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

本文对102例女性中度肥胖者（体重指数29.5±0.5kg/m^2;年龄47.0±0.9）在3个月内的血压变化与血清瘦素和胰岛素水平的关系进行了研究。高血压组（n=31）和正常血压组（n=71）在体重减轻前的年龄、脂肪量、HOMA、Leptin IRI、血浆肾素活性（PRA）和24 h去甲肾上腺素排泄量（24 hU-NE）无显著差异，但高血压组的基础瘦素水平显著高于正常血压组。经过3个月的减肥计划后，两组的总腹脂、血清瘦素和血清瘦素IRI均显著下降。收缩压、舒张压仅HT组显著降低，NT组无显著变化。24 h U-NE仅HT组显著降低。两组瘦素水平的变化分别与体重减轻后BMI、HOMA的变化显著相关。最后，仅在HT组中观察到瘦素变化与平均血压（MBP）变化之间存在统计学显著正相关。多元逐步回归分析显示，所有受试者MBP的变化与24 h U-NE的变化、NIRI和HOMA的变化独立相关。然而，仅在HT组中观察到MBP变化与瘦素水平变化之间的统计学正相关性，即使调整了总腹部脂肪、24 h U-NE和URIRI（均表示为基线值的百分比）。这些结果表明，瘦素可能在肥胖性高血压的病理生理学中发挥作用。此外，饱和脂肪酸摄入量与BMI呈显著正相关。这些结果表明，饱和脂肪酸的摄入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.