肥胖人群中血清瘦素、游离脂肪酸和脂联素水平的相互关系

Relationship among serum leptin, free fatty acid and adiponectin levels in obesity

目的 测定肥胖人群中血清瘦素、游离脂肪酸(FFA)和脂联素的血清水平及分析其相互之间的关系。方法 20名正常非肥胖对照和63名体重指数>25kg/m^2的超重肥胖个体进入研究,后者按其血糖水平又分为单纯性肥胖组(38例)和2型糖尿病组(25例)。所有研究对象均分别完成口服葡萄糖耐量试验和减少样本数的静脉葡萄糖耐量试验(FSIVGTT)。使用SPSS10.0统计软件包统计分析血清胰岛素、瘦素、游离脂肪酸和脂联素在各组人群间的水平差异以及与肥胖度和胰岛素敏感指数等指标的关系。结果 肥胖患者的血清瘦素和FFA水平均显著高于正常对照,唯血清脂联素水平显著低于正常对照[瘦素:单纯肥胖(15.55±1.87)μg/L,糖尿病肥胖(13.41±5.07)μg/Lvs正常对照(2.83±0.70)μg/L,均P<0.001;FFA:单纯肥胖(670.5±239.8)μmol/L,糖尿病肥胖(780.8±381.7)μmol/Lvs正常对照(393.2±152.1)μmol/L,P<0.001和P<0.01;脂联素:单纯肥胖(9.11±2.16)μg/L,糖尿病肥胖(4.25±1.59)μg/Lvs正常对照(12.14±3.57)μg/L,P<0.01和P<0.001]。在以胰岛素敏感指数为应变量的多元回归方程中,脂联素、空腹胰岛素、FFA和腰臀比(WHR)进入方程(r~=0.28,P<0.001)。结论 肥胖人群的血清瘦素、FFA水平显著高于正常人群,血清脂联素水平则与之相反;

Objective To measure serum leptin, free fatty acid (FFA) and adiponectin levels and to analyse relationships among them in obese subjects. Methods Sixty-three overweight or obese subjects (body mass index (BMI) >25 kg/m2] and 20 normal lean controls all took oral 75 g glucose tolerance test and frequently sampled intravenous glucose tolerance test ( FSIVGTT). According to their plasma glucose level, the obese subjects were divided into simple obesity group (n=38) and diabetic obesity group (n= 25). Fasting leptin, FFA and adiponectin concentrations were measured at the same time in all subjects. The relationships among these factors were analyzed by SPSS 10.0 software. Results The serum leptin and FFA levels in obese subjects were significantly higher than those of normal controls, while serum adiponectin level was significantly lower in obese subjects than that of normal controls. (Leptin: simple obesity (15.55±1.87)μg/L, diabetic obesity (13.41±5.07)μg/L vs' normal control ( 2.83±0.70)μg/L, both P <0.001;FFA:simple obesity (670.5±239.8) μmol/L,diabetic obesity (780.8±381.7) μmol/L vs normal control (393.2±152.1) μmnol/L, P<0.001 and P<0.01; Adiponectin: simple obesity (9.11±2.16) mg/L, diabetes obesity (4.25±1.59) mg/L vs normal control (12.14±3.57) mg/L, P <0.01 and P<0.001]. Further analysis revealed that adiponectin, fasting insulin, FFA levels and waist hip ratio contributed to the degree of insulin resistance. ( Multivariate regression function r2=0. 28, P<0.001).Conclusion Serum leptin and FFA levels in obese subjects are much higher than those of normal control, while serum adiponectin level is lower. Adiponectin, fasting insulin, FFA and WHR are good indexes in evaluating the insulin resistance syndrome.