单纯性肥胖儿童血清生物标志物表达的临床研究  

Expression of serum biomarkers levels in diagosing simple obesity in children

作　　者：周剑昕 杨永青[2] 

机构地区：[1]南京医科大学附属苏州市立医院总部儿科,215002 [2]南京医科大学附属苏州市立医院核医学科,215002

出　　处：《中国医药》2015年第3期416-418,共3页China Medicine

摘　　要：目的研究单纯性肥胖儿童血清生物标志物的表达水平。方法应用放射免疫分析和酶免疫分析测定了186例单纯性肥胖儿童血清瘦素、神经肽Y、胰岛素样生长因子1（IGF-1）和肿瘤坏死因子仪（TNF-α）水平并与80名正常儿童进行比较。采用受试者工作特征曲线（ROC）分析各生物标志物对单纯性肥胖的诊断价值。对血清瘦素、神经肽Y、IGF-1和TNF-α水平进行Spearman秩相关性分析。结果单纯性肥胖儿童血清瘦素、神经肽Y、IGF-1和TNF-α水平较正常儿童明显增高[（14．9±3．6）μg/L比（4．4±0．7）μg/L，（112±25）ng／L比（86±12）ng／L，（242±83）μg／L比（142±62）μg／L，（2．11±0．31）ng／L比（0．93±0．27）ng／L]（P〈0．01或P〈0．05）。ROC曲线分析显示，瘦素的曲线下面积（AUC）为0．932[95％置信区间（CI）：0．895～0．975，P〈0．001，临界值为7．79μg/L，敏感度85．0％，特异度93．8％]；神经肽Y、IGF-1和TNF-α的AUC分别为0．569（95％CI：0．531—0．612，P〈0．05，临界值为97．53ng／L，敏感度51．6％，特异度72．5％），0．634（95％CI：0．598～0．726，P〈0．01，临界值为188．47μg／L，敏感度61．8％，特异度58．8％）和0．864（95％CI：0．813～0．916，P〈0．01，临界值为1．56ng／L，敏感度74．7％，特异度78．8％）。血清瘦素与血清神经肽Y、IGF-1和TNF-α呈正相关（r=0．563，P〈0．05；r=0．761，P〈0．01；r=0．858，P〈0．01）。结论血清瘦素和TNF-α水平对儿童单纯性肥胖的诊断和病情的评估具有较神经肽Y和IGF-1更高的敏感度和特异度。Objective To explore the value of serum biomarkers levels in diagnosing simple obesity in children. Methods The serum leptin, neuropeptide Y, insulin growth factor-1 （IGF-1） and tumor necrosis factor-α（TNF-α） levels were determined by radioimmunoassay and enzyme immunoassay in 186 patients with simple obesity childhood and 80 cases normal childhood as controls. The value of each index in diagnosis of simple obesity childhood was analyzed with receiver operating characteristic （ROC） curve. There was Spearman correlation analysis done among serum leptin, serum neuropeptide Y, IGF-1 and TNF-α. Results The serum leptin, neuropeptide Y,IGF-1 and TNF-α levels in 186 patients with simple obesity childhood were significantly higher than those in 80 cases of normal childhood [ （ 14.9 ± 3.6 ） μg/L vs （ 4.4 ± 0.7 ） μg/L, （ 112 ± 25 ） ng/L vs （ 86 ± 12）ng/L,（242±83）μg/Lvs （142 ±62）μg/L,（2.11 ±0.31）ng/Lvs （0.93±0.27）ng/L± （P〈0.01 orP〈 0.05）. The area under the ROC curve （AUC） for leptin was 0. 932 [ 95% confidence interval （CI） ：0. 895- 0. 975, P 〈 0. 001, critical value 7.79 μg/L, sensitivity 85.0%, specificity 93.8% ] , higher than that for neuropeptide Y （0.569, 95% CI： 0. 531-0. 612 ,P 〈0.05, critical value 97.53 ng/L, sensitivity 51.6% , specificity 72.5 % ）, IGF-1 （0. 634,95 % CI： 0. 598-0. 726,P 〈 0.01, critical value 188.47 p.g/L, sensitivity 61.8% , specificity 58.8% ） and TNF-α （0. 864,95% CI： 0. 813-0. 916, P 〈 0.01, critical value 1.56 ng/L, sensitivity 74.7%, specificity 78.8% ）. There was a positive correlation between the serum leptin with neuropeptide Y, IGF- 1 andTNF-α （r=0. 563,P〈0. 05;r=0. 761,P〈0. 01;r=0. 858,P〈0. 01,respeetively）.Concluslon The serum leptin and TNF-α levels are more sensitive and specific in diagnosing simple obesity in children than neuropeptide Y, IGF-I.

关 键 词：单纯性肥胖 儿童 瘦素 生物标志物 

分 类 号：R723.14[医药卫生—儿科]