2型糖尿病与糖耐量低减病人血清瘦素水平的变化及其相关因素

CHANGES OF SERUM LEPTIN LEVELS AND RELATED FACTORS IN PATIENTS WITH TYPE 2 DIABETES AND IMPAIRED GLUCOSE TOLERANCE

①目的 探讨初诊的 2型糖尿病 (DM )与糖耐量低减 (IGT)病人血清瘦素水平的变化及其与年龄、性别、体质量指数 (BMI)、糖代谢、脂代谢以及其他激素的关系。②方法 采用放射免疫分析法 (RIA)和酶联免疫吸附法 (ELISA) ,检测了初诊未经治疗的 77例 2型糖尿病病人 ,32例IGT病人及 5 2例正常人的空腹血清瘦素、睾酮(TT)、雌二醇 (E2 )和真胰岛素 ;同时测定血糖、血清胆固醇、三酰甘油和尿酸。③结果 女性 2型糖尿病组及IGT组血清瘦素水平明显低于女性对照组 (F =9.14 8,P <0 .0 0 1) ;各组肥胖者血清瘦素水平明显高于非肥胖者 (F =31.0 11,6 .84 2 ,Z =4 .2 2 0 ,P <0 .0 0 1,0 .0 1) ;各组女性血清瘦素水平明显高于男性 (F =2 5 .812～ 71.4 31,P <0 .0 0 1,0 .0 1) ;女性 2型糖尿病绝经后病人组与绝经前病人组瘦素水平比较差异无显著性 (F =0 .16 2 ,P >0 .0 5 ) ;2型糖尿病组及IGT组血清瘦素水平与BMI ,胰岛素浓度、腰围呈正相关 (P <0 .0 1,0 .0 5 ) ,与睾酮、空腹血糖及胰岛素敏感指数呈负相关 (P <0 .0 1,0 .0 5 )。④结论 女性 2型糖尿病及IGT病人体内瘦素的合成较男性病人更易受血糖和胰岛素调控的影响 ;2型糖尿病及IGT病人血清瘦素水平与性别、BMI,腰围、胰岛素浓度、睾酮等多种因素相关 ;

Objective\ To investigate the changes of serum leptin levels and the relationships between serum leptin levels and body mass index (BMI), age, gender, glycometabolism, lipometabolism and some hormones in initially diagnosed patients with type 2 diabetes and impaired glucose tolerance(IGT). \ Methods\ By using radioimmunoassay(RIA) and enzyme linked immunosorbent assay(ELISA) methods, the changes of fasting serum levels of leptin, testosterone (TT), estradiol(E 2) and true insulin were measured in 52 healthy subjects, 77 patients with type 2 diabetes and 32 patients with IGT. All patients were newly diagnosed and untreated. The fasting blood glucose(FBG), cholesterol, triglycerid and uric acid were assayed simultaneously.\ Results\ The serum leptin levels were significantly lower in women with type 2 diabetes and IGT than in normal women( F=9.148,P <0.001). In the groups of type 2 diabetes, IGT and controls, the serum leptin levels were significantly higher in patients with obesity than those without and significantly higher in women than in men ( F=6.842-71.431, Z=4.220,P <0.001, 0.01). There was no significant difference between the menopause women with type 2 diabetes and the pre-menopause women with type 2 diabetes( F= 0.162 , P >0.05). In the groups of type 2 diabetes and IGT, the serum leptin levels were positively correlates with BMI, true insulin concentration, waist circumference and negatively correlated with TT, FBG and ISI( P <0.01,0.05).\ Conclusion\ The synthesis of leptin by adipose tissue may be more susceptible to regulation in vivo by insulin and glucose in women than in men. The serum leptin levels correlates with gender, BMI, waist circumference, insulin concentration, TT and other factors in patients with type 2 diabetes and IGT. Estrogenic hormone is not a major determinant of the serum leptin concentration. Leptin may play a part in the occurrence of type 2 diabetes and IGT by participating in the regulation of glycometabolism.