Relationship between Leptin，Uric Acid，and Obesity in Type 2 Diabetes Mellitus
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摘要:
目的 研究瘦素（LEP）、血尿酸（SUA）与肥胖的2型糖尿病（T2DM）患者的关系。 方法 111例初诊T2DM患者，根据体重指数（BMI）分为T2DM正常体重组（n = 69），T2DM合并肥胖组（n = 42），比较2组患者LEP、性别、吸烟情况、年龄、饮酒情况、血压、血脂、空腹血糖、OGTT-2h、糖化血红蛋白（HBA1c）、空腹胰岛素（FINS）、餐后2 h胰岛素、HOMR-IR、血尿酸（UA）的差异；采用Logistic回归分析筛选2型糖尿病合并肥胖的独立危险因素。 结果 2组患者比较，饮酒情况、OGTT-2h、HBA1c、UA差异有统计学意义（P < 0.05），而LEP差异无统计学意义（P > 0.05 ）；回归分析显示：UA可进入方程，LEP不能进入方程。 结论 初诊2型糖尿病患者，无论是否合并肥胖，均存在明显的胰岛素抵抗及高瘦素水平；尿酸是2型糖尿病合并肥胖的独立危险因素。 Abstract:Objective To investigate the relationship between leptin（LEP） 、serum uric acid（SUA） and obese patients with type 2 diabetes mellitus（T2DM）. Methods According to body mass index（BMI）, 111 newly diagnosed T2DM patients were divided into normal weight group（69 cases） and T2DM combined with obesity group（42 cases）, The differences in LEP, sex, smoking status, age, drinking status, blood pressure, blood lipid, fasting blood glucose, OGTT-2h, glycated hemoglobin（HBA1c）, fasting insulin（FINS）, insulin 2 hours after meals, HOMR-IR and UA were compared between the two groups. Logistic regression analysis was used to screen the independent risk factors of type 2 diabetes combined with obesity. Results There were statistically significant differences in alcohol consumption, OGTT-2h, HBA1c, and UA between the two groups（P < 0.05）, but no statistically significant differences in LEP between the two groups（P > 0.05）. Regression analysis showed that UA could enter the equation, while LEP could not. Conclusions Patients with newly diagnosed type 2 diabetes, regardless of whether they are combined with obesity, have obvious insulin resistance and leptin levels. Uric acid is an independent risk factor for type 2 diabetes with obesity. -
Key words:
- Type 2 diabetes mellitus /
- Obesity /
- Leptin
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表 1 研究对象的一般资料比较 [
$\bar x \pm s$ /M（P25，P75）]Table 1. Comparison of general data of study [
$\bar x \pm s$ /M（P25，P75）]指标 T2DM正常体重组（n = 69） T2DM合并肥胖组（n = 42） t/χ2 P LEP（ng/mL） 8.20（4.84，9.76 ） 8.24（6.37，9.44 ） −0.454 0.654 性别（男/女） 36/33 27/15 1.560 0.212 吸烟（是/否） 18/51 15/27 1.158 0.282 年龄（岁） 53.87 ± 15.25 46.64 ± 13.96 1.442 0.158 饮酒（是/否） 9/60 15/27 4.266 0.039* SBP（mmHg） 127.35 ± 14.99 121.64 ± 18.73 1.021 0.314 DBP（mmHg） 81.35 ± 9.59 82.36 ± 14.57 −0.255 0.800 身高（m） 1.64 ± 0.07 1.69 ± 0.11 −1.335 0.247 体重（kg） 59.57 ± 6.39 88.86 ± 14.50 −8.486 0.001* BMI（kg/m2） 21.99 ± 1.54 31.12 ± 2.30 −14.489 0.001* TC（mmol/L） 5.09 ± 1.45 5.01 ± 1.04 −0.178 0.860 TG（mmol/L） 1.72（1.25，2.32） 2.24（1.29，3.03） −0.799 0.429 HDLC（mmol/L） 1.10 ± 0.28 0.96 ± 0.17
1.7400.091 LDLC（mmol/L） 3.18（2.16，3.78） 3.14（2.24，3.84） 0.184 0.871 FPG（mmol/L） 7.55 ± 2.01 8.15 ± 1.33 −0.999 0.325 OGTT-2h（mmol/L） 17.03 ± 4.40 14.14 ± 3.34 2.082 0.045* HBA1c（%） 11.58 ± 2.82 9.55 ± 1.99 3.040 0.004* FINS（mIU/L） 44.52 ± 23.65 48.09 ± 12.96 −0.514 0.570 INS-2h（mIU/L） 53.45（39.10，75.22） 63.10（52.12，83.19） 1.152 0.261 HOMR-IR 15.13（10.04，17.45） 15.62（12.46，21.36） 0.993 0.325 UA（µmol/L） 307（202，402） 455（362，499） 3.030 0.002* 25（OH）D3 （ng/mL） 20.70 ± 6.41 19.78 ± 5.62 0.410 0.685 *P < 0.05 。 
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表 2 Logistic回归分析
Table 2. Logistic analysis
因素 B P OR 95%CI OGTT-2h −0.655 0.019* 0.520 0.301～0.897 HBA1c −1.014 0.025* 0.331 0.126～0.873 UA 0.015 0.020* 1.015 1.002～1.029
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