维生素D制剂干预对单纯性肥胖学龄前儿童免疫功能及血清脂肪因子水平的影响

Effect of vitamin D preparation on the immune function and serum fat factors in preschool children with simple obesity

目的探讨维生素D制剂干预对单纯性肥胖学龄前儿童血清免疫球蛋白、T淋巴细胞亚群及脂肪因子(网膜素-1、趋化素、内脂素)水平的影响。方法选取2018年2月至2019年2月诊治的单纯性肥胖学龄前儿童80例作为研究对象,均在饮食及运动干预基础上于每日早餐后口服维生素D制剂,连续服用6个月。观察干预前后体重指数(BMI)及BMI标准差积分(BMISDS),使用化学发光法检测血清25-羟维生素D3[25-(OH)D3]、网膜素-1、趋化素及内脂素水平,使用免疫散射比浊法检测血清免疫球蛋白(Ig)A、IgG、IgM水平,使用流式细胞仪检测血清T淋巴细胞亚群CD3^+、CD4^+、CD8^+绝对计数,用MRFlow分析软件计算CD4^+/CD8^+。结果干预后单纯性肥胖学龄前儿童,其BMI、BMISDS显著低于干预前,血清25-(OH)D3水平明显高于干预前(P<0.01);血清IgA、IgG水平显著高于干预前,IgM水平明显低于干预前(P<0.01);CD3^+、CD4^+水平及CD4^+/CD8^+显著高于干预前,CD8^+水平明显低于干预前(P<0.01);血清网膜素-1水平显著高于干预前,趋化素、内脂素水平明显低于干预前(P<0.01)。单纯性肥胖学龄前儿童BMI、BMISDS与血清IgM、CD8^+、趋化素及内脂素水平分别呈正相关关系,与血清IgA、IgG、CD3^+、CD4^+、CD4^+/CD8^+、网膜素-1水平分别呈负相关关系(P<0.05,P<0.01);血清25-(OH)D3水平与血清IgA、IgG、CD3^+、CD4^+、CD4^+/CD8^+、网膜素-1水平分别呈正相关关系,与血清IgM、CD8^+、趋化素及内脂素水平分别呈负相关关系(P<0.05 P<0.01)。结论适量补充维生素D可明显改善单纯性肥胖学龄前儿童免疫功能,提高血清网膜素-1水平,降低血清趋化素、内脂素水平。

Objective To investigate the effects of vitamin D preparation on serum immunoglobulin and the levels of T lymphocyte subsets and adipokines(Omentin-1,Chemerin,Visfatin)in preschool children with simple obesity.Methods Eighty preschool children with simple obese admitted to hospital from February 2018 to February 2019 were selected as the research subjects.On the basis of diet and exercise intervention,they took vitamin D preparations orally after breakfast every day for 6 months.Before and after the intervention,body mass index(BMI)and BMI standard deviation score(BMISDS)were observed.The chemiluminescence method was used to detect the levels of serum 25 hydroxyvitamin D3[25-(OH)D3],Omentin-1,Chemerin and Visfatin;immunoturbidimetric method was used to detect the serum levels of IgA,IgG and IgM;flow cytometry was used to detect the levels of T lymphocyte subsets(the absolute counts of CD3^+,CD4^+,CD8^+)and CD4^+/CD8^+were calculated by MRFlow analysis software.Results After intervention,BMI and BMISDS were significantly lower than those before intervention,and serum 25-(OH)D3 level was significantly higher than that before intervention(all P<0.01).Compared with those before intervention,the levels of serum IgA,IgG,CD3^+,CD4^+,CD4^+/CD8^+and Omentin-1 significantly increased,and the levels of serum IgM,CD8^+,Chemerin and Visfatin significantly decreased(all P<0.01).BMI and BMISDS were positively correlated with serum levels of IgM,CD8+,Chemerin and Visfatin and were negatively correlated with serum levels of IgA,IgG,CD3^+,CD4^+,CD4^+/CD8^+and Omentin-1(P<0.05,P<0.01);serum 25-(OH)D3 level was positively correlated with serum levels of IgA,IgG,CD3^+,CD4^+,CD4^+/CD8^+and Omentin-1 and was negatively correlated with serum levels of IgM,CD8^+,Chemerin and Visfatin,respectively(P<0.05,P<0.01).Conclusion In preschool children with simple obese,appropriate vitamin D supplementation can significantly improve the immune function,increase the level of serum Omentin-1 and reduce the levels of serum Chemerin and Visfatin.