Owecki Maciej, Nikisch Elżbieta, Miczke Anna, Pupek-Musialik Danuta, Sowiński Jerzy
Department of Endocrinology and Metabolism, University of Medical Sciences in Poznan, Poznań, Poland.
Neuro Endocrinol Lett. 2010;31(5):679-83.
Glycosylated haemoglobin (HbA1c), leptin, leptin soluble receptors (sOB-R) and free leptin index (FLI) may all be influenced by diabetes, but their associations remain unclear. Therefore, we put forward a hypothesis that serum leptin, sOBR and FLI might be parallel to Hb1c, as they all reflect the metabolic status.
We measured leptin and sOB-R concentrations in 97 obese non-diabetic (47 women and 50 men), and 65 obese diabetic (32 women and 33 men) humans, and examined whether they were related to HbA1c. Under the condition, the presence of diabetes was the only differentiating factor between two groups of frankly obese humans.
Non-diabetic vs. diabetic, median and interquartile range, respectively: Leptin (ng/ml), 30.83, 37.27 vs. 28.24, 23.34; p>0.05; sOB-R (ng/ml), 17.62, 17.05 vs. 21.81, 16.61, p<0.05; FLI, 231.23, 310.00 vs. 131.76, 157.68, p<0.05. To investigate the influence of HbA1c on leptin and sOB-R, both groups were divided into tertiles based on HbA1c. In diabetics, leptin did not differ between the high, intermediate, and low HbA1c levels subgroups, p>0.05, and leptin was not influenced by HbA1c levels: r=0.086; p>0.05. For sOB-R, respectively: p>0.05; r=0.080; p>0.05. In non-diabetics, respectively: p<0.05; r=0.2923; p<0.05 for leptin; and p<0.0001, r=0.5103; p<0.0001, for s-OB-R.
Not leptin alone but serum sOB-R and FLI are the markers of leptin action impairment in type 2 diabetes. Further, HbA1c is not associated with metabolic status of leptin in obese diabetic patients, whereas this association is found in obese non-diabetic humans.
糖化血红蛋白（HbA1c）、瘦素、瘦素可溶性受体（sOB-R）和游离瘦素指数（FLI）可能均受糖尿病影响，但其关联尚不清楚。因此，我们提出一个假设，即血清瘦素、sOBR和FLI可能与Hb1c平行，因为它们都反映代谢状态。
我们测量了97名肥胖非糖尿病患者（47名女性和50名男性）和65名肥胖糖尿病患者（32名女性和33名男性）的瘦素和sOB-R浓度，并检查它们是否与HbA1c相关。在此条件下，糖尿病的存在是两组明显肥胖人群之间唯一的区分因素。
非糖尿病患者与糖尿病患者，中位数和四分位间距分别为：瘦素（ng/ml），30.83，37.27对28.24，23.34；p>0.05；sOB-R（ng/ml），17.62，17.05对21.81，16.61，p<0.05；FLI，231.23，310.00对131.７６，157.68，p<0.05。为研究HbA1c对瘦素和sOB-R的影响，两组均根据HbA1c分为三分位数组。在糖尿病患者中，高、中、低HbA1c水平亚组之间的瘦素无差异，p>0.05，且瘦素不受HbA1c水平影响：r=0.086；p>0.05。对于sOB-R，分别为：p>0.05；r=0.08０；p>0.05。在非糖尿病患者中，分别为：p<0.05；瘦素r=0.2923；p<0.05；对于s-OB-R，p<0.0001，r=0.5103；p<0.0001。
在2型糖尿病中，并非单独的瘦素，而是血清sOB-R和FLI是瘦素作用受损的标志物。此外，在肥胖糖尿病患者中，HbA1c与瘦素的代谢状态无关，而在肥胖非糖尿病患者中发现了这种关联。
