人血浆瘦素水平与肥胖及血糖、胰岛素的关系

The relationship between human plasma leptin levels and obesity, plasma glucose as well as insulin concentrations

目的 探讨人血浆瘦素水平与肥胖程度、血糖、胰岛素浓度的关系。方法 免疫放射法测定 171例检查者 (2型 DM 84例 ,IGT 36例 ,NGT 5 1例 ;男 90例 ,女 81例 )的空腹血浆瘦素水平 ,并行口服葡萄糖耐量试验 ,测定血浆胰岛素和葡萄糖浓度 ,同时测量身高、体重 ,计算体重指数 (BMI)。结果 空腹血浆瘦素水平与体重指数呈正相关 (男 r=0 .6 772 ,P<0 .0 1;女 r=0 .7191,P<0 .0 1) ,但性别差异显著 (P<0 .0 0 1) ,女性是男性的 2～ 3倍。采用多元逐步回归法分析 ,去除体重指数等因素的影响后 ,瘦素与胰岛素曲线下面积呈正相关 ,与血糖浓度无相关性。结论 肥胖者空腹血浆瘦素升高 ,血浆高瘦素水平与高胰岛素血症的相关性提示瘦素可能在 2型糖尿病的发病中起一定作用。

Objective To investigate the relationship between plasma leptin levels and obesity,plasma glucose as well as insulin concentrations.Methods Fasting plasma leptin concentrations were measured with IRMA in 171 cases (including 84 type 2 DM,36 IGT,51 NGT;90 men,81 women),and oral glucose tolerance test was done in every case to measure plasma glucose and insulin concentrations.Height,body weight were measured to calculate body mass index (BMI).Results Fasting plasma leptin levels are correlated with BMI( r=0.6772,P <0.01 in male and r=0.7191,P <0.01 in female),and leptin levels were 2～3 times higher in female than in male ( P <0.001).The stepwise multiple regression analysis shows that leptin variations were positively correlated with insulin curve areas.Conclusion Fasting plasma leptin levels are higher in obese subjects than that in non obese ones.The correlation between hyperleptinemia and hyperinsulinemia suggests a possible role for leptin in type 2 diabetes pathogenesis.