Clinic Study On Relationship Between Leptin,Insulin Resistance In Patients With Nonalcoholic Fatty Liver Diseases

Objective To analyses their mutual correlationship amonganthropometic variables such as body mass indexs(BMI), metabolic variables such as glucose metabolism , lipid profiles , liver functional variables such as alanine aminotransference (ALT) , aspartate aminotransferase (AST) and radioimmunoreactive variables such as fasting serum insulin (FINS) , fasting serum leptin via medical statistical methods. To investtigate both the various degreesof insulin resistance , leptin resistance and the correlationship of insulin resistance with leptin resistance in patients withnonalcoholic fatty liver diseases in order to grasp both theFINS and leptin 's contributors to the pathogenesis of nonalcoholic fatty liver diseases .Method The investtigation was conducted by meansof case control study . 31 cases of patients withnonalcoholic fatty liver diseases and 30 cases of normal ones were divided into two groups according to their body mass indexs(BMI): normal BMI group( BMI < 24kg/m2 ) , obesegroup(BMI 24kg/m2 ), their height, weight, waist circumference , hipcircumference , blood presure , fasting serum glucose (FPG) , total cholesterol (TC) , triglycerides (TG) , high density lipoprotein-cholesterol (HDL-C) , ALT , AST , FINS leveK fasting leptin level were also measured , ISI=1/ (FPG FINS) as insulin sensitivity index. They were used to analyses the correlationship of anthropometicvariables , metabolic variables with fasting serum leptin leveK FINS level and ISI respectively by means of sample ,multiple stepwise regression analysis of correlationship of all variables .Result The level of FINS in patients withnonalcoholic fatty liver diseases were significantly higher than that of controls (p<0.01) , but the ISI was significantly lower than that of controls (p<0.01) . The level of FINS in obesegroup in patients with nonalcoholic fatty liver diseases were significantly higher than that in normal BMI group (p<0.01) , but the ISI in obese group were significantly lower than that in normal BMI group (p<0.01). The level of the femalefasting leptin level in patients with nonalcoholic fatty liverdiseases were significantly higher than that of the male (p<0.05), and the level of fasting serum leptin in patients withnonalcoholic fatty liver diseases were not higher than that of controls (p > 0.05). Sample analysis of correlationship of all variables in patients with nonalcoholic fatty liver diseases showed that: their height, BMI, waist circumference are correlated with fasting serum leptin level(r1=-0.538, r2=0.518, r3=0.364), the ISI is negatively correlated with FINS (r1=-0.651) , both the hip circumference andthe FINS are correlated with ISI (r1=0.485, r2=-0.651) . Multiple stepwise regression analysis showed that in patients withnonalcoholic fatty liver diseases , their waist circumference ,waist-hip ratio (WHR), FINS level are positively correlated with fasting serum leptin ' level (rl=0.484, r2=3.921, r3=0.07616) , their height, weight, AST/ALT, are negatively correlated with fasting serum leptin level (rl=-0.245, r2=-35.986, r3=-1.623) , their FINS level is positively correlated with systolic blood presure ( r=0.997), their weights AST/ALT, FPG, ISI are negatively correlated with FINS level(rl=-0.174, r2=-2.267, r3=-1.321, r4=-2.267, r5=-1733.20) , their height, BMI, FPG, ALT, FINS are negatively correlated with ISI (rl=-0.01225, r2=-0.0009002, r3=-0.0003276, r4=-0.00004741, r5=-0.0002216) , and their hip circumference is positively correlated with ISI( r= 0.0002934). In controls,their weight , AST/ALT , TG are posi...