胰岛素对成人隐匿性自身免疫性糖尿病患者血浆瘦素水平的影响

Effects of insulin on plasma leptin level in patients with latent autoimmune diabetes mellitus in adult

目的 探讨胰岛素对成人隐匿性自身免疫性糖尿病 (LADA)患者血浆瘦素水平 (PLEP)的影响。 方法 以 32名健康者为正常对照 ,用ELISA法测定 32例LADA患者基础血浆胰岛素水平(PINS)和PLEP ,并于胰岛素治疗后第 1、2、3、5、7日和第 12周分别复查空腹PINS和PLEP。 结果 ( 1)LADA患者基础PINS和PLEP均显著低于对照组 ,PINS越低 ,PLEP也越低 ,两者呈显著正相关 (r =0 .5 72 ,P <0 .0 1) ;( 2 )胰岛素治疗后 ,在体脂无变化条件下 ,PLEP随PINS的升高而上升 ,两者呈显著正相关 (r=0 .86 8,P <0 .0 5 ) ;( 3)PLEP与体重指数和脂肪百分比呈显著正相关 (P均 <0 .0 5 )。 结论 LADA患者内源性胰岛素缺乏导致低瘦素血症 ,PINS是影响PLEP的主要因素。

Objective To evaluate effects of insulin on plasma leptin level (PLEP) in patients with latent autoimmune diabetes mellitus in adult (LADA). Methods Basic plasma insulin levels (PINS) and PLEP were measured by the method of ELISA in 32 cases of LADA and 32 healthy subjects as a control group. The fasting PINS and PLEP were detected respectively on the first, the second, the third, the fifth and the seventh day and in the twelfth week after insulin therapy. Results (1)Both basic PINS and PLEP in LADA were significantly lower in patients than those in controls, and the lower PINS was, the lower PLEP was. There was a positive correlation between them (r= 0.572, P<0.005). (2)After insulin therapy, the PLEP increased with the increase of the PINS before any considerable change of the body fat took place, and the PLEP was significantly related with the PINS (r=0.868, P<0.05). (3)PLEP was positively related with BMI and percent body fat (all of P<0.05). Conclusion The endogenous insulin deficiency results in hypoleptinemia in LADA. The PINS is the major factor influencing PLEP.