单纯性肥胖儿童血清胰岛素水平与瘦素、肿瘤坏死因子-α的关系  

Relationships of Serum Leptin,Tumor Necrosis Factor-α and Insulin Resistance in Simple Obesity Children

作　　者：龚敏 李峻峰[2] 孙黎明 黄静宁[3] 陈寿康[2] 金建年[3] 

机构地区：[1]青岛市海慈医疗集团内分泌科,山东青岛266033 [2]青岛市妇女儿童医疗保健中心儿内科,山东青岛266011 [3]武汉市儿童医院内分泌科,武汉430016

出　　处：《实用儿科临床杂志》2007年第8期595-596,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨单纯性肥胖儿童血清胰岛素水平与瘦素(LP)、肿瘤坏死因子-α(TNF-α)的关系。方法肥胖儿童47例依据空腹血清胰岛素和空腹血糖水平,分为高胰岛素血症组(HIG)23例。男16例,女7例;年龄(11.3±2.0)岁。正常胰岛素水平组(NIG)24例。男15例,女9例;年龄(11.8±2.7)岁。并选取同年龄段非肥胖正常儿童10例为健康对照组(NCG)。测量各组身高、体质量、腰围等,检测空腹血清胰岛素(FINS)、LP及TNF-α水平,并计算相关指标,分析它们之间的关系。结果1.HIG组BMI、腰围、臀围、腰臂比(WHR)、LP、TNF-α、胰岛素抵抗指数(HOMA-IR)明显高于NIG组及NCG组(Pa<0.05,0.01);胰岛素敏感指数(HOMA-IAI)低于NIG和NCG组(P<0.05,0.01);2.与NCG组比较,NIG组BMI、腰围、臀围、WHR、LP、HOMA-IR明显增高(Pa<0.05,0.01),HOMA-IAI显著降低(P<0.05),TNF-α、空腹血糖(FBG)比较差异不显著(Pa>0.05);3.HIG组FINS与LP、TNF-α、HOMA-IR分别呈显著正相关(r=0.560,0.413,0.846 P<0.01,0.05,0.01),与HOMA-IAI呈显著负相关(r=-0.823P<0.01),与血糖无相关性。LP、TNF-α与IR独立相关。结论肥胖患儿血清胰岛素水平与LP、TNF-α密切相关,LP、TNF-α致胰岛素抵抗可能是肥胖患儿高胰岛素血症的原因之一。Objective To explore the relationships of serum leptin（ LP）, tumor necrosis factor -α（ TNF -α）and insulin resistance in simple obesity children. Methods Forty - seven children with simple obesity were divided into two groups： high insulin group（HIG） and normal insulin group（NIG） according to the levels of fasting state of serum insulin and glucose. The fasting state of serum insulin（ FINS）, LP ,TNF -α and fasting blood glucose（FBG） were measured. The relationships of LP, TNF -α and insulin resistance index（MOMA-IR） were also analyzed. Results 1. The BMI, waist, hip, waist hip ratio（ WHR）, LP,TNF -α, HOMA -IR were obviously higher in the HIG than those in the NIG and NCG groups （Pa 〈0.05,0. 01 ） ,but the insulin action index（ HOMA- IAI） was lower than that in the NIG and NCG groups（P 〈0.05,0. 01 ）. 2. Compared with NCG group, the BMI, waist, hip, WHR, LP, HOMA - IR were higher in the NIG group （ P 〈 0. 05,0.01 ）, the HOMA - IAI was lower （P 〈 0. 05 ）, the TNF - α, FBG were not very different （ Pa 〉 0. 05 ）. 3. In the HIG group, the FINS was positively correlated to LP, TNF -α and HOMA -IR （r =0.560, 0.413, 0. 864 P〈0.01,0.05,0.01） and negatively correlated to HOMA-IAI （ r = - 0. 823 P 〈 0.01 ）, but was not correlated to FPG. The LP and TNF - α were positively correlated to HOMA - IR independently. Conclusions In simple obesity children the level of insulin is correlated to LP and TNF - α, the insulin resistance by LP and TNF - α is one of the reasons for the hyperinsulinism.

关 键 词：肥胖症 高胰岛素血症 瘦素 肿瘤坏死因子 胰岛素抵抗 

分 类 号：R725.8[医药卫生—儿科]