高血压病患者血清瘦素含量与胰岛素抵抗水平的相关性研究

Association of serum leptin level with insulin resistance in essential hypertension patients

目的 :探讨高血压病患者血清瘦素水平与胰岛素抵抗的关系。方法 :测定 2 17例高血压病患者 (男 92例 ,女 12 5例 )的空腹血清瘦素含量、空腹血糖、胰岛素、收缩压、舒张压和体质量指数 (BMI) ,稳态模式评估法计算胰岛素抵抗指数 (HOMA-IR)。分析瘦素与其他各项参数的相关性。结果 :以 HOMA- IR的 2 5 %位点 ,作为判断胰岛素抵抗的切割点 ,把高血压病患者分为胰岛素抵抗组 (IR)和胰岛素敏感组 (IS) ,血清瘦素浓度 IR组显著高于 IS组 (P<0 .0 5 )。血清瘦素浓度与 HOMA- IR呈显著正相关 (男性 r=0 .4 0 7,P<0 .0 1;女性 r=0 .2 5 4 ,P<0 .0 1) ;校正年龄和 BMI后 ,男性组两者仍呈显著正相关 (r=0 .2 19,P<0 .0 5 ) ,女性组两者无相关 ;逐步回归分析显示 ,男性组 HOMA - IR为血清瘦素浓度的独立预测因素。结论 :男性高血压病患者血清瘦素浓度与胰岛素抵抗直接相关 ,女性则无直接相关性。

Objective:To explore the relationship between serum leptin and insulin resistance in essential hypertension patients.Methods:Serum leptin concentrations,fasting plasma glucose,serum insulin,blood pressure and body mass index (BMI) were determined in 217 patients with essential hypertension [92 males,125 females].Homeostasis model assessment was applied to assess the status of insulin resistance (HOMA IR).The correlation between leptin and other parameters were analyzed.Results:Based on the HOMA IR,the essential hypertension patients were divided into 4 quartiles,considering as insulin sensitive individuals (IS) from quartile 1 to quartile 3,and insulin resistant subjects (IR) in quartile 4.Serum leptin concentrations were significantly higher in IR group [males (8.1±3.8) μg/L,females (17.8±7.9) μg/L] than in IS group [males (6.0±3.3) μg/L,females (13.9±8.6) μg/L].Pearson analysis showed that fasting serum leptin concentrations were correlated with HOMA IR in males( r =0.407, P <0.001) and females ( r =0.254, P <0.01). After adjustment of age and BMI,partial correlation analysis showed that fasting serum resistin concentrations were correlated with HOMA IR ( r = 0.219, P <0.05)in males and not in females( r =0.074, P =NS).A stepwise multiple linear regression analysis showed that HOMA IR was a significant independent predictor of fasting serum resistin concentrations.Conclusion:Serum leptin concentrations are directly related to insulin resistance in males with essential hypertension and not in females.The mechanism of difference in sex need further study.