肥胖患儿血糖、血脂与血浆生长激素释放多肽水平的关系

The relationship between plasma ghrelin levels and glucose and lipid metabolisms of child and adolescent obesity

目的 探讨肥胖患儿血脂和血糖与血浆生长激素释放多肽（ghrelin）水平的关系.方法 选择年龄、性别相匹配的肥胖患儿（肥胖组）和正常体质量儿童（对照组）各30例,采用酶联免疫吸附方法检测血浆ghrelin水平;同步取血采用化学发光法测定血清胰岛素（INS）、C肽（CPE）水平;采用生化仪检测血清空腹血糖（FBG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）.结果 肥胖组血浆ghrelin水平较对照组明显降低[（15.49±1.98）与（19.47±1.50）ng/ml],BMI、腰围、FBG、INS值较对照组明显增高,分别为（28.19 ±3.83）与（21.07±1.53）kg/m2、（88.60±6.13）与（78.52±4.40）cm、（5.23±0.49）与（4.59±0.63）mmol/L、（22.32±3.50）与（16.98±2.50）μIU/L,差异均有统计学意义（均P＜0.01）;TC值较对照组亦明显增高[（5.87±0.88）与（4.05±0.76）nmol/L].肥胖组的血浆ghrelin水平与体质量、BMI、腰围、INS、TC呈显著的负相关,（r=-0.385、-0.466、-0.336、-0.387、-0.373,均P＜0.01）,与FBG呈负相关,（r=-0.324,P＜0.05）,与年龄、身高、CPE、TG、HDL-C、LDL-C等因素无显著相关性.结论 肥胖患儿血浆ghrelin水平明显降低,并与血脂和血糖明显相关.

Objective To explore the relationship between plasma ghrelin levels and glucose and lipid metabolisms of child and adolescent obesity.Methods 30 cases of obesity and 30 healthy normal weisht children and adolescents with same age and gender were selected.Plasma ghrelin level,serum insulin（INS）,C-peptide（CPE）,fasting blood glucose（FBG）,total cholesterol（TC）,triglyceride（TG）,high-density lipoproteins（HDL）,low-density lipoproteins（LDL）were measured.Results For the obesity group：Plasma ghrelin level significantly decreased [（15.49±1.98）vs（19.47 ±1.50）μg/L]compared with control（P＜0.05）;BMI,waistline,FBG,INS were very significantly increased（28.19±3.83）vs（21.07±1.53）kg/m2;（88.60±6.13）vs（78.52 ±4.40）cm;（5.23±0.49）vs（4.59 ±0.63）mmol/L;（22.32 ±3.50）vs（16.98±2.50）μIU/ml,respectively compared with control（all P＜0.01）;TC was significantly increased（5.87±0.88）vs（4.05±0.76）nmol/L compared with control（P＜0.05）.For the plasma ghrelin level of obesity：The relationship between plasma ghrelin level and body weight,BMI,waistline,INS,TC was obviously negative（r=-0.385,-0.466,-0.336,-0.387,-0.373,respectively,all P＜0.01）;The relationship between plasma ghrelin level and FBG was obviously negative（r=-0.324,P＜0.05）;No relationship between plasma ghrelin level and age,body height,CPE,TG,HDLC,LDLC.Conclusion Plasma ghrelin level of children and adolescent obesity was obviously decreased,and was strongly related with disordem of glucose and lipid metabolisms.