胰岛素瘤患者血浆瘦素水平变化及其与肥胖的关系

Relationship between the changes of plasma levels of leptin and obesity in patients with insulinoma

目的分析胰岛素瘤患者术前空腹血浆瘦素水平变化及其与肥胖的关系。方法选取2003年1月至2008年5月于北京协和医院确诊的40例胰岛素瘤患者,取其术前的空腹血浆标本。另收集2006年1月至2008年5月与胰岛素瘤患者年龄、性别和体质量相匹配的28例志愿者的血浆作为对照。将所有受试者按BMI分成体质量正常组和超重肥胖组。采用ELISA法检测所有受试者的血浆瘦素水平。统计学方法为Mann-Whitney U检验和相关系数检验。结果胰岛素瘤患者血浆瘦素水平为0.35 ng/mL (0.25~1.13 ng/mL),高于对照者的0.29 ng/mL (0.25~1.15 ng/mL),差异有统计学意义(U=324.500, P=0.003)。体质量正常组中,胰岛素瘤患者血浆瘦素水平为0.35 ng/mL (0.27~0.62 ng/mL),高于对照者的0.28 ng/mL (0.25~0.37 ng/mL),差异有统计学意义(U=28.000, P=0.001);超重肥胖组中,胰岛素瘤患者和对照者血浆瘦素水平分别为0.35 ng/mL (0.25~1.13 ng/mL)和0.34 ng/mL (0.26~1.15 ng/mL),差异无统计学意义(U=153.500, P=0.525)。胰岛素瘤患者和对照者的血浆瘦素水平均与BMI相关(r=0.355,P=0.025;r=0.571,P=0.001)。结论胰岛素瘤患者术前空腹血浆瘦素水平升高,而且与BMI相关。

Objective To analyze the relationship between the changes of fasting plasma level of leptin and obesity in patients with insulinoma before operation. Methods From January 2003 to May 2008, 40 patients with insulinoma diagnosed at Peking Union Medical College Hospital were selected. Preoperative fasting plasma samples of them were collected. From January 2003 to May 2008, the plasma samples of 28 volunteers matched with age, gender and body weight matched with the patients were collected as the controls. All the subjects were divided into overweight-obesity group and normal weight group according to their body mass index (BMI). Plasma levels of leptin of all the subjects were measured by enzyme linked immunosorbent assay(ELISA). The Mann-Whitney U test and the correlation coefficient test were used for statistical analysis. Results The plasma leptin level of patients with insulinoma was 0.35 ng/mL (0.25 ng/mL to 1.13 ng/mL), which was higher than that of the control group (0.29 ng/mL, 0.25 ng/mL to 1.15 ng/mL), and the difference was statistically significant (U=324.50, P=0.003). In the normal-weight group, the plasma leptin level of the patients with insulinoma was 0.35 ng/mL (0.27 ng/mL to 0.62 ng/mL), which was higher than that of the control group (0.28 ng/mL, 0.25 ng/mL to 0.37 ng/mL), and the difference was statistically significant (U=28.000, P=0.001). While in the overweight-obesity group, the plasma leptin levels of the patients with insulinoma and the controls were 0.35 ng/mL (0.25 ng/mL to 1.13 ng/mL) and 0.34 ng/mL (0.26 ng/mL to 1.15 ng/mL), respectively, and the difference was not statistically significant (U=153.500, P=0.525). Plasma leptin levels in both the patients with insulinoma and the controls, were correlated with BMI (r=0.355, P=0.025;r=0.571, P=0.001, respectively). Conclusion Preoperative fasting plasma level of leptin increase in patients with insulinoma which is correlated with BMI.