肥胖儿童血浆脂联素的变化及临床意义

Level of Plasma Adiponectin and Its Clinical Significance in Children with Obesity

目的:检测儿童血浆脂联素(ADPN)的变化及其与肥胖的关系,探讨ADPN在儿童肥胖症发病的意义。方法:265名儿童随机分为肥胖组和正常对照组,分别测定腰围(WC),臀围,腰臀比(WHR),体脂百分比(%BF),甘油三酯(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C),空腹血糖(FBG),空腹胰岛素(FINS)及ADPN,计算稳态模型胰岛素抵抗指数(HOMA-IR),并分析ADPN与体质量指标、糖脂代谢指标的关系。结果:肥胖组儿童ADPN水平低于正常组儿童(P<0.05),且与BMI、WHR、HOMA-IR、%BF、FINS、TG呈显著负相关(P均<0.05);多元逐步回归分析显示%BF、BMI、HOMA-IR、FINS是影响ADPN的主要因素。结论:肥胖儿童ADPN水平显著下降,且与体脂含量及胰岛素抵抗密切相关。

Objective： To investigate the change of plasma adiponectin（ADPN） level and the relation with obesity and to explore its clinical significance in children obesity. Methods： A total of 265 children were randomly divided into obese group （n = 147） and non-obese group （n = 118）. All. subjects received the determination of waist circumference（WC）, hip circumference, percentage of body fat （%BF）, triglycerides （TG）, total cholesterol （TC）, high density lipoprotein-cholesterol （HDL-C）, low density lipoprotein-cholesterol （LDL-C）, fasting plasma glucose （FPG）, fasting insulin （FINS）, ADPN levels. Homeostasis model assessment for insulin resistance （HOMA-IR） and waist to hip ratio （WHR） were also calculated. The correlations between the levels of plasma ADPN and the parameters of body mass and glucolipid metabolism were analyzed as well. Results： Compared with non-obese children, the Plasma adiponectin levels significantly decreased in obese children （P〈0.05）, and had a negative correlation with the levels of %BF, BMI, WHR and HOMA-IR, FINS and TG （P〈0.05）. Multiple stepwise regression analysis showed that %BF, BMI, HOMA-IR, FINS were the main risk factors for ADPN. Conclusion： The decrease of plasma ADPN level was significantly correlated with %BF and insulin resistance in obese children.