青少年空腹血浆Ghrelin水平改变及其意义

Changes of fasting plasma Ghrelin and its implication in adolescents

目的 探讨青少年空腹血浆Ghrelin水平改变及其意义.方法 选取2006年秦皇岛市青少年肥胖与代谢综合征流行病学调查对象共4604人,排除近期有急慢性炎症个体.通过查取随机数字表,从中随机选取13～15岁青少年158名,根据Ghrelin中位数分为2组各79例：A组（Ghrelin ＜1336.9 ng/L）,B组（Ghrelin≥1336.9 ng/L）,测量身高、体质量及腰围（WC）.空腹静脉采血,测量血糖、真胰岛素（true insulin,TI）和ghrelin水平,计算胰岛素抵抗指数.组间比较采用t检验,相关分析采用Pearson相关,多因素分析应用多元线性回归.结果 （1）A组空腹血糖（FPG）、TI和胰岛素抵抗指数（HOMA-IR）高于B组（P＜0.05）,两组体质指数（BMI）和WC比较差异无统计学意义（P＞0.05）.（2）Ghrelin与FPG（r=-0.367,P=0.000）和In（HOMA-IR）（r=-0.196,P＜0.05）存在单变量相关.多元线性回归显示,以Ghrelin为因变量,FPG（β=-337.2,P=0.000）和ln（HOMA-IR）（β=-160.0,P＜0.05）被引入方程.结论 青少年空腹血浆Ghrelin水平降低与FPG升高和胰岛素抵抗密切相关.Ghrelin水平降低可能是青少年糖代谢异常的保护因素.

Objective To evaluate the variation of fasting plasma ghrelin and its implication in adolescents. Methods In 2006,the study included 158 adolescents aged 13 to 15 years in Qinhuangdao. They were divided into two groups： group A（ n = 79,Ghrelin 〈 1336. 9 ng/L） and group B （n= 79,Ghrelin ≥ 1336.9 ng/L）. Anthropometric measurements including height,weight and waist circumference （ WC ）. Blood samples were collected and fasting plasma glucose （ FPG）,true insulin （ TI ）,and Ghrelin were assayed. The methods used for analysis were t test,Pearson correlation and multiple linear regression. Results （1） Group A had significantly higher levels of FPG,TI,insulin resistance index （HOMA-IR） than group B （P〈0. 05 ）. Body mass index（BMI） and WC showed no significant difference between two groups （ P 〉 0. 05 ）. （ 2 ） Ghrelin showed negative correlation with FPG （ r = - O. 367,P =0. 000） and In（HOMA-IR） （ r = -0. 196,P 〈 0. 05 ）. In multiple regression analyses,FPG（ β = - 337. 2,P =0. 000） and In （HOMA-IR） （ β = - 160. 0,P 〈 0. 05 ） were consistently associated with ghrelin.Conclusions Ghrelin correlated with FPG and HOMA-IR. The data suggests that the lower Ghrelin level may be a protective factor in adolescent with abnormal glucose metabolism.