新疆地区单纯性肥胖儿童血清指标与肾素-血管紧张素-醛固酮系统的关系

The correlation between serum indexes and the renin-angiotensin-aldosterone system in children with simple obesity in Xinjiang area

目的探讨新疆地区单纯性肥胖儿童血清学指标与肾素-血管紧张素-醛固酮(RAS)系统的关系, 为明确儿童肥胖发生机制提供依据。方法按照横断面研究, 采用整群随机抽样的方法选取新疆塔城地区单纯性肥胖儿童41例作为病例组, 年龄(10.04±1.66)岁。同期选取健康正常体质量儿童41例作为对照组, 年龄(10.12±1.68)岁。采用t检验比较2组研究对象血清中脂肪因子、胰岛素、RAS系统指标含量的差异, 采用Pearson检验分析单纯性肥胖儿童血清脂肪因子含量与RAS系统活性的相关性。结果病例组患儿血清中脂肪因子脂联素(APN)水平[(7.90±1.96) μg/L]低于对照组[(8.87±1.61) μg/L](P=0.017), 瘦素(LEP)[(6.81±1.88) ng/L比(5.87±1.79) ng/L]、抵抗素[(12.61±3.63) ng/L比(10.18±3.07) ng/L]均高于对照组(P=0.023、0.002)。病例组血清中RAS系统相关指标肾素[(35.78±10.08) ng/L比(29.24±10.69) ng/L](P=0.007)、醛固酮(ALD)[(106.90±20.18) ng/L比(97.68±17.60) ng/L](P=0.028)、血管紧张素-Ⅱ(Ang-Ⅱ)[(55.65±10.37) ng/L比(48.78±9.26) ng/L](P=0.002)均高于对照组, 差异均有统计学意义。病例组患儿血清中脂肪因子APN含量与肾素、ALD、Ang-Ⅱ呈负相关(r=-0.646、-0.752、-0.839, 均P<0.001), 血清中瘦素、抵抗素含量与肾素、ALD、Ang-Ⅱ呈正相关(r=0.940、0.871、0.875;0.877、0.892、0.914, 均P<0.001)。结论新疆地区学龄期单纯性肥胖儿童血清中脂肪因子表达紊乱, 干扰机体RAS系统的活性。

Objective To investigate the correlation between serum indexes of children with simple obesity in Xinjiang area and the renin-angiotensin-aldosterone(RAS)system,thus providing evidence to clarify the pathogenesis of childhood obesity.Methods It was a cross-sectional study involving 41 children with simple obesity(case group)and 41 age-matched healthy children(control group)through the cluster random sampling in Tacheng area of Xinjiang.The mean age of in both groups was(10.04±1.66)years and(10.12±1.68)years,respectively.Serum adipokines,insulin level and RAS indexes between groups were compared by the Student′s t test.The correlation between serum adipokines and RAS activity in children with simple obesity was assessed by the Pearson′s correlation test.Results The serum adiponectin(APN)level[(7.90±1.96)μg/L vs.(8.87±1.61)μg/L,P=0.017]was significantly lower in case group than that of control group,while leptin[(6.81±1.88)ng/L vs.(5.87±1.79)ng/L,P=0.023]and resistin levels[(12.61±3.63)ng/L vs.(10.18±3.07)ng/L,P=0.002]were significantly higher.RAS indexes,including the renin[(35.78±10.08)ng/L vs.(29.24±10.69)ng/L,P=0.007],aldosterone(ALD)[(106.90±20.18)ng/L vs.(97.68±17.60)ng/L,P=0.028]and angiotensin-Ⅱ(Ang-Ⅱ)[(55.65±10.37)ng/L vs.(48.78±9.26)ng/L,P=0.002]levels were significantly higher in case group than those of control group.In the case group,serum APN level was negatively correlated with renin,ALD and Ang-Ⅱlevels(r=-0.646,-0.752,-0.839,all P<0.001),while serum leptin and resistin levels were positively correlated with renin,ALD and Ang-Ⅱlevels(r=0.940,0.871,0.875;0.877,0.892,0.914,all P<0.001).Conclusions Serum adipokine in school-age children with simple obesity in Xinjiang area is dysregulated,which interferes with the activity of RAS.