【摘要】 目的了解高血压病患者血清抵抗素和瘦素的关系,比较抵抗素和瘦素水平与血糖、胰岛素抵抗及(细胞胰岛素分泌功能的关系。方法检测71例高血压病患者的空腹血清抵抗素和瘦素水平,口服葡萄糖耐量试验(OGTT)和胰岛素释放试验,测定血浆葡萄糖浓度和血清胰岛素浓度,计算葡萄糖曲线下面积(AUCG)和OGTT开始30min胰岛素和血糖变化的比值(ΔI30/ΔG30),根据Cederholm公式计算胰岛素敏感指数(ISI)。结果空腹血清抵抗素浓度(μg/L):DM组(30±12)显著高于NGT组(22±8)(P<0.05),略高于IGT组(25±10)(P>0.05);空腹血清抵抗素浓度与AUCG呈显著正相关,与ISI及ΔI30/ΔG30呈显著负相关。空腹血清瘦素浓度(μg/L):DM组(22±11)显著高于IGT组(12±9)(P<0.05)和NGT组(10±7)(P<0.05),瘦素浓度与AUCG呈显著正相关,与ISI呈显著负相关,与ΔI30/ΔG30无相关。空腹血清抵抗素浓度与空腹血清瘦素浓度呈显著正相关;多元逐步回归分析表明抵抗素浓度显著影响AUCG,瘦素对AUCG无直接影响。结论抵抗素和瘦素可能联合影响体内能量代谢和平衡,但低抗素与糖代谢的关系较瘦素更密切。更多还原

【Abstract】 Aim To investigate the relationship betwee n serum resistive level and leptin level,and compare s erum resistive level and leptin leve l with plasma glucose,insulin resistance andβ-cell secretory fun ction.Methods Oral glucose tolerance test and insu lin release test were condu cted to me asure plasm glucose concentration and serum insulin concentration for calcul ating glucose area(AUC G )and insulin area(AUG IN )under the curve,the radio of changes in glucose and insulin withi n 30 min after glucose ingestion(ΔI 30 /ΔG 30 ),and insulin sensitivity index(ISI )by Cederholm formula among seven-t y-one hypertensive patients,33ma les,38females,aged 37-69,who soug ht medical advice in Shanghai Changhai Hospital 2000-10/2001-12 .Accordi ng to the results,71patients were divi ded into 3groups:type 2di abetes mel litus group(DM group),impaired glucose tolerance group(IGT group ),and normal glucose tolerance group(NGT group).Then fasting serum concent rations of re-sistin and leptin were measured in th ree groups.Results Fasting serum re-sistin concentration in DM was(30±12)μg /L,significantly hi gher than that in NG(22±8)μg /L,P<0.05,appreciably higher than th at in IG(25±10)μg /L,P>0.05.Pearson analysis showed that fasti n g serum resistin concentrations were highly positiv ely correlated with AUC G (r=0.380,P<0.001),and highly negatively correlated with ISI (r=-0.276,P<0.05)andΔI 30 /ΔG 30 (r=-0.298,P<0.05).Fasting serum leptin concentratio n in DM was(22.2±10.9)μg /L,significantly higher than that in IGT(12 ±9)μg /L,P<0.05and NG(10±7)μg /L,P<0.05.Pearson analysis shows that fasting serum leptin concentrations were positively correla ted with AUCG(r=0.442,P<0.001),negatively correlated with ISI (r=-0.468,P<0.001),but not correlated toΔI 30 /ΔG 30 (r=-0.111,P>0.05).Fasting serum resistin concentrati ons wer e highly positively correlat ed with fasting serumleptin concentration s(r=0 .253,P<0.05).Astepwise multiple regression analysis showed that resi stin level had an important effect on AUC G and leptin had not a direct impact on AUC G .Conclusion Resistin and leptin effect energy metabolism and balance,but r esistin is more closely corre lated with glucose metabolism than leptin in essen tial hypertension patients.更多还原