Tseng Pei-Wei, Wu Du-An, Hou Jia-Sian, Hsu Bang-Gee
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Division of Metabolism and Endocrinology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Tzu Chi Med J. 2017 Apr-Jun;29(2):109-114. doi: 10.4103/tcmj.tcmj_31_17.
It is well established that patients with metabolic syndrome (MetS) demonstrate elevated levels of serum leptin. The aim of this study is to identify fasting serum leptin as an independent marker of MetS in geriatric diabetic patients.
Sixty-four patients over 65 years old with type 2 diabetic mellitus (T2DM) were assessed for MetS based on the diagnostic criteria of the International Diabetes Federation. Fasting blood samples including serum leptin concentrations were obtained from the participants. Leptin levels were determined using a commercial enzyme immunoassay.
Forty-five (70.3%) of the 64 geriatric T2DM patients enrolled in this study were found to have MetS. This group of participants compared with those in the non-MetS group had higher serum levels of leptin ( = 0.004), triglycerides ( = 0.005), fasting glucose ( = 0.049), glycated hemoglobin ( = 0.016), white blood cells ( = 0.003), C-reactive protein (CRP, = 0.028), insulin ( < 0.001), higher homeostatic model assessment insulin resistance values (HOMA1-IR and HOMA2-IR, both < 0.001), a higher body weight ( = 0.024), body mass index ( < 0.001), body fat mass ( < 0.001), waist circumference ( < 0.001), systolic blood pressure (BP) ( < 0.001), diastolic BP ( < 0.001), percentage of women ( = 0.011), prevalence of hypertension ( = 0.042), and a lower level of serum high-density lipoprotein cholesterol ( = 0.001). Univariate linear analysis of the clinical variables associated with the fasting serum leptin level revealed that height ( = 0.020) had a negative correlation, while body fat mass ( < 0.001) and logarithmically transformed CRP (log-CRP, < 0.001) had positive correlations with serum leptin levels. Multivariate forward step-wise linear regression analysis of the variables significantly associated with fasting serum leptin levels showed that body fat mass ( < 0.001) and log-CRP ( = 0.001) were independent predictors of these values.
Serum leptin is positively correlated with MetS. It serves as an independent marker of MetS in elderly patients with T2DM.
代谢综合征（MetS）患者血清瘦素水平升高已得到充分证实。本研究的目的是确定空腹血清瘦素作为老年糖尿病患者MetS的独立标志物。
根据国际糖尿病联盟的诊断标准，对64例65岁以上的2型糖尿病（T2DM）患者进行MetS评估。从参与者中采集包括血清瘦素浓度在内的空腹血样。使用商业酶免疫测定法测定瘦素水平。
本研究纳入的64例老年T2DM患者中，有45例（70.3%）被发现患有MetS。与非MetS组相比，这组参与者的血清瘦素水平更高（P = 0.004）、甘油三酯水平更高（P = 0.005）、空腹血糖水平更高（P = 0.049）、糖化血红蛋白水平更高（P = 0.016）、白细胞水平更高（P = 0.003）、C反应蛋白（CRP，P = 0.028）、胰岛素水平更高（P < 0.001）、稳态模型评估胰岛素抵抗值（HOMA1-IR和HOMA2-IR，均P < 0.001）更高、体重更高（P = 0.024）、体重指数更高（P < 0.001）、体脂量更高（P < 0.001）、腰围更大（P < 0.001）、收缩压更高（P < 0.001）、舒张压更高（P < 0.001）、女性比例更高（P = 0.011）、高血压患病率更高（P = 0.042），而血清高密度脂蛋白胆固醇水平更低（P = 0.001）。对与空腹血清瘦素水平相关的临床变量进行单变量线性分析发现，身高（P = 0.020）呈负相关，而体脂量（P < 0.001）和对数转换后的CRP（log-CRP，P < 0.001）与血清瘦素水平呈正相关。对与空腹血清瘦素水平显著相关的变量进行多变量向前逐步线性回归分析表明，体脂量（P < 0.001）和log-CRP（P = 0.001）是这些值的独立预测因子。
血清瘦素与MetS呈正相关。它是老年T2DM患者MetS的独立标志物。
