Leptin, the gene product of adipose tissue that signals caloric plentitudeviacentral nervous system receptors, may also have diverse peripheral metabolic actions. Of paramount interest has been the potential interaction(s) between leptin and insulin. Insofar as insulin alters leptin secretion/action (orvice versa), dysregulation of this system could contribute to disease states such as diabetes.
The purpose of this study was to examine the effect of exogenous insulin on serum leptin in children with newly-diagnosed Type 1 diabetes. Since these patients are hypoinsulinemic (insulindeplet. ed) at diagnosis, they present an ideal opportunity to examine the effect of insulin repletion on serum leptin. Seventeen patients were enrolled. At baseline (prior to insulin therapy), leptin levels were 4.3 ± 1.1ng/ml; they were not statistically related to the baseline serum insulin or illness severity. There was no significant change in serum leptin before, shortly (1–6 days) or several weeks (3–26 weeks) after insulin treatment even when the data was corrected for changes in BMI, hemoglobinA1C, and daily insulin dose. Since repletion of the insulin deficiency that is present in non-acidotic, ambulatory patients with new onset Type 1 diabetes did not alter serum leptin, these results argue against an effect of insulin on serum leptin in the absence of the acute diabetic ketoacidosis. Because as the recuperative months following the diagnosis of new onset Type 1 diabetes are marked by weight gain, the absence of a rise in serum leptin might also indicate either an adaptive (weight permissive) or pathologic (impaired secretory) deficit.
瘦素是脂肪组织的基因产物,能向中枢神经系统受体发出热量丰度信号,也可能对外周代谢产生多种作用。最令人感兴趣的是瘦素与胰岛素之间的潜在相互作用。只要胰岛素能改变瘦素的分泌/作用(反之亦然),这一系统的失调就可能导致糖尿病等疾病。由于这些患者在确诊时处于低胰岛素血症(胰岛素分泌不足)状态,因此为研究胰岛素补充对血清瘦素的影响提供了一个理想的机会。17 名患者被纳入研究。在基线(胰岛素治疗前),瘦素水平为 4.3 ± 1.1ng/ml ;在统计学上,瘦素水平与基线血清胰岛素或病情严重程度无关。胰岛素治疗前、治疗后不久(1-6 天)或治疗后数周(3-26 周),血清瘦素水平均无明显变化,即使根据体重指数、血红蛋白 A1C 和胰岛素日剂量的变化对数据进行校正也是如此。由于在非酸中毒、非卧床的新发 1 型糖尿病患者体内补充胰岛素不足并不会改变血清瘦素,因此这些结果证明,在没有急性糖尿病酮症酸中毒的情况下,胰岛素不会对血清瘦素产生影响。由于新发 1 型糖尿病患者在确诊后的数月恢复期中体重会增加,因此血清瘦素不升高也可能表明存在适应性(体重许可)或病理性(分泌受损)赤字。