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目的 :通过对肥胖及伴有 2型糖尿病患者瘦素、C -肽及外周脂肪组织leptin受体表达的研究 ,进一步探讨肥胖及肥胖伴 2型糖尿病患者发生发展的机制。方法 :用放射免疫分析和放射配基结合实验的方法 ,对 91例受检者 (其中肥胖 38例 ,超重 2 3例 ,正常对照 30例 )外周脂肪组织leptin受体的密度及血清中的瘦素、C -肽水平进行检测。结果 :随着BMI的增加 ,瘦素受体密度肥胖组和超重组与正常组比较差异十分显著(p <0 0 1) ,肥胖组与超重组比较有显著性差异 (p <0 0 1) ;而受体与瘦素结合的能力 (Kd值 )没有显著性差异(p >0 0 5 )。三组间的Kd值无差异。从散点分布图可以看出体重指数越大其leptin受体的密度就越小 ,BMI与Bmax相关性 (r=- 0 70 ,p<0 0 1) ;在超重和肥胖伴有 2型糖尿病患者 ,血清中的瘦素和C -肽水平肥胖组比超重组明显升高 ,二者的比值有明显差异 (p <0 0 1) ;血清C -肽增高幅度比瘦素明显 ;血清C -肽水平与体重指数呈正相关。结论 :单纯性肥胖及肥胖伴 2型糖尿病患者血清瘦素、C -肽水平及外周脂肪组织中leptin受体的密度的变化与BMI密切相关 ,肥胖病人所并发的 2型糖尿病与瘦素抵抗和胰岛素抵抗密切相关
OBJECTIVE: To investigate the mechanism of leptin, C - peptide and leptin receptor expression in peripheral adipose tissue of type 2 diabetes mellitus and obese patients with obesity and obesity with type 2 diabetes mellitus. Methods: By radioimmunoassay and radioligand binding assay, the density of leptin receptor in peripheral adipose tissue of 91 subjects (38 obese, 23 overweight and 30 normal controls) and the serum lean Su-C-peptide levels were detected. Results: With the increase of BMI, there were significant differences between the obesity group and the overweight group and the normal group (p <0.01), and there was significant difference between the obesity group and the overweight group (p <0.01) There was no significant difference in the ability of receptor to bind leptin (Kd value) (p> 0.05). There was no difference in Kd between the three groups. From the scatter plot, it can be seen that the greater the body mass index, the lower the density of leptin receptor, the correlation between BMI and Bmax (r = - 0 70, p <0.01); in overweight and obesity patients with type 2 diabetes Serum levels of leptin and C - peptide in obesity group were significantly higher than those in overweight group (p <0.01), serum C - peptide increased more significantly than leptin, serum C - Peptide levels were positively correlated with body mass index. Conclusion: The changes of serum leptin, C - peptide and the density of leptin receptor in peripheral adipose tissue of simple obesity and obesity with type 2 diabetes mellitus are closely related to BMI. The incidence of type 2 diabetes and leptin resistance in obese patients and Insulin resistance is closely related