The Correlation Between Leptin, ADPN And Insulin Resistance Of Hepatogenous Diabetes

Diabetes succeeding to hepatic injury is called hepatogenous diabetes (HD). Previous studies demonstrated that patients with chronic hepatitis and hepatocirrhosis are accompanied with the disorder of sugar tolerance, and that the disorder incidence of sugar tolerance increased gradually with time. However, there are therapeutic contradictions between diabetes and liver cirrhosis. Therefore, it is very important to study the cause and mechanism of hepatogenous diabetes(HD). So far, insulin resistance(IR) has been widely identified as a common causes. In addition, although many studies has been performed in recent years, factors invovled the pathogenesis of HD have not been completely recognized.Leptin(LEP) and adiponectin(ADPN) are principal hormones produced by fat cells. The former is a central signal, the latter is a periphery signal. They interact on each other to balance the body's energy metabolism and homeostasis. Many studys demonstrated that LEP and ADPN play an important role in the pathogenesis of type 2 diabetes and are concerned with IR. To study the relationship between LEP and ADPN has become a hot spot in recent years. Howerer, the relationship between LEP and ADPN in HD has not been intensively studied up to now. In the present study, we analyzed the correlation between LEP and IR in patients with HD. Levels of LEP, fasting plasma glucose (FPG) and serum fasting plasma insulin (FINS) were detected. The value of IR was evaluated by the homeostasis model assessment HOMA-IR, and insulin sensitivity index (ISI) was calculated. The correlation between leptin and IR was analyzed.Methods: 1. Twenty patients with HD were assigned to HD group (group A), twenty patients with cirrhosis were assigned to cirrhosis group (group B), twenty patients with diabetes mellitus were assigned to diabetes mellitus group (group C), and twenty normal subjects (group D) were served as control. 2.â‘ Serum levels of LEP and ADPN were determined by ELISA,â‘¡Levels of FINS were determined by MEIF,â‘¢Levels of FPG were determined using the method of glucose oxidase. 3. The correlations of HOMA-IR, ISI, LEP, ADPN with IR were analyzed.Results: The level of serum FPG in group A was significantly lower than that in group C (p<0.05); FINS in group A was significantly higher than those in group D (p<0.05), The HOMA-IR in group A was higher than group D and lower than group C; ISI was higher than group C and lower than group D(p<0.05). The level of serum of LEP in group A was significantly higher than that in group B and D(p<0.05); ADPN in group A was significantly lower than that in group B and D(p<0.05), LEP levels in group A positively correlated with HOMA-IR, whereas negatively correlated with ISI (p<0.05), The level of serum ADPN negatively correlated with HOMA-IR, whereas positively correlated with ISI (p<0.05).Conclusions: (1) Patients with HD have an incresed serum level of FINS and obvious IR. (2) Patients with HD have an incresed serum level of LEP, which is positively correlated with FINS, HOMA-IR. Higher serum level LEP probably contribute to higher degree of IR. (3) Patients with HD have a decresed serum level of ADPN, which is negatively correlated with FINS, HOMA-IR. Decresed serum levels of ADPN probably contribute to lower degree of IR.