Vicennati V, Gambineri A, Calzoni F, Casimirri F, Macor C, Vettor R, Pasquali R
Dipartimento di Medicina Interna e Gastroenterologia, University of Bologna, Italy.
Metabolism. 1998 Aug;47(8):988-92. doi: 10.1016/s0026-0495(98)90356-0.
Leptin is a hormone produced in the adipose tissue and its concentrations in peripheral blood are significantly correlated with the amount of body fat. Whether other factors, including the pattern of body fat distribution and several hormones (such as insulin, sex steroids, and glucocorticoids), may be involved in the regulation of circulating blood leptin levels is controversial. Women with the polycystic ovary syndrome (PCOS) are hyperandrogenic and most of them are characterized by hyperinsulinemia, insulin resistance, and obesity, particularly the visceral phenotype. To assess the potential contribution of anthropometric factors, androgens, and insulin in determining leptin levels, we examined their relationship with body-mass index (BMI), visceral (VAT) and subcutaneous (SAT) adipose tissue areas, basal androgen levels, and fasting and glucose-stimulated (AUC) insulin in different groups of obese women with PCOS (n = 23) and of age-matched obese (n = 16) and non-obese (n = 10) otherwise healthy controls. The VAT/SAT ratio was measured as a parameter of body fat distribution. Serum leptin levels were significantly higher in obese PCOS women than in obese and normal-weight healthy controls and, within the controls, in the obese than in the non-obese group. In all women considered together, and in each group separately, leptin concentrations were highly significantly correlated with BMI. In addition, after adjusting for BMI, both VAT and the VAT/SAT ratio were positively and significantly correlated with leptin. Partial correlations with the VAT/SAT ratio remained significant in both the obese PCOS group and in controls considered separately, whereas the correlation with the SAT value was significant only in the control group. After adjusting for BMI, no correlation between leptin, androgens and fasting or stimulated (like AUC) insulin was found. These findings indicate that leptin levels in obese women with PCOS are higher than those observed in obese and non-obese controls. Moreover, they suggest that, other than BMI, the pattern of body fat distribution may be an independent factor related to circulating leptin levels, which, on the contrary, do not appear to be related to either androgen or insulin concentrations.
瘦素是一种在脂肪组织中产生的激素，其在外周血中的浓度与体脂量显著相关。包括体脂分布模式和几种激素（如胰岛素、性激素和糖皮质激素）在内的其他因素是否参与循环血中瘦素水平的调节仍存在争议。多囊卵巢综合征（PCOS）女性具有高雄激素血症，其中大多数表现为高胰岛素血症、胰岛素抵抗和肥胖，尤其是内脏型肥胖。为了评估人体测量因素、雄激素和胰岛素在决定瘦素水平方面的潜在作用，我们在不同组的肥胖PCOS女性（n = 23）、年龄匹配的肥胖（n = 16）和非肥胖（n = 10）健康对照中，研究了它们与体重指数（BMI）、内脏（VAT）和皮下（SAT）脂肪组织面积、基础雄激素水平以及空腹和葡萄糖刺激（AUC）胰岛素的关系。VAT/SAT比值作为体脂分布的一个参数进行测量。肥胖PCOS女性的血清瘦素水平显著高于肥胖和正常体重的健康对照，且在对照组中，肥胖组高于非肥胖组。在所有女性总体以及各单独组中，瘦素浓度与BMI高度显著相关。此外，在调整BMI后，VAT和VAT/SAT比值均与瘦素呈显著正相关。在单独考虑的肥胖PCOS组和对照组中，与VAT/SAT比值的偏相关性均保持显著，而与SAT值的相关性仅在对照组中显著。在调整BMI后，未发现瘦素、雄激素与空腹或刺激（如AUC）胰岛素之间存在相关性。这些发现表明，肥胖PCOS女性的瘦素水平高于肥胖和非肥胖对照中的观察值。此外，它们提示，除BMI外，体脂分布模式可能是与循环瘦素水平相关的一个独立因素，相反，循环瘦素水平似乎与雄激素或胰岛素浓度均无关。
