肥胖儿童运动减肥治疗前后的瘦素抵抗 血脂及炎症状态分析

Changes of leptin resistance,blood lipids and inflammatory response before and after the exercise therapy in children with obesity

目的研究显示C-反应蛋白(CRP)、瘦素(Lp)、可溶性瘦素受体(sLR)及多种血脂成分均参与了肥胖的发生发展。本研究旨在探讨运动减肥治疗前后肥胖儿童瘦素抵抗、血脂及炎症状态的改变,以期明确运动对肥胖儿童内分泌环境的影响。方法对51例12岁肥胖儿童进行为期2月的运动减肥治疗,观察血清高敏C反应蛋白(hs-CRP)、Lp、sLR、甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平变化。40例健康体检儿童作为对照组。结果肥胖儿童组血清Lp、TG、TC、LDL-C和hs-CRP水平及体重指数(BMI)均显著高于对照组(均P<0.01),sLR水平低于对照组(P<0.05)。运动减肥治疗后肥胖儿童组血清hs-CRP、Lp、TC、TG和LDL-C水平及BMI与治疗前比较显著下降(P<0.05)。相关性分析显示肥胖儿童血清Lp水平与血脂及hs-CRP呈显著正相关(P<0.05);Lp、hs-CRP与sLR呈显著负相关(P<0.05);hs-CRP与血脂呈显著正相关(P<0.01)。结论肥胖儿童已存在瘦素抵抗及血脂和炎症状态的改变,运动减肥治疗可不同程度地改善这些改变。

Objective Some research has shown that C-reactive protein （CRP）, leptin, soluble leptin receptor （sLR） and blood lipids are involved in the development of obesity. This study aimed to investigate the changes of leptin resistance, blood lipids and inflammatory response before and after the exercise therapy in children with obesity. Methods Fifty-one obese children at ages of 12 years received an exercise therapy for 2 months. The levels of serum leptin, sLR, triglyceride （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C） and high-sensitivity C-reactive protein （hs-CRP） were measured before and after the exercise therapy. Forty normal children served as the control group. Results Compared with the control group, serum levels of leptin, TG, TC, LDL-C and hs-CRP and the body mass index （BMI） in the obese group increased （P 〈0.01 ）, while the serum level of sLR decreased significantly （P 〈0.05）. The levels of hs-CRP, leptin, TC, TG, LDL-C and BMI in the obese group were significantly reduced after the exercise therapy （ P 〈 0.05 ）. In the obese group, the serum leptin level was positively correlated with the levels of blood lipids and hs-CRP （ P 〈 0.05 ） ; serum levels of leptin and hs-CRP were negatively correlated with the sLR level （ P 〈 0.05 ） ; the hs-CRP level was positively correlated with the levels of blood lipids （ P 〈 0.01 ）. Conclusions Leptin resistance and the changes of blood lipids and inflammatory response are found in children with obesity. Exercise therapy can partially improve these changes.