不同糖耐量状态肥胖儿童血清脂联素的变化及其临床意义

Serum adiponectin level in different glucose tolerance obese children and its clinical significance

目的了解不同葡萄糖耐量状态的肥胖儿童血清脂联素水平,探讨其与年龄、体重指数(BMI)、血脂、血糖及胰岛素水平的关系。方法选择2002～2004年于广州市儿童医院初诊并住院诊治的肥胖儿童52例,分为36例糖耐量正常(NGT)肥胖组和16例糖耐量受损(IGT)肥胖组。测定两组肥胖儿童和41例年龄、性别匹配的正常儿童空腹血清脂联素、胆固醇(CHO)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、血糖和胰岛素(FINS),计算胰岛素抵抗指数(HOMAIR)。肥胖组儿童均做口服葡萄糖耐量试验(OGTT),测定OGTT2h血糖和胰岛素。结果正常对照组、NGT肥胖组及IGT肥胖组血清脂联素水平依次降低,HOMAIR依次升高,且均有统计学意义;相关性分析显示肥胖儿童血清脂联素与TG、LDLC、FINS呈显著负相关(P<0.05)。结论肥胖儿童血清脂联素水平降低,并与血脂、胰岛素抵抗密切相关;与NGT肥胖组相比,IGT肥胖组儿童的血清脂联素水平进一步降低。

Objective To investigate the levels of serum adiponectin in obese children and to explore its clinical significance. Methods From 2002 to 2004 52 obese children （ 16 with IGT and 36 with NGT according to the oral glucose tolerance test ） and 41 normal controls were enrolled in the study. Their ages ranged from 7 to 15 years. Serum glucose and lipid profiles were measured by automatic biochemistry analyzer and serum insulin was determined by electrochemiluminescence immunoassay. Serum adiponectin were detected by ELISA technique. Insulin resistance index （HOMA-IR） and body mass index （ BMI） were calculated. Results Serum level of adiponectin was significantly lower in obese group than that in control group and the lowest in obese group with IGT（ P 〈0. 01 ） ,while HOMA-IR was significantly higher in obese group than that in control group and the highest in obese group with IGT（ P 〈0. 01 ）. Serum adiponectin level in obese group was inversely correlated with TG, LDL-C and FlNS（ P 〈 0. 05）. Conclusion Serum level of adiponectin in obese children is significantly decreased and is related to lipid metabolic disturbance and insulin resistance. Serum level of adiponectin in obese children with IGT is significantly lower than that in obese children with NGT.