肥胖症儿童血浆脑源性神经营养因子水平及其代谢异常的相关性研究  

Research on plasma brain-derived neurotrophic factor level and its correlation with metabolic abnormalities in obese children

作　　者：李英纳 李敏 周澳洋 李平 杨凡 Li Yingna;Li Min;Zhou Aoyang;Li Ping;Yang Fan(Department of Pediatrics,Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西第二医院儿科、出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第1期81-88,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：四川省科技计划重点研发项目(2023YFS0034);四川大学华西第二医院临床学科发展基金(KL119)。

摘　　要：目的探讨肥胖症儿童与体重正常儿童血浆脑源性神经营养因子(BDNF)水平差异,以及其与各代谢表型及代谢指标的关系。方法选择2022年3月至10月于四川大学华西第二医院儿科门诊就诊的41例肥胖症儿童为研究对象,纳入肥胖症组。选择同期于本院门诊进行常规体检的11例非肥胖症健康儿童作为对照,纳入对照组。收集2组受试儿体格生长指标及血浆肌肉因子检测结果,包括BDNF、鸢尾素(irisin)、成纤维细胞生长因子(FGF)-21与白细胞介素(IL)-6及-15水平,以及临床检查结果。采用Mann-Whitney U检验,对2组受试儿血浆BDNF水平进行比较。对2组受试儿及脂、糖、嘌呤代谢异常与正常的肥胖症患儿血浆BDNF水平进行差异倍数(FC)分析,若FC>1.20或<0.83,则判断为具有显著FC。采用Spearman秩相关性分析,对2组受试儿人体质量指数(BMI)、BMI标准差评分(BMI-SDS)及血浆IL-6、irisin水平与其血浆BDNF水平进行相关性分析。本研究已获得四川大学华西第二医院医学伦理委员会的批准(审批文号:医学科研2022伦理审批第084号)。2组受试儿年龄、性别构成比、身高等一般临床资料比较,差异均无统计学意义(P>0.05)。结果①肥胖症组患儿的体重、BMI,均显著高于对照组(t=4.30,P<0.001;Z=-5.05,P<0.001)。②肥胖症组患儿血浆BDNF水平中位数为2402.0 pg/mL(1370.0 pg/mL,3958.5 pg/mL),显著高于对照组的1442.0 pg/mL(933.2 pg/mL,1688.0 pg/mL),差异有统计学意义(Z=-2.10,P=0.036);对2组受试儿血浆BDNF水平进行FC分析结果显示,肥胖症组与对照组受试儿血浆BDNF水平具有显著FC(FC=1.42)。③脂、糖、嘌呤代谢异常的肥胖症患儿血浆BDNF水平,均分别显著高于脂、糖、嘌呤代谢正常的肥胖症患儿,均具有显著FC(FC=1.43、1.47、1.98)。④男性受试儿血浆BDNF水平低于女性受试儿,二者血浆BDNF水平具有显著FC(FC=0.69)。血清25-羟维生素D[25-(OH)-D]重度缺乏、不足受试�Objective To explore the differences in plasma brain-derived neurotrophic factor(BDNF)level between obese and normal children,and its relationship with different metabolic phenotypes and factors.Methods A total of 41 obese children who attended the pediatric outpatient clinic of West China Second University Hospital,Sichuan University from March to October 2022 were selected for the study and included in the obese group.Another 11 cases of non-obese healthy children who underwent routine physical examinations in outpatient clinic of our hospital during the control same period were selected as controls and included in the control group.Physical growth indicators,clinical examination results and plasma muscle factors[BDNF,irisin,fibroblast growth factor(FGF)-21 and interleukin(IL)-6 and-15]levels were collected from the 2 groups.Plasma BDNF levels were compared between the 2 groups by Mann-Whitney U test.Plasma BDNF levels were analysed for fold-change(FC)in children between 2 groups and children with abnormal lipid,glucose and purine metabolism versus normal children,and were judged to have a significant FC if FC was>1.20 or<0.83.Correlations of body mass index(BMI),BMI standard deviation scores(BMI-SDS),and plasma levels of IL-6 and irisin with plasma BDNF level in two groups were analyzed by Spearman′s rank correlation test.The study was approved by the Medical Ethics Committee of West China Second University Hospital,Sichuan University(Approval No.2022-084).The baseline information was not significantly different between the obese and control group(P>0.05),including age,gender ratio,and height.Results①The weight and BMI of the obese group were significantly higher than those in the control group(t=4.30,P<0.001;Z=-5.05,P<0.001).②The median plasma BDNF level of children in obese group was 2402.0 pg/mL(1370.0 pg/mL,3958.5 pg/mL),which was significantly higher than that of control group 442.0 pg/mL(933.2 pg/mL,1688.0 pg/mL),with a statistically significant difference(Z=-2.10,P=0.036);and there was a significa

关 键 词：肥胖症 儿童 脑源性神经营养因子 肌肉因子 代谢异常 脂代谢障碍 葡萄糖代谢障碍 

分 类 号：R723.14[医药卫生—儿科]