肥胖儿童血浆瘦素水平及其与糖脂代谢的关系

Plasma leptin level and its association with blood glucose and lipid metabolisms in obese children

目的探讨肥胖儿童血浆瘦素水平的变化及其与糖脂代谢的关系,为有效开展儿童肥胖防治工作提供参考。方法随机抽取147例肥胖儿童及118例健康儿童,进行腰围(WC)、腰臀比(WHR)、体脂百分比(%BF)、空腹血糖(FPG)、血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)检测。应用放射免疫法(RIA)测定空腹胰岛素水平(FINS),计算稳态模型胰岛素抵抗指数(HOMA-IR),酶联免疫法(ELISA)测定瘦素水平。结果肥胖儿童的TG、LDL-C、FINS、HOMA-IR、瘦素水平明显高于健康儿童,HDL-C明显低于健康儿童。多元逐步回归分析显示,影响男生瘦素水平的顺序依次为BMI、FINS和%BF,影响女生瘦素水平的顺序依次为BMI和FINS。结论肥胖儿童存在瘦素抵抗、胰岛素抵抗和血脂紊乱,儿童瘦素水平与胰岛素水平密切相关。

Objective To investigate plasma leptin level and its association with blood glucose and lipid metabolisms in obese children, and to provide reference for prevention of childhood obesity. Methods A total of 147 obese and 118 health children were selected. Waist circumference （WC） ,waist to hip ratio （WHR）, percentage of body fat （%BF）, fasting plasma glucose （FPG）, serum triglycerides （TG）, total cholesterol （ TC ）, high density lipoprotein-cholesterol （ HDL-C ）, low density lipoprotein- cholesterol （LDL-C） were examined. The plasma fasting insulin （FINS） levels of children were measured by radioimmunoassay （RIA）. Homeostasis model assessment for insulin resistance （HOMA-IR） were calculated. The plasma leptin levels of children were measured by enzyme-linked immunosorbent assay （ELISA）. Results Obesity group had higher TG, LDL-C, FINS, HOMA-IR, leptin levels and lower HDL-C as compared with those of control group. The multiple stepwise regression analysis showed that BMI, FINS, and %BF had main effects on leptin in boys and BMI, FINS had main effects on leptin in girls. Conclusions Leptin resistance,insulin resistance and dyslipidemia are present in obese children. The leptin level is correlated to the insulin level in children.