Njelekela M, Kuga S, Hiraoka J, Masesa Z, Ntogwisangu J, Mashalla Y, Ikeda K, Mtabaji J, Nara Y, Yamori Y, Tsuda K
Department of Human and Environmental Science, Graduate School of Human and Environmental Studies, Kyoto University, Kyoto 606-8501, Japan.
East Afr Med J. 2003 Apr;80(4):195-9. doi: 10.4314/eamj.v80i4.8641.
To examine the determinants for elevated plasma leptin concentration in normal weight (NW), obese (OB), and morbidly obese (MO) individuals in Tanzania.
Cross-sectional epidemiological study, the CARDIAC study.
Three areas in Tanzania; Dar es Salaam, urban (U), Handeni, rural (R) and Monduli, pastoralists (P), in August 1998.
Five hundred and forty five participants from a random sample of 600 people aged 46-58 years.
Plasma leptin concentrations, height, weight, body mass index (BMI), lipid profiles, haemoglobin A1c (HBA1c), and blood pressure (BP).
Plasma leptin concentrations were higher in women than in men (women; 16.0 ng/mL, men; 3.1 ng/mL; p<0.0001). Women showed a higher mean body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) than men. In both genders, plasma leptin concentration, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), systolic BP (SBP) and diastolic BP (DBP) were significantly higher in OB than in NW participants. MO women had significantly higher leptin concentration, SBP and DBP compared with the other two groups. In NW men, log leptin concentrations showed a direct correlation with weight, BMI, HBA1c, TC, LDL-C, TG, SBP and DBP (all p<0.0001 except TG; p<0.001), while among NW women and OB men, weight and BMI correlated positively with log leptin (all p<0.05). OB women observed a positive correlation between log leptin and weight, BMI and LDL-C. Regression analysis indicated that among NW subjects, gender, BMI and TC explained 53.9% of the variation in log leptin. In OB subjects, gender, BMI and LDL-C explained 51.7% of the variability in leptin levels. No relationship was found between log leptin and CVD risk factors among MO subjects.
The most important determinants for hyperleptinaemia in NW participants were gender, BMI, TC, while in addition to these LDL-C, was an important determinant of leptin concentration in OB individuals. In MO women, the high leptin concentrations did not reflect the amount of adipose stores.
研究坦桑尼亚正常体重（NW）、肥胖（OB）和病态肥胖（MO）个体血浆瘦素浓度升高的决定因素。
横断面流行病学研究，即心脏研究。
1998年8月在坦桑尼亚的三个地区；达累斯萨拉姆市（城市，U）、汉德尼（农村，R）和蒙杜利（牧民区，P）。
从600名年龄在46 - 58岁的人群中随机抽取的545名参与者。
血浆瘦素浓度、身高、体重、体重指数（BMI）、血脂谱、糖化血红蛋白（HBA1c）和血压（BP）。
女性的血浆瘦素浓度高于男性（女性：16.0 ng/mL，男性：3.1 ng/mL；p<0.0001）。女性的平均体重指数（BMI）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）均高于男性。在男女两性中，OB参与者的血浆瘦素浓度、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、收缩压（SBP）和舒张压（DBP）均显著高于NW参与者。MO女性的瘦素浓度、SBP和DBP显著高于其他两组。在NW男性中，瘦素浓度对数与体重、BMI、HBA1c、TC、LDL-C、TG、SBP和DBP呈直接相关性（除TG外，所有p<0.0001；TG：p<0.001），而在NW女性和OB男性中，体重和BMI与瘦素浓度对数呈正相关（所有p<0.05）。OB女性中，瘦素浓度对数与体重、BMI和LDL-C呈正相关。回归分析表明，在NW受试者中，性别、BMI和TC可解释瘦素浓度对数变异的53.9%。在OB受试者中，性别、BMI和LDL-C可解释瘦素水平变异的51.7%。在MO受试者中，未发现瘦素浓度对数与心血管疾病危险因素之间存在关联。
NW参与者高瘦素血症的最重要决定因素是性别、BMI和TC，而在OB个体中，除这些因素外，LDL-C是瘦素浓度的重要决定因素。在MO女性中，高瘦素浓度并未反映脂肪储存量。
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