儿童青少年脂肪细胞因子等指标与超重和肥胖关系研究

Relationship of adipocytokines and other indexes with overweight and obesity in children and adolescents

目的探讨儿童青少年的脂肪细胞因子等指标与超重和肥胖的关系。方法调查儿童青少年827人,测量其身高、体重和血压,检测血糖、血脂、空腹胰岛素、瘦素、脂联素、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)等指标,比较超重与肥胖组和正常组的差异,分析其与超重和肥胖的关联性。结果超重与肥胖儿童青少年的胰岛素抵抗、血压升高,血脂异常患病率高于正常组,调整性别和年龄分期因素后,其体重指数(body mass index,BMI)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、载脂蛋白(apolipoprotein,Apo)B、瘦素和TNF-α水平仍高于正常组,与BMI呈正相关(r分别为0.419、0.304、0.249、0.151、0.148、0.432和0.157),而高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和脂联素含量则低于正常人群,并与BMI呈负相关(r分别为-0.112和-0.182),差异和相关均具有统计学意义(P<0.05)。多元线性回归分析得到由瘦素、TNF-α、SBP、IGF-1和年龄因素构成的回归方程可解释BMI信息量的51.2%(F=172.440,P<0.001)。结论超重与肥胖儿童青少年易发生胰岛素抵抗、血压升高,血脂异常等改变,瘦素、TNF-α和IGF-1与儿童青少年的超重和肥胖有关,可能参与超重和肥胖的发生发展。

Objective To explore the association of adipocytokines and other indexes with overweight and obesity in children and adolescents.Methods Height,weight,blood pressure,fasting plasma glucose,blood lipid,fasting insulin,leptin,adiponectin,tumor necrosis factor-α1(TNF-α),insulin-like growth factor 1(IGF-1)and other indicators of 827 children and adolescents were measured,the differences between the overweight and obesity group and the normal control group were compared,and their correlation with overweight and obesity were analyzed.Results The prevalence rates of insulin resistance,elevated blood pressure and dyslipidemia in the overweight and obese children and adolescents were all higher than those in the normal control group.After adjusting for gender and age staging,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),apolipoprotein B(Apo B),leptin and TNF-αlevels of the overweight and obese children and adolescents were still higher than those of the normal control group,and presented a positive correlation with BMI(r=0.419,r=0.304,r=0.249,r=0.151,r=0.148,r=0.432,r=0.157).The content of high density lipoprotein cholesterol(HDL-C)and adiponectin in the overweight and obese children and adolescents was lower than that in the normal controls,and presented a negative correlation with BMI(r=-0.112,r=-0.182).The differences and correlation were statistically significant(all P<0.05).Multiple linear regression analysis showed that the regression equation composed of factors like leptin,TNF-α,SBP,IGF-1 and age could explain 51.2%of BMI variation(F=172.440,P<0.001).Conclusions Overweight and obese children and adolescents are more likely to occur insulin resistance,elevated blood pressure,dyslipidemia and other changes.Leptin,TNF-αand IGF-1 are associated with overweight and obesity of children and adolescents,which may be involved in the occurrence and development of overweight and obesity.