代谢及炎性因子在肥胖儿童高血压中的作用

Effects of metabolism and inflammatory factors on hypertension in obese children

目的分析肥胖患儿体内代谢紊乱及炎性因子对血压的影响及其在高血压中的作用。方法以2012年6月至2014年8月就诊于西安交通大学第二附属医院小儿内分泌门诊的120例肥胖儿童为研究对象,测量儿童身高、体重、腰围、体质量指数(BMI)及血压,用酶联免疫法检测血中胰岛素(insulin)、分泌型卷曲相关蛋白5(Sfrp5)、Wnt家族分泌性相关蛋白(Wnt5a)、超敏C反应蛋白(hsCRP)和肿瘤坏死因子-α(TNF-α)水平,计算胰岛素抵抗指数(HOMA-IR),并对检测结果进行分析。结果高血压组与非高血压组比较,HOMA-IR、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)指标显著升高(t值分别为3.41、4.27、3.85、6.23,均P<0.05);Sfrp5在肥胖高血压儿童中显著降低(t=6.38,P<0.05),而Wnt5a、hsCRP在肥胖高血压儿童中显著升高(t值分别为5.82、2.98,均P<0.05)。Insulin、腰围、TC、Sfrp5、Wnt5a及hsCRP与SDS-SBP显著相关(回归系数分别为2.69、4.24、3.03、2.94、-2.81及2.32);TC、Sfrp5、Wnt5a及hsCRP与SDS-DBP显著相关(回归系数分别为2.01、1.92、-3.63、2.32)。结论 TC、hsCRP、Wnt5a、Sfrp5与血压密切相关,在高血压发病中具有重要作用。

Objective To evaluate the effects of metabolic disorders and inflammatory factors on hypertension in obese children.Methods From June 2012 to August 2014 totally 120 obese children visiting the Second Affiliated Hospital of Xi＇an Jiaotong University were selected as subjects,and their height,weight,waist circumference,BMI and blood pressure were measured.The blood insulin,Sfrp5,Wnt5 a,hsCRP and TNF-a were measured by ELIS,and HOMA-IR was calculated.Results Compared with non-hypertensive group,HOMA-IR,TG,TC and LDL were significantly increased（t value was 3.41,4.27,3.85 and 6.23,respectively,all P〈0.05）.Sfrp5 in obese children with hypertension reduced significantly（t=6.38,P〈0.05）,but Wnt5 aand hsCRP were significantly increased（t value was 5.82 and 2.98,respectively,both P〈0.05）.Insulin,waist circumference,TC,Sfrp5,Wnt5 aand hsCRP were significantly correlated with SDS-SBP（regression coefficient was 2.69,4.24,3.03,2.94,-2.81 and 2.32）,and TC,Sfrp5,Wnt5 aand hsCRP were significantly correlated with SDS-DBP（regression coefficient was 2.01,1.92,-3.63 and 2.32）.Conclusion TC,hsCRP,Wnt5 aand Sfrp5 are closely related to blood pressure and play a key role in the progression of hypertension.