Department of Nutrition and Food Hygiene, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
PLoS One. 2013;8(1):e54615. doi: 10.1371/journal.pone.0054615. Epub 2013 Jan 22.
Insulin resistance contributes to the cardio-metabolic risk. The effect of leptin in obese and overweight population on insulin resistance was seldom reported.
A total of 1234 subjects (572 men and 662 women) aged ≥18 y was sampled by the procedure. Adiposity measures included BMI, waist circumference, hip circumference, WHR, upper arm circumference, triceps skinfold and body fat percentage. Serum leptin concentrations were measured by an ELISA method. The homeostasis model (HOMA-IR) was applied to estimate insulin resistance.
In men, BMI was the variable which was most strongly correlated with leptin, whereas triceps skinfold was most sensitive for women. More importantly, serum leptin levels among insulin resistant subjects were almost double compared to the subjects who had normal insulin sensitivity at the same level of adiposity in both men and women, after controlling for potential confounders. In addition, HOMA-IR increased significantly across leptin quintiles after adjustment for age, BMI, total energy intake, physical activity and smoking status in both men and women (p for trend <0.0001).
There was a significant association between HOMA-IR and serum leptin concentrations in Chinese men and women, independently of adiposity levels. This may suggest that serum leptin concentration is an important predictor of insulin resistance and other metabolic risks irrespective of obesity levels. Furthermore, leptin levels may be used to identify the cardio-metabolic risk in obese and overweight population.
胰岛素抵抗会导致心脏代谢风险。瘦素在肥胖和超重人群中对胰岛素抵抗的影响鲜有报道。
本研究通过程序共抽取了 1234 名年龄≥18 岁的受试者(572 名男性和 662 名女性)。肥胖指标包括 BMI、腰围、臀围、腰臀比、上臂围、三头肌皮褶和体脂百分比。采用 ELISA 法检测血清瘦素浓度。应用稳态模型(HOMA-IR)评估胰岛素抵抗。
在男性中,与瘦素相关性最强的变量是 BMI,而女性中最敏感的变量是三头肌皮褶。更重要的是,在控制了潜在混杂因素后,无论男女,在相同的肥胖水平下,胰岛素抵抗患者的血清瘦素水平几乎是胰岛素敏感性正常者的两倍。此外,在男性和女性中,经过年龄、BMI、总能量摄入、体力活动和吸烟状况的调整后,HOMA-IR 随着瘦素五分位的增加而显著升高(趋势 p<0.0001)。
在中国男性和女性中,HOMA-IR 与血清瘦素浓度之间存在显著相关性,独立于肥胖水平。这可能表明,血清瘦素浓度是胰岛素抵抗和其他代谢风险的重要预测因子,而与肥胖水平无关。此外,瘦素水平可用于识别肥胖和超重人群的心脏代谢风险。