Ventricular Remodeling In Patients With Leptin Resistance And Insulin Resistance In Study

Objective:To explore the alteration of plasma leptin and soluble leptin receptor (SLR)in patients with different kinds ventricular remoldling,and to assess the relation between plasma leptin and insulin resistance as well as soluble leptin receptor and insulin resistance.Methods:This study consisted of 180 patients with different kinds ventricular remodeling and 60 cases of healthy controls.The level of fasting plasma leptin,SLR and insulin were examined by means of enzyme linked immunosorbent assay(ELISA) in all subjects.Meanwhile,several biochemical Parameters were measured,including fasting glucose,triglyceride and total cholesterol,et al.Body mass index,waist-hip ratio and other indicators were measured.Left ventricle diastasis interventricular septal thickness(IVST),posterior left ventricular wal1 thickness(PWT),left ventricle inner diastasis diameter(LVIDd) and left ventricular ejection fraction(LVEF)in 180 patients with different kinds ventricular remodeling were measured by color Doppler diasonography,after calculated left ventricular mass index(LVMI).Results:1.Plasma leptin and insulin levels were significantly higher in patients with ventricular remodeling than those of control group(LEP:12.217±6.10VS8.8±5.27,P＜0.01;INS:14.37±7.19VS10.48±5.17,P＜0.01),soluble leptin receptor levels were lower than those of control group(SLR:124.08±62.12VS 164.23±69.60,P＜0.01)。2.Among the three different basic causes of ventricular remodeling in patients,the levels of leptin and insulin were highest in ischemic cardiomyopathy patients compared with patients of hypertensive heart disease and dilated cardiomyopathy. Soluble leptin receptor level showed opposite changes and was the highest in the control group,compared with dilated cardiomyopathy,hypertensive heart disease and ischemic cardiomyopathy.3.Pearson correlation analysis showed that plasma leptin level was positively correlated with FINS(r=0.700,P＜0.01 ),BMI(r=0.422,P＜0.01),WHR(r=0.601, P＜0.01),FAT%(r=0.491,P＜0.01)and female(r=0.693,P＜0.01)in two groups.However the leptin is negatively correlated with soluble leptin receptor,stepwise regression analysis that Leptin,FINS and SLR were isolated factors affecting LVMI in ventricular remoldling,equation:LVMI=107.64+0.399X₅(LEP)+0.106X₆(INS)-0.163 X₇(SLR)。(X5,P＜0.01;X6,P＜0.01;X7,P＜0.05).Conclusion:Plasma leptin levels increase in patients with ventricular remoldling. There are positive relationships between plasma leptin and insulin concentration besides of insulin resistance,but is negatively relationships between leptin and soluble leptin receptor.Description of leptin resistance and insulin resistance involved in the formation of ventricular remodeling.