单纯性肥胖儿童血浆卡尼汀、游离脂肪酸水平与胰岛素抵抗的相关性

Relationships between Plasma Carnitine,Free Fat Acid Levels and Insulin Resisitance in Children with Simple Obesity

目的了解单纯性肥胖儿童血浆卡尼汀(CT)、游离脂肪酸(FFA)水平与胰岛素抵抗相关参数的关系。方法选择56例确诊为单纯性肥胖的儿童作为研究对象(肥胖组),36例健康体检儿童为健康对照组。采用放射免疫法(RIA)测定二组血浆胰岛素,高效液相色谱法(HPLC)测定血浆CT水平,酶比色法测定血浆FFA及三酰甘油(TG)。计算体质量指数(BMI)及腰臀比(WHR),按稳态模式胰岛素(HOMA-IR)计算其胰岛素抵抗指数(InRI)和胰岛素敏感指数(InSI),应用SPSS13.0软件进行统计学分析。结果肥胖组血浆CT水平为(43.67±12.75)μmol/L,健康对照组为(58.31±21.25)μmol/L,二组比较差异有统计学意义(t=2.566P<0.05)。肥胖组血浆FFA水平为(785.32±284.91)μmol/L,健康对照组为(604.87±136.52)μmol/L,二组比较差异有统计学意义(t=2.143P<0.05)。肥胖组WHR、TG、胰岛素(Ins)水平、InRI与健康对照组比较差异均有统计学意义(Pa<0.05)。血浆FFA与BMI、WHR、TG均呈正相关(r=0.403,0.320,0.406Pa<0.05),与InSI呈负相关(r=-0.364P<0.01);血浆CT与空腹胰岛素(FINS)、InSI呈正相关(r=0.365,0.364Pa<0.01),与WHR呈负相关(r=-0.614P<0.01);肥胖组血浆CT水平与FFA水平呈负相关(r=-0.592P<0.01)。结论肥胖患儿存在明显的脂肪代谢紊乱,血浆FFA及CT水平的变化与胰岛素抵抗密切相关,这些变化可能参与肥胖及肥胖相关并发症的发生。

Objective To investigate the correlations between plasma levels of earnitine（CT）,free fat acid（FFA） and insulin resisitance in children with simple obesity. Methods Fifty - six children diagnosed with simple obesity were enrolled as study group （ obesity group） ,36 healthy ehihiren as control group. The concentration of plasma level of insulin was measured by radioimmunoassay（RIA） ,CT was measured by high performance liquid chromatography（HPLC） , FFA and triglyceride（TG） were measured by enzymatic -colorimetric assay. Body mass index（BMI） and waist to hip ratio（WHR） were caculated. Insulin sensitivity index （InSI） and insulin resistance index （InRI） were cacula-ted by homeostasis model assessment of insulin resistance （HOMA- IR）. SPSS 13.0 software was used to analyze the data. Resuits The concentration of CT in plasma was （43.67 ± 12.75 ） μmol/L in obesity group, （ 58.31 ± 21.25 ） μmol/L in control group, respectively. There was a significant difference between 2 groups （ t = 2. 566 P 〈 0.05 ）. The concentration of FFA in plasma was （785.32 ± 284.91 ） μmol/L in obesity group, （604.87 ± 136.52 ） μmol/L in control group, respectively. There was also a significant difference between 2 groups （ t = 2. 143 P 〈 0. 05 ）. The concentration of FFA had positive correlations with BMI, WHR and TG （ r = 0. 403,0. 320,0. 406 Pa 〈 0.05）, but negative correlation with InSI （ r = - 0. 364 P 〈 0.01 ） ; The concentration of CT had positive correlations with fasting .insulin （FINS） andInSI（r=0.365,0.364 Pa 〈0.01）,but negative correlation with WHR（r= -0.614 P〈0.05）.The concentration of FFA had significant ne-gative correlation with CT in obesity group （r = - 0. 592 P 〈 0. 01 ）. Conclusions There are significant abnormalities of fat metabolism in children with simple obesity. The concentration of CT or FFA has a closly correlation with the pathophysiology of insulin resistance. The changes of CT and FFA in plasma may contribute to obesity and its related complications,more research is needed to clarify the mechanism.