单纯性肥胖儿童血清内脂素与促炎因子的相关性  

The relationship between visfatin and proinflammatory factors in children with simple obesity

作　　者：李瑞珍[1] 卢慧玲[2] 马新瑜[3] 曹中强[1] 常雪凝 陈艳[1] Li Ruizhen;Lu Huiling;Ma Xinyu;Cao Zhongqiang;Chang Xuening;Chen Yan(Department of Child Healthcare,Wuhan Children′s Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430016,China;Department of Pediatrics,Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Department of Radiology,Wuhan Children′s Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院儿童保健科,武汉430016 [2]华中科技大学同济医学院附属同济医院儿科,武汉430030 [3]华中科技大学同济医学院附属武汉儿童医院放射科,武汉430016

出　　处：《中华实用儿科临床杂志》2020年第24期1886-1890,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：湖北省自然科学基金(2018CFB187);湖北省中央引导地方科技发展专项资金(2019ZYYD051);武汉市卫生计生委科研计划资助项目(WX16D17)。

摘　　要：目的探讨单纯性肥胖儿童血清内脂素(visfatin)水平的变化及其与炎症标志物和糖脂代谢参数的相关性。方法选择2009年6月至2011年2月在武汉儿童医院门诊就诊、符合单纯性肥胖诊断标准的肥胖儿童44例(男23例,女21例),同时选择门诊体检的年龄、性别相匹配的正常体质量儿童50例(男23例,女27例)为健康对照组。指派专人进行完整的体格检查,包括人体测量参数(身高、体质量、腰围和血压),测定空腹血清visfatin、高敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、血糖、胰岛素和血脂水平,采用SPSS 15.0软件进行统计分析。结果1.肥胖组儿童血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)均明显高于健康对照组(均P<0.05),而血清高密度脂蛋白胆固醇(HDL-C)均明显低于健康对照组(均P<0.01);肥胖组儿童空腹血糖、空腹胰岛素、胰岛素敏感性指数(HOMA-IR)均明显高于健康对照组(均P<0.01)。2.肥胖儿童血清visfatin、hs-CRP和IL-6水平均明显高于健康对照组,差异均有统计学意义(均P<0.05);肥胖儿童血清TNF-α水平与健康对照组比较差异无统计学意义(P>0.05)。3.肥胖儿童血清visfatin水平与体质量指数(BMI)(r=0.218,P<0.05)、腰围(r=0.332,P<0.05)、TG(r=0.283,P<0.01)均呈正相关;与IL-6(r=0.376,P<0.05)、hs-CRP(r=0.321,P<0.05)均呈正相关;与空腹血糖、空腹胰岛素和HOMA-IR均无相关性;与TNF-α亦无相关性(r=0.085,P>0.05)。4.visfatin与人体测量、代谢参数和炎性因子之间的相关性存在性别差异。visfatin在男童和女童中均与腰围、TG和hs-CRP呈正相关,但仅与男童的BMI(r=0.247,P=0.029)和IL-6(r=0.427,P=0.013)呈正相关。结论肥胖儿童存在明显的糖脂代谢紊乱和胰岛素抵抗。visfatin作为一种内脏脂肪因子,具有调节糖脂代谢和促炎的双层作用,可能参与肥胖相关的代谢紊乱及炎症反应。检测肥胖儿童血清visfatin水平�Objective To investigate the change of serum visfatin concentration in simple obese children and its correlation with inflammatory markers,glucose and lipid parameters.Methods A total of 44 obese children(23 males,21 females)who met the diagnostic criteria of simple obesity were selected,and 50 age-and gender-matched normal weight children(23 males,27 females)were used as the healthy controls.A complete physical examination,including anthropometric parameters(height,body mass,waist circumference and blood pressure),was carried out by a specially assigned person.The fasting serum levels of visfatin,high sensitivity C-reactive protein(hs-CRP),interleukin(IL)-6,tumor necrosis factor(TNF)-α,blood glucose,insulin and blood lipid were measured and analyzed by SPSS 15.0 software.Results(1)The serum levels of total cholesterol(TC),triacylglycerol(TG)and low density lipoprotein-cholesterol(LDL-C)of obese children were significantly higher than those of healthy children(all P<0.05),while the serum high density lipoprotein cholesterol(HDL-C)level was significantly lower than that of healthy children(all P<0.01).The fasting blood glucose level,fasting insulin level and the value of homeostatic model assessment of insulin resistance(HOMA-IR)of obese children were significantly higher than those of healthy children(P<0.01).(2)The serum levels of visfatin,hs-CRP and IL-6 in obese children were significantly higher than those in the healthy control group(all P<0.05);there was no significant difference between the serum levels of TNF-αin obese children and the healthy control group(P>0.05).(3)The serum visfatin level was significantly positively correlated with body mass index(BMI)(r=0.218,P<0.05),waist circumference(r=0.332,P<0.05),TG(r=0.283,P<0.01),IL-6(r=0.376,P<0.05),and hs-CRP(r=0.321,P<0.05),but not significantly correlated with fasting blood glucose,fasting insulin,HOMA-IR,and TNF-α(r=0.085,P>0.05).(4)There were gender differences in the correlation of visfatin with anthropometric parameters,metabolic parameters and in

关 键 词：内脂素 胰岛素抵抗 脂肪因子 儿童 肥胖 

分 类 号：R723.14[医药卫生—儿科]