Donahue R P, Zimmet P, Bean J A, Decourten M, DeCarlo Donahue R A, Collier G, Goldberg R B, Prineas R J, Skyler J, Schneiderman N
SUNY at Buffalo, Department of Social and Preventive Medicine, NY 14214, USA.
Ann Epidemiol. 1999 Feb;9(2):108-13. doi: 10.1016/s1047-2797(98)00037-4.
To examine the correlates of plasma leptin, including fasting insulin, adiposity, and several health habits and behaviors among a nondiabetic multiethnic population.
A cross-sectional study was conducted among 25-44 year old African-Americans (n = 126), Cuban-Americans (n = 107), and non-Hispanic whites (n = 189) randomly selected from Dade County Florida. Fasting leptin levels were correlated with fasting insulin, percent body fat, smoking, alcohol use, and physical activity within each sex. Multiple linear regression and analysis of covariance were used to estimate the independent determinants of plasma leptin concentration separately among men and women.
Stepwise linear regression analyses revealed statistically significant associations of leptin with percent body fat, fasting insulin, cigarette smoking, and physical activity (both inversely) among men (p < 0.05 for each). Among women, percent body fat, fasting insulin (both positively), cigarette smoking, and alcohol use (inversely) were independent predictors of leptin levels explaining over 70% of the variance. Analyses of covariance revealed that women had higher adjusted mean leptin levels than men (13.1 ng/ml vs. 5.9 ng/ml; p < 0.001), whereas no separate effect of ethnicity was noted.
Although adiposity was the strongest correlate of leptin levels, fasting insulin and several health habits and behaviors were independently associated with leptin. After adjustment for these factors, women had significantly higher mean leptin levels than men. The independent association among leptin and insulin levels is intriguing and suggests additional avenues for epidemiologic research.
研究非糖尿病多民族人群中血浆瘦素的相关因素，包括空腹胰岛素、肥胖及几种健康习惯和行为。
对从佛罗里达州戴德县随机选取的25 - 44岁非裔美国人（n = 126）、古巴裔美国人（n = 107）和非西班牙裔白人（n = 189）进行横断面研究。分别在男性和女性中，将空腹瘦素水平与空腹胰岛素、体脂百分比、吸烟、饮酒及身体活动进行相关性分析。采用多元线性回归和协方差分析分别估计男性和女性血浆瘦素浓度的独立决定因素。
逐步线性回归分析显示，在男性中，瘦素与体脂百分比、空腹胰岛素、吸烟及身体活动（均呈负相关）存在统计学显著关联（每项p < 0.05）。在女性中，体脂百分比、空腹胰岛素（均呈正相关）、吸烟及饮酒（呈负相关）是瘦素水平的独立预测因素，可解释超过70%的变异。协方差分析显示，女性调整后的平均瘦素水平高于男性（13.1 ng/ml对5.9 ng/ml；p < 0.001），而未发现种族的单独影响。
虽然肥胖是瘦素水平最强的相关因素，但空腹胰岛素及几种健康习惯和行为与瘦素独立相关。在对这些因素进行调整后，女性的平均瘦素水平显著高于男性。瘦素与胰岛素水平之间的独立关联很有趣，为流行病学研究提供了新的途径。
