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

本研究的目的是阐明102名中度肥胖女性（BMI, 29.5±0.5kg/m^2，年龄，47.0±0.9）在3个月期间的血压变化与血清瘦素水平或胰岛素水平的关系。高血压（HT）组（n=31）和正常血压（NT）组（n=71）在减重前的年龄、脂肪量、HOMA、ΣIRI、血浆肾素活性（PRA）和24小时去甲肾上腺素排泄（24hU-NE）均无差异，但HT组的基础瘦素明显高于NT组（n=71）。经过3个月的减肥计划，两组的总腹部脂肪、血清瘦素和ΣIRI显著下降。收缩压、舒张压仅在HT组显著降低，而在NT组无显著降低。24h U-NE仅HT组显著降低。两组减肥后瘦素水平的变化分别与ΣIRI和HOMA的变化显著相关。最后，仅在HT组中，瘦素的变化与平均血压（MBP）的变化之间存在统计学上显著的正相关。多元回归分析显示，所有受试者的MBP变化与24h U-NE的变化以及ΣIRI和HOMA的变化独立相关。然而，仅在HT组中，即使调整了总腹部脂肪、24小时U-NE和ΣIRI（均以基线值的百分比表示），MBP的变化与瘦素水平的变化之间也存在统计学上的正相关。这些结果提示瘦素可能在肥胖高血压的病理生理中起作用。饱和脂肪酸摄入量与ΣIRI呈显著正相关。这些结果表明，摄入饱和脂肪酸可能会增加胰岛素抵抗。

The aims of this study to clarify the relationship between changes in blood pressure and either the serum leptin level or the insulin levels in 102 moderately obese females (BMI, 29.5±0.5kg/m^2; age, 47.0±0.9) during a 3month period. No differences in age, fat-mass, HOMA, ΣIRI, plasma renin activity (PRA) or 24h norepinephrine excretion (24hU-NE) were observed between the hypertensive (HT) group (n=31) and normotensive (NT) group (n=71) before weight loss, but the basal leptin was significantly higher in the HT than in the NT group. After a 3month weight reduction program, the total abdominal fat serum leptin and ΣIRI significantly decreased in both groups. The SBP, DBP significantly decreased only in the HT but not in the NT group. The 24h U-NE significantly decreased only the HT group. The changes in the leptin level were significantly correlated with 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 change in the leptin and the changes in the mean blood pressure (MBP) only in the HT group. Multiple regression analysis revealed that the changes in MBP were independently associated with the changes in 24h U-NE and the changes in either ΣIRI and HOMA in all subjects. However, a statistically positive correlation was observed between the changes in MBP and the changes in leptin levels even adjusting for the total abdominal fat, 24h U-NE and ΣIRI (both expressed as a percentage of the baseline value) only in the HT group. These results suggest that leptin may play a role in the pathophysiology of obese hypertension. In addition, a significant positive correlation was observed between the saturated fatty acid intake and ΣIRI. These results suggest that saturated fatty acid intake may increased insulin resistance.