The ratio of leptin to adiponectin can be used as an index of insulin resistance
The ratio of leptin to adiponectin can be used as an index of insulin resistance
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DOI：
10.1016/j.metabol.2007.09.011
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发表时间：
2008-02-01
影响因子：
9.8
通讯作者：
Itoh, Mitsuyasu
中科院分区：
文献类型：
--
作者：
Oda, Naohisa;Iniamura, Shigeo;Itoh, Mitsuyasu
瘦素水平随肥胖而升高，而脂联素水平随肥胖而降低。有研究表明，瘦素/脂联素比值（L/A）与胰岛素抵抗有关。糖尿病患者存在胰岛素分泌功能障碍，胰岛素抵抗的评价比较困难。本研究的目的是检查L/A比值是否是糖尿病患者胰岛素抵抗的有用标志物。我们检查了139名日本2型糖尿病患者（66名女性和73名男性）和7名健康人血清中的L/A。采用口服葡萄糖耐量试验和正常血糖钳夹试验观察瘦素和脂联素水平的变化。21例2型糖尿病患者接受吡格列酮治疗后观察6个月以上，31例2型糖尿病患者接受二甲双胍治疗后观察6个月以上。139例日本2型糖尿病患者的L/A平均值为1.22 ± 1.41（女性为1.68 ± 1.76，男性为0.81 ± 0.80; P = 0.0002）。在钳夹试验中，L/A与葡萄糖输注速率（GIR）相关（r（2）= 0.26，P = .0034）。L/A和GIR的相关性比瘦素（r（2）= 0.144，P = 0.03）或单独的脂联素（r（2）= 0.023，P = 0.41）或胰岛素抵抗的稳态模型评估（r（2）= 0.103，P = 0.08）更强。吡格列酮治疗6个月后，平均血红蛋白A（1c）（HbA（1c））从10.2% +/- 1.2%改善至9.2% +/- 1.6%（P = 0.0037）。我们的研究结果表明，吡格列酮对高L/A和低L/A受试者的HbA（1c）改善有效。二甲双胍治疗6个月后，平均HbA（1c）从9.2% +/- 0.9%改善至8.0% +/- 1.2%（P = 0.0002）。我们的结果表明二甲双胍对低L/A受试者的HbA（1c）改善有效。总之，我们表明，L/A是不同的男性和女性的主题。正常血糖高胰岛素钳夹试验结果表明，L/A与GIR相关，提示L/A可作为糖尿病治疗药物选择的一个有用指标。(C)2008年爱思唯尔公司All rights reserved.
The level of leptin increases with obesity, whereas that of adiponectin decreases with obesity. It is reported that the ratio of leptin to adiponectin (L/A) is associated with insulin resistance. It is difficult to evaluate insulin resistance in diabetic patients who have a dysfunction of insulin secretion. The aim of this study was to examine whether the L/A ratio is a useful marker for insulin resistance in diabetic patients. We examined L/A in the serum of a total of 139 Japanese patients with type 2 diabetes mellitus (66 women and 73 men) and 7 healthy individuals recruited in our hospital. Changes in the levels of leptin and adiponectin were observed using the oral glucose tolerance test and a hyper- and euglycemic clamp test. Twenty-one patients with type 2 diabetes mellitus were observed for more than 6 months after treatment with pioglitazone, and 31 patients with type 2 diabetes mellitus were observed for more than 6 months after the treatment with metformin. The mean value of L/A in 139 Japanese patients with type 2 diabetes mellitus was 1.22 +/- 1.41 (1.68 +/- 1.76 in women, 0.81 +/- 0.80 in men; P = .0002). In the clamp tests, L/A correlated with glucose infusion rate (GIR) (r(2) = 0.26, P = .0034). The correlation of L/A and GIR indicated a stronger correlation than either leptin (r(2) = 0.144, P = .03) or adiponectin alone (r(2) = 0.023, P = .41), or the homeostasis model assessment of insulin resistance (r(2) = 0.103, P = .08). The average hemoglobin A(1c) (HbA(1c)) improved from 10.2% +/- 1.2% to 9.2% +/- 1.6% (P = .0037) in 6 months after treatment with pioglitazone. Our results indicate pioglitazone to be effective for HbA(1c) improvement in subjects with high L/A and low L/A. The average HbA(1c) improved from 9.2% +/- 0.9% to 8.0% +/- 1.2% (P = .0002) in 6 months after treatment with metformin. Our results indicate metformin to be effective for HbA(1c) improvement in subjects with a low L/A. In conclusion, we demonstrate that L/A is different between male and female subjects. The correlation of L/A and GIR by the euglycemic hyperinsulinemic clamp test suggests that L/A is a useful indicator for the choice of drug to treat diabetes mellitus. (C) 2008 Elsevier Inc. All rights reserved.