Widjaja A, Stratton I M, Horn R, Holman R R, Turner R, Brabant G
Department of Diabetes Research Laboratories, Oxford, United Kingdom.
J Clin Endocrinol Metab. 1997 Feb;82(2):654-7. doi: 10.1210/jcem.82.2.3744.
We measured plasma leptin and insulin concentrations across a spectrum of obesity in 829 white Caucasian, 154 Afro-Caribbean, and 204 Asian type 2 diabetic subjects. Although the leptin concentrations covered a large range, there were no subgroups of diabetic subjects with very high or low leptin levels that would suggest mutations in the leptin gene or leptin receptor gene comparable to the obese diabetic ob/ob and db/db mice models respectively. In all three ethnic groups, leptin concentrations correlated with body mass index (BMI) in a similar manner to nondiabetic patients and were higher in females than males after adjustment for BMI, with no difference between ethnic groups. In a multivariate regression analysis, plasma leptin was associated with gender and BMI, (both P < 1 x 10(-17)) and with fasting plasma insulin concentrations (P = 5 x 10(-9)). Subjects treated with insulin had both raised insulin and leptin concentrations. When matched for different therapies, gender, and BMI, diabetic subjects with high leptin levels also had high insulin levels (P < 0.0009). High leptin concentrations may in part be influenced by hyperinsulinemia or impaired insulin sensitivity.
我们测量了829名白人、154名非裔加勒比人和204名亚洲2型糖尿病患者在不同肥胖程度下的血浆瘦素和胰岛素浓度。尽管瘦素浓度范围很广，但没有糖尿病患者亚组的瘦素水平极高或极低，这表明瘦素基因或瘦素受体基因不存在分别与肥胖糖尿病ob/ob和db/db小鼠模型相当的突变。在所有三个种族群体中，瘦素浓度与体重指数（BMI）的相关性与非糖尿病患者相似，在调整BMI后，女性的瘦素浓度高于男性，不同种族群体之间无差异。在多变量回归分析中，血浆瘦素与性别和BMI相关（P均<1×10⁻¹⁷），与空腹血浆胰岛素浓度相关（P = 5×10⁻⁹）。接受胰岛素治疗的受试者胰岛素和瘦素浓度均升高。当根据不同治疗方法、性别和BMI进行匹配时，瘦素水平高的糖尿病患者胰岛素水平也高（P < 0.0009）。高瘦素浓度可能部分受高胰岛素血症或胰岛素敏感性受损的影响。
