderly patients with slightly increased blood pressure and impaired glucose metabolism, while the gender, body fat distribution, insulin levels and sensitivity are the main influencing factors.(Shanghai Med J, 2000,23∶270 272)