Donahue R P, Prineas R J, Donahue R D, Zimmet P, Bean J A, De Courten M, Collier G, Goldberg R B, Skyler J S, Schneiderman N
Department of Social and Preventive Medicine, University of Buffalo, NY 14214, USA.
Diabetes Care. 1999 Jul;22(7):1092-6. doi: 10.2337/diacare.22.7.1092.
Whether serum leptin levels are associated with insulin resistance independent of the effects of hyperinsulinemia and adiposity is an important unanswered question. We examined the relationship between the rate of insulin-mediated glucose uptake and serum leptin concentrations among nondiabetic men and women.
A cross-sectional analysis was performed among 49 young to middle-aged men and women who participated in the Miami Community Health Study. All participants had measures of insulin resistance (euglycemic-hyperinsulinemic clamp), postchallenge insulin levels, fasting serum leptin levels, and several measures of adiposity.
The rate of insulin-mediated glucose uptake (M in milligrams per kilogram per minute) was significantly associated with leptin concentrations in both men (r = -0.83; P < 0.001) and women (r = -0.59; P < 0.001). M was also inversely related to percent body fat and to the 2-h insulin area under the curve (AUC). After covariate adjustment for sex, percent body fat, and AUC, leptin remained a significant correlate of M (P = 0.04).
Cross-sectionally, leptin was significantly associated with insulin resistance in this nondiabetic sample of men and women. There may be a different physiological mechanism to explain the leptin/insulin resistance association apart from the insulin/adiposity link. Confirmatory evidence awaits the results of clinical trials.
血清瘦素水平是否独立于高胰岛素血症和肥胖的影响而与胰岛素抵抗相关，这是一个重要的尚未解决的问题。我们研究了非糖尿病男性和女性中胰岛素介导的葡萄糖摄取率与血清瘦素浓度之间的关系。
对参与迈阿密社区健康研究的49名年轻至中年男性和女性进行了横断面分析。所有参与者均测量了胰岛素抵抗（正常血糖-高胰岛素血症钳夹）、激发后胰岛素水平、空腹血清瘦素水平以及多项肥胖指标。
胰岛素介导的葡萄糖摄取率（M，单位为毫克/千克/分钟）在男性（r = -0.83；P < 0.001）和女性（r = -0.59；P < 0.001）中均与瘦素浓度显著相关。M还与体脂百分比和曲线下2小时胰岛素面积（AUC）呈负相关。在对性别、体脂百分比和AUC进行协变量调整后，瘦素仍然是M的显著相关因素（P = 0.04）。
在横断面研究中，瘦素与该非糖尿病男性和女性样本中的胰岛素抵抗显著相关。除了胰岛素/肥胖联系外，可能存在不同的生理机制来解释瘦素/胰岛素抵抗关联。确证性证据有待临床试验结果。
