单纯性肥胖儿童黑色棘皮症与胰岛素抵抗性及细胞因子的关系

Association of acanthosis nigricans with insulin resistance and adipocytokine in children with simple obese

目的 探讨单纯性肥胖儿童的黑色棘皮症(AN)和体质量指数、胰岛素抵抗性、瘦素、血浆酶原纤维蛋白溶解原活化抑制剂(PAI-1)的关系。方法 单纯性肥胖儿童38例,其中AN阳性17例,测量身高、体质量、腹围、臀围,同时测血胰岛素、瘦素、空腹血糖、PAI-1。结果 AN阳性者肥胖度、腹围、空腹胰岛素、自动动态平衡标准评价胰岛素抵抗指数(HOMA-R)关系有显著差异,AN与体脂肪率间无关。AN阳性肥胖儿中均升高,PAI-1 40μg／L以上,瘦素30 μg／L以上者均为AN阳性。结论 单纯性肥胖儿童,特别是伴AN阳性肥胖儿,要特别注意随访观察2型糖尿病和冠状动脉疾病的发生和发展。

Objective To determine the association of acanthosis nigricans(AN) with values for estimating insulin resistance and adipocytokine levels in simple obese children. Methods These subjects concluded 38 simple obese children. AN was present in 17 of 38 children. Height, weight and abdominal circumference were recorded and fasting blood sample was obtained for measurement of blood glucose, plasma insulin, leptin, and plasminogen activator inhibitor 1 (PAI-1) levels which were known as the risk factors of cardiovascular disease. We obtained homeostasis model assessment insulin resistance index (HOMA-R) by fasting blood glucose and plasma insulin levels. Results The severity of obesity, abdominal circumference, fasting insulin levels and HOMA-R were significantly higher in obese children to AN compared to those without AN. There was the tendency that children with AN had higher levels of leptin and PAI-1 compared to children without AN. Conclusions These results suggest that obese children with AN may have a risk of cardiovascular disease as well as type 2 diabetes mellitus.