初发2型糖尿病患者血清瘦素水平变化及OGTT对其影响

目的　观察初发 2型糖尿病患者血清瘦素水平变化及糖负荷对瘦素分泌的影响 ,进而探讨瘦素与肥胖、2型糖尿病间的关系。方法　测定 4 0例正常对照者 (肥胖与非肥胖各为 2 0例 )及 5 0例初发 2型糖尿病者(肥胖者 2 0例 ,非肥胖者 30例 )空腹及口服葡萄糖耐量试验 (OGTT)后血清瘦素、胰岛素、血糖水平 ,同时测定糖化血红蛋白、三酰甘油及胆固醇水平。结果　 ( 1)对照组和初发 2型糖尿病组肥胖者血清瘦素水平均高于非肥胖者 (均P <0 .0 0 1) ,但 2型糖尿病患者血清瘦素水平与对照组差异无显著意义 (P >0 .0 5 ) ;( 2 )不论是对照组 ,还是 2型糖尿病组 ,糖负荷后血清胰岛素水平升高 ,而瘦素水平呈下降趋势 ,但无统计学意义 (P >0 .0 5 ) ;( 3)相关分析显示 ,空腹血清瘦素水平与性别、体重指数和胰岛素水平具有相关性。结论　初发 2型糖尿病患者血清瘦素水平无显著变化 ;短期血胰岛素水平升高对血清瘦素水平无明显影响。

Changes of Serum Leptin Levels in Type 2 Diabetics and The Effect of OGTT on Them

Purpose To observe the changes of leptin levels in newly diagnosed type 2 diabetic patients and the effect of oral glucose tolerance test (OGTT) on leptin levels,so as to investigate the relationship between leptin,obesity and type 2 diabetes. Methods Fasting serum levels of leptin,insulin,glucose,hemoglobinA1c(HbA1c),triglycerides and cholesterol were analyzed in 40 normal controls(including 20 non obese and 20 obese subjects)and 50 newly diagnosed type 2 diabetic patients (30 non obese and 20 obese subjects).All subjects received 75 g glucose orally and blood samples were taken for the determination of serum leptin,insulin and plasma glucose levels at 0,60,120,180 min. Results (1) In both control group and type 2 diabetic group,leptin levels of obese subjects were higher than those of non?obese subjects ( P < 0.001 , P <0.001).Levels of leptin in type 2 diabetic group were not different from those in control group( P >0.05 ).(2) During OGTT,serum insulin levels rose significantly.The leptin release curve showed a decrease pattern during OGTT in both normal group and type 2 diabetic group,although no statistical dif ference was revealed( P >0.05).(3) Serum leptin levels were correlated to sex,BMI and insulin levels. Conclusions Levels of leptin in newly diagnosed type 2 diabetic patients were not different from those in control subjects.It is likely that short term hyperinsulinemia has no effect on serum leptin levels.