单纯性肥胖儿童骨密度、25(OH)D3水平与炎症指标及代谢指标的相关性研究

Study on correlation between bone mineral density and 25(OH)D3 level with inflammatory and metabolic indicators in simple obese children

目的探讨单纯性肥胖儿童骨密度、25-羟基维生素D3[25(OH)D3]水平与炎症指标及代谢指标的相关性。方法纳入2018年1月至2020年1月于重庆市渝北区妇幼保健院儿童保健门诊就诊的单纯性肥胖患儿80例作为肥胖组,选取同期于重庆市渝北区妇幼保健院体检的健康儿童65例作为对照组。比较两组骨密度、血清25(OH)D3以及炎症指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、代谢指标[空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、三酰甘油(TG)]水平。分析单纯性肥胖患儿各指标与体质量指数(BMI)的相关性,并观察其骨密度、血清25(OH)D3与各炎症指标、代谢指标的相关性。结果肥胖组血清25(OH)D3、骨密度T值低于对照组(P<0.05),而FBG、HOMA-IR、TG以及血清IL-6、TNF-α、CRP水平均高于对照组(P<0.05)。相关性分析显示,单纯性肥胖儿童的血清25(OH)D3水平、骨密度T值与BMI呈负相关(r<0,P<0.05),FBG、HOMA-IR、TG、IL-6、TNF-α、CRP与BMI呈正相关(r>0,P<0.05)。单纯性肥胖儿童的血清TG、IL-6、TNF-α、CRP与25(OH)D3呈负相关(r<0,P<0.05)。结论单纯性肥胖患儿的血清25(OH)D3水平、骨密度明显下降,且二者均与BMI呈负相关,其中血清25(OH)D3与患儿的机体炎症指标(IL-6、TNF-α、CRP)及TG有相关性,而骨密度与炎症指标(IL-6、TNF-α、CRP)、糖脂代谢指标(FBG、HOMA-IR、TC、TG)无相关性。

Objective To explore the correlation between the bone mineral density and 25-dihydroxyvitamin D3[25(OH)D3]level with the inflammation indexes and metabolic indexes in simple obese children.Methods A total of 80 children with simple obesity visited in the children′s care health clinic of Chongqing Yubei District Maternal and Child Health Care Hospital from January 2018 to January 2020 were included as the obesity group,and 65 healthy children undergoing the physical examination in this hospital during the same period were selected as the control group.The bone density,serum 25(OH)D3 and inflammatory indexes[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]and metabolic indexes[fasting blood glucose(FBG),homeostasis model assessment of insulin resistance index(HOMA-IR),total cholesterol(TC),triglycerides(TG)]levels were compared between the two groups.The correlation between the various indexes and body mass index(BMI)in children with simple obesity was analyzed,and the correlation between BMD and serum 25(OH)D3 with various inflammatory indexes and metabolic indexes was observed.Results The serum 25(OH)D3 and bone mineral density T values of the obese group were lower than those of the control group(P<0.05),while the levels of FBG,HOMA-IR,TG,and serum IL-6,TNF-α,and CRP were higher than those of the control group(P<0.05).The correlation analysis showed that serum 25(OH)D3 level and bone mineral density T value of children with simple obesity were negatively correlated with BMI(r<0,P<0.05),and FBG,HOMA-IR,TG,IL-6,TNF-αand CRP were positively correlated with BMI(r>0,P<0.05).The serum TG,IL-6,TNF-αand CRP levels of children with simple obesity were negatively correlated with 25(OH)D3(r<0,P<0.05).Conclusion Serum 25(OH)D3 level and bone mineral density of simple obese children are significantly decreased,and the both are negatively correlated with BMI,in which serum 25(OH)D3 is correlated with the body inflammation indexes(IL-6,TNF-α,CRP)and TG,but the bone mineral density has no significant correlation with the inflammation indicator(IL-6,TNF-α,CRP),glucose and lipid metabolism indexes(FBG,HOMA-IR,TC,TG).