Clinical Study On Determination Of The Serum Leptin And Insulin In The Patients With Chronic Alcoholism

Objective:To study the effect of serum leptin and insulin level changes in patients with chronic alcoholism on insulin sensitivity and investigate the relationship between alcoholism and stroke, to provide a new basis for clinical diagnosis and treatment of chronic alcoholism and explore the mechanism of alcoholism.Methods:Selected 54 patients with chronic alcoholism, all in accordance with alcohol-induced mental disorders (refer to the Chinese classification and diagnostic criteria for mental disorders CCMD-3) diagnostic criteria, and history of drinking more than five years. The patients with alcoholism is divided into 5-10 years group(n=17), 10-20 years group(n=19),20-30 years group(n=18) according to drinking ages. The patients with alcoholism was divided into abnormal CT group(n=28) and normal CT group(n=26) according to exsit cerebral atrophy and cerebrovascular disease in CT. And selected 33 cases of healthy individuals as control group.The levels of serum leptin, insulin were detemined with RIA (radio-immunity analysis) in alcoholism group and the control group.The insulin sensitivity index(ISI),the insulin resistance(IR) of the subjects were caculated by blood fasting glucose, serum insulin levels.Results:(1) The levels of serum leptin, blood fasting glucose, SBP, cholesterol, IR in alcoholism group were significantly higher than those in control group(P<0.01). The levels of ISI, HDL in alcoholism group were significantly lower than those in control group(P<0.001).The levels of serum insulin, TG, LDL, DBP, there were no significant difference between alcoholism group and the control group(P>0.05). (2) With the increasing of drinking age IR was increased because of the levels of serum leptin, insulin in alcoholism group were increased, the level of ISI was decreased.The levels of serum leptin, insulin there were no significant difference between the 5-10 years group, the 10-20 years group, the 20-30 years group and in the control group(P>0.05). The levels of IR and ISI, there were significant difference between the 5-10 years group, the 10-20 years group, the 20-30 years group and in the control group(P<0.01, P<0.05, respecteively). The levels of ISI in 5-10 years group,10-20 years group,20-30 years group were significantly lower than that in the control group(P<0.05). The levels of IR in 10-20 years group and 20-30 years group were significantly higher than that of the control group(P<0.05). (3) The prevalence of diabetes mellitus in alcoholism group was significantly higher than that in the control group(P<0.001). The prevalence of metabolic syndrome, hypercholesterolemia, central obesity, hypertension in alcoholism group were significantly higher than those in the control group(P<0.01). The level of overall obesity in alcoholism group was significantly lower than that in the control group(P<0.01). (4) The level of BMI in alcoholism group was significantly lower than that in the control group(P<0.01). The level of WHR, WHtR, WC, there were no significant difference between alcoholism group and the control group (P>0.05). (5) The levels of serum leptin and ISI, there were significant difference between the abnormal CT group, the normal CT group and in the control group(P<0.05). The levels of serum insulin there were no significant difference between the abnormal CT group, normal CT group and in the control group (P>0.05). The levels of serum leptin in abnormal CT group and normal CT group were significantly higher than that in the control group(P<0.05).The levels of ISI in abnormal CT group and normal CT group were significantly higher than that in the control group(P<0.01).Conclusion:(1) Chronic alcoholism can increase the level of serum leptin, and the level of serum leptin in alcoholism was increased with ISI negative correlation and increased with the drinking year, insulin and IR positive correlation. (2) Chronic alcoholism can increase prevalence of the metabolic syndrome and diabetes, hypertension, hyperlipidemia and other related diseases. (3) Chronic alcoholism can increase the level of serum leptin, it might be related to reducing ISI and participating in the formation of IR, it is one of the mechanisms of alcoholism leading to cerebrovascul-ar disease.