视黄醇结合蛋白4与儿童及青少年肥胖的关系

Relationship of Retinol Binding Protein 4 with Obese in Children and Adolescent

目的研究视黄醇结合蛋白4(retinol binding protein 4,RBP4)与肥胖儿童中各种体格检测与生化指标的关系,并进一步探究其对胰岛素抵抗与肥胖的危害。方法本实验分为两组,包括肥胖组与正常对照组。对两组儿童分别进行体格监测,包括身高、体重和腰围的测量、血压测量;生化检查,包括空腹血糖(GLU)、总胆固醇(TG)、总甘油三酯(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和血清胰岛素(INS)水平的检测。同时检测两组儿童血清中的RBP4水平,并探究RBP4与各指标之间的联系,最后用多重线性回归分析肥胖儿童中RBP4的独立危险因素。结果本实验纳入年龄6～15岁的男性儿童45例与女性儿童31例,共计76例儿童。正常男性与女性儿童之间RBP4的血清含量差异无统计学意义(43. 59±19. 18mg/L vs 38. 97±17. 66mg/L,P=0. 086)。肥胖儿童在体重、BMI、腰围、空腹胰岛素水平、HOMA-IR、总胆固醇水平(TC)、低密度脂蛋白(LDLC)与收缩压上明显高于正常对照组儿童。肥胖儿童中RBP4的血清含量也明显高于对照组(P=0. 000)。肥胖儿童中年龄、体重、身高、BMI、腰围、空腹胰岛素水平、HOMA-IR、TC、收缩压等指标与RBP4水平呈正相关。多重线性回归分析发现对于正常体重儿童年龄是RBP4水平增高的独立危险因素(β=0. 470,P=0. 000)。而肥胖儿童中除了年龄(β=0. 118,P=0. 000),BMI(β=1. 569,P=0. 000)与TC(β=0. 223,P=0. 000)也是RBP4水平增高的独立危险因素。结论正常体重和肥胖儿童血清中的RBP4水平都会随着发育和年龄的增加而增高。肥胖儿童中RBP4水平与脂肪组织沉积相关,且RBP4水平与胰岛素抵抗的关系可间接影响肥胖的发生。且年龄、BMI与TC是肥胖儿童RBP4增高的独立危险因素。

Objective To study the relationship between RBP4 and variety of physical and biochemical markers in obese children and explore the dangers of RBP4 to insulin resistance and obesity.Methods The experiment was divided into two groups,including obesity group and normal control group.Anthropometry,fasting glucose,insulin concentrations,total cholesterol,high density lipoprotein (HDL),low density lipoprotein (LDL),triglycerides,systolic and diastolic blood pressure (BP)were measured in both of groups. Meanwhile children were detected for the serum RBP4 levels and the link between RBP4 and various indicators.Then independent risk factors of RBP4 in obese children was analyzed by multiple linear regression.Results The experiment included 45of male children and 31 of female children between ages of 6-15,a total of 76 children.Serum RBP4 levels did not differ between male and female in normal children (43.59±19.18vs 38.97±17.66mg/L,P =0.086).Obese children in weight,BMI,waist cireumferenee,fasting insulin, HOMA -IR,the total cholesterol level (TC),low density lipoprotein (LDL -C)and systolic blood pressure was significantly higher than the control group children.Serum levels of RBP4 was also significantly higher in obese children (P =0.000).The age,weight,height, BMI,waist circumference,fasting insulin,HOMA -IR,TC,systolic blood pressure and other indicators are positively eorrelated with RBP4 levels in obese children.Multiple linear regression analysis revealed age is an independent risk factor for elevated levels of RBP4 in normal weight children (β=0.470,P=0.000).In addition to,ages (β=0.118,P=0.000),BMI (β=1.569,P=0.000)and TC (β=0.223,P =0.000)were independent risk factors of RBP4 in obese children.Conclusion Serum RBP4 levels will be inereased with the development and increasing age in both of normal weight and obese children.RBP4 levels in obese children was associated with adipose tissue deposition,and the relationship between RBP4 and insulin resistanee may indirectly influence the occurrence of obesity.And age,BMI and TC are independent risk factors of RBP4 in obese children.