Relationship between changes in the serum leptin and blood pressure after weight loss.

这项研究的目的是阐明中度肥胖女性血压变化与血清瘦素水平或胰岛素水平之间的关系。102例(体重指数29.5±0.5 kg/m^2，年龄47.0±0.9岁)，非糖尿病患者，饮食和运动治疗3个月内未接受任何药物治疗。测定减肥前后的腹部总脂肪、血清瘦素和75gOGTT。将受试者分为高压组(n=31)和高压组(n=71)。两组患者的年龄、脂肪质量、内脏脂肪、HOMA、Σ胰岛素抵抗指数、PRA、24hU-NE在减肥前差异无统计学意义，但基础血清瘦素水平高血压组显著高于正常对照组。血压/舒张压仅在高血压组下降到130/77毫米汞柱，而非高血压组无明显变化。两组患者的血浆肾素活性均下降，而24hU-NE显著降低了…Σ、胰岛素抵抗指数和瘦素水平的变化与两组减肥后内脏脂肪的变化显著相关。内脏脂肪的变化与减肥后单糖和脂肪摄入量的变化呈显著正相关。两组瘦素水平的变化分别与Σ胰岛素抵抗指数和HOMA的变化显著相关。多元回归分析显示，在所有受试者中，血压的变化与24hU-NE的变化、Σ胰岛素抵抗指数或HOMA的变化独立相关。多元回归分析显示，即使在调整了腹脂总量、24hU-NE、Σ胰岛素抵抗指数或HOMA后，血压的变化与瘦素的变化仍呈显著正相关。较少

The aim of this study was to clarify the relationship between changes in the blood pressure and either the serum leptin level or the insulin level in moderately obese females. One-hundred two(BMI 29.5±0.5kg/m^2, age 47.0±0.9), who were nondiabetic and did not receive any medication during a 3 month period under dietary and exercise therapy. We measured the abdominal total fat, serum leptin and 75gOGTT before and after weight loss. The subjects were classified into HT(n=31)and NT(n=71)group. No differences regarding age, fat-mass, visceral fat, HOMA, ΣIRI, PRA or 24hU-NE were observed between the HT and the NT before weight loss, but the basal serum leptin was significantly higher in the HT than in the NT.After a 3 month weight reduction program, the abdominal total fat, serum leptin and ΣIRI significantly decreased in both groups. The SBP/DBP significantly decreased from 144//84 to 130/77 mmHg only in the HT but not in the NT.The PRA decreased in both groups, while the 24hU-NE signific … More antly decreased only in the HT.The changes in the ΣIRI and leptin level significantly correlated to the changes in visceral fat after weight loss in both groups. A significantly positive correlation was observed between the changes of visceral fat and changes of simple carbohydrate and fat intakes after weight loss. The changes in the leptin level significantly correlated to the changes in both ΣIRI and HOMA after weight loss in the two groups, respectively. Finally, a statistically significant positive correlation was observed between the changes in the leptin and the changes in the MBP only in the HT.A multiple regression analysis showed the changes in MBP to be independently associated with the changes in 24hU-NE and the changes in either ΣIRI or HOMA in all subjects. However, a statistically significant positive correlation was observed between the changes in the MBP and changes in the leptin even after adjusting for the total abdominal fat, 24hU-NE and either ΣIRI or HOMA in a multiple regression analysis only in the HT group. Less