儿童肥胖脂肪因子与血管内皮功能、氧化应激的关系研究

Relationship among childhood obesity adipokines,vascular endothelial function and oxidative stress

目的探讨儿童肥胖脂肪因子与血管内皮功能和氧化应激的关系。方法将2009年12月至2012年12月在东阳妇女儿童医院诊断的肥胖症患儿160例纳入肥胖组,随机抽取同期体检的健康儿童50例纳入对照组。采用ELISA法分别对两组儿童血清瘦素(LP)、内脂素(VFT)和肿瘤坏死因子-α(TNF-α)脂肪因子进行检测,采用高分辨率超声检测肱动脉扩张力,评估两组儿童血管内皮功能,采用相应的方法检测丙二醛(MDA)、维生素E、低密度脂蛋白胆固醇(LDL-C)。结果肥胖组儿童血清中LP、VFT和TNF-α表达水平均高于对照组,差异均有统计学意义(t值分别为0.043、0.039和0.042,均P<0.05)。肥胖组儿童肱动脉反应性充血后及含服硝酸甘油(GTN)后相对于静息状态的扩张百分率均低于对照组,差异均有统计学意义(t值分别为0.049和0.047,均P<0.05)。血清LP、VFT、TNF-α指标表达水平与肱动脉扩张百分率均呈负相关(r_(LP)=-0.407、r_(VFT)=-0.397、r_(TNF)=-0.420,均P<0.05)。与对照组相比,肥胖组的LDL-C和MDA较高(t值分别为0.037和0.039,均P<0.05),血浆维生素E水平较低(t=0.031,P<0.05)。结论肥胖儿童血清LP、VFT、TNF-α脂肪因子表达水平与血管内皮功能呈负相关,肥胖儿童体内存在氧化应激。

Objective To explore the relationship between childhood obesity adipokines and vascular endothelial function and oxidative stress. Methods From December 2009 to December 2012 160 children were diagnosed with obesity in Dongyang Women and Children＇ s Hospital, and they were recruited in obesity group. Another 50 healthy children taking physical examination at the same period were randomly selected in control group. ELISA method was use to detect serum LP, VFT and TNF-α adipokine, and brachial artery dilation was detected by using high resolution ultrasound. Vascular endothelial function of two groups was assessed, and corresponding methods were applied to detect MDA, vitamin E and LDL-C. Results Expressions of serum LP, VFT and TNF-α adipokine in the obesity group were higher than those of the control group, and the difference was significant （ t value was 0.043, 0. 039 and 0.042, respectively, all P 〈 0.05 ）. The dilation percentage of the obesity group after reactive hyperemia and after sublingual GTN was lower than the control group, and the difference was statistically significant （t value was 0. 043, 0. 039 and 0. 002, respectively, all P 〈 0.05 ）. The expressions of serum LP, VFT and TNF-oL3 showed negative correlation with brachial artery dilation percentage （ rLP = - 0. 407; rVFT = - 0. 397, rTNf-α= - 0. 420, all P 〈 0.05）. Compared with the control group, LDL-C and MDA increased significantly in the obesity group （ t value was 0.037 and 0.039, respectively, both P 〈 0. 05 ） but plasma vitamin E level decreased significantly （ t = 0. 031, P 〈 0.05 ）. Conclusion The expressions of serum LP, VFT and TNF-α adipokine are negatively correlated with vascular endothelial function in obese children. Oxidative stress exists in obese children.