肝硬化患者的血清瘦素水平

Serum leptin levels in patients with liver cirrhosis

目的:研究肝硬化患者血清瘦素水平的变化,探讨其与肝功能及胰岛素水平的关系.方法:肝硬化组50例(男性40例,女性10例),对照组30例(男20例,女10例),用放射免疫分析法测定血清瘦素和胰岛素水平,同时测量反映营养状态的人体测量学指标(身高和体重),体重指数(BMI)=体重(kg)/身高2(m2).分析各组间瘦素的变化及其与各指标间的关系.结果:肝硬化组及对照组中女性的血清瘦素水平均显著高于男性(P<0.01).肝硬化组的血清瘦素、胰岛素水平显著高于对照组(P<0.01).随着肝功能的恶化,男性肝硬化患者的血清瘦素水平逐渐增高,A和B级、B和C级之间比较无显著性差异(P>0.05),A和C级之间差异有显著性(P<0.05).ChildA级的BMI与对照组比较差异显著(P<0.05),但ChildB、C级的BMI与对照组无显著性差异(P>0.05).随着肝功能的恶化,肝硬化组空腹血糖和胰岛素水平逐渐升高.在对照组,瘦素与体重、BMI、空腹血糖和胰岛素显著相关.在肝硬化组,瘦素与体重、BMI和胰岛素水平显著相关,而与空腹血糖无相关性.结论:肝硬化患者的血清瘦素升高,女性的瘦素水平高于男性,并随着肝功能的逐渐恶化而升高,与体重、BMI和胰岛素明显相关.

AIM: To determine serum leptin levels in patients withposthepatic liver cirrhosis and investigate its relationshipwith gender, anthropometric features, serum glucose andinsulin level and liver function.METHODS: Fifty patients with posthepatic liver cirrhosis(M/F: 40/10) and 30 healthy control subjects (M/F: 20/10)participated. Liver function was assessed with Child-Pughclassification; anthropometric parameters (weight, height,body mass index, and BMI) were measured; serum leptinand insulin levels were determined by radioimmunoassay;serum glucose levels were determined by autoanalyzer.RESULTS:Compared with those in male subjects,leptin lev-els in female subjects increased in healthy controls and pa-tients with liver cirrhosis. Serum leptin and insulin levelswere higher in cirrhosis than those in control group. In malepatients with posthepatic liver cirrhosis, serum leptin levelstended to increase as liver function worsened. Serum leptinlevel correlated significantly with gender, weight, BMI andinsulin levels.CONCLUSION:There are higher leptin levels in cirrhosis thanin control group, and serum leptin levels tended to increaseas liver function worsened. Serum leptin level correlatessignificantly with gender, BMI and insulin levels.