儿童单纯性肥胖干预前后脑钠肽、心肌素、内脂素及脂糖代谢变化与关系研究

Changes and relationship of brain natriuretic peptide,cardiac myosin,visfatin and lipid glucose metabolism in children with simple obesity before and after intervention

目的 探讨儿童单纯性肥胖干预前后脑钠肽、心肌素、内脂素及脂糖代谢的变化与关系。方法 采用回顾性研究方法,选取2018年1月至2021年12月在江南大学附属医院治疗的单纯性肥胖儿童80例作为观察组,其中轻度、中度和重度肥胖患儿分别为23、40和17例,同时选取正常儿童80名作为对照组。检查各受试者血液脑钠肽、心肌素、内脂素及脂糖代谢指标,同时比较观察组患儿干预前后上述指标的变化情况。结果 观察组和对照组患儿N末端B型利钠肽原(NT-pro BNP)、心肌素比较,差异无统计学意义(P>0.05);观察组患儿内脂素、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、空腹血糖和胰岛素抵抗指数(HOMA-IR)均明显高于对照组,而高密度脂蛋白胆固醇(HDL-C)明显低于对照组,差异均有统计学意义(P<0.05)。观察组不同肥胖程度患儿内脂素、总胆固醇、甘油三酯、LDL-C、空腹血糖、HOMA-IR、HDL-C比较,差异均有统计学意义(P<0.05)。内脂素与总胆固醇、空腹血糖及HOMA-IR呈正相关(P<0.05),其余未见明显相关性。观察组患儿干预前后血液NT-pro BNP、心肌素无明显变化(P>0.05);观察组患儿干预后内脂素、总胆固醇、甘油三酯、LDL-C、空腹血糖和HOMA-IR明显低于干预前,而HDL-C明显高于干预前,差异均有统计学意义(P<0.05)。结论 儿童单纯性肥胖干预前后脑钠肽、心肌素无明显变化,内脂素及脂糖代谢指标改善,其中内脂素及脂糖代谢指标与肥胖程度有关,同时内脂素与脂糖代谢密切相关。

Objective To explore the changes and relationship of brain natriuretic peptide,cardiac myosin,visfatin and lipid glucose metabolism in children with simple obesity before and after intervention.Methods A retrospective study was conducted,80 simple obese children treated in Affiliated Hospital of Jiangnan University from January 2018 to December 2021 were selected as the observation group,including 23,40 and 17 mild,moderate and severe obese children respectively.And 80 normal children were selected as the control group,the blood brain natriuretic peptide,cardiac myosin,visfatin and lipid glucose metabolism indexes of each subject were examined,and the changes of the observation group before and after intervention were compared.Results There were no significant difference in N-terminal pro-B-type natriuretic peptide(NT proBNP)and cardiac myosin between the observation group and the control group,the differences were no statistically significant(P>0.05).Lipoprotein,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),fasting blood glucose and insulin resistance index(HOMA-IR)in the observation group were significantly higher than those in the control group,while high density lipoprotein cholesterol(HDL-C)was significantly lower than those in the control group,the differences were statistically significant(P<0.05).There were significant differences in visfatin,TC,TG,LDL-C,fasting blood glucose,HOMA-IR and HDL-C among children with different degrees of obesity in the observation group(P<0.05).Visfatin was positively correlated with TC,fasting blood glucose and HOMA-IR,the differences were statistically significant(P<0.05),no significant correlation was found in the rest.There were no statistically significant changes in blood NT proBNP and cardiac myosin before and after intervention in the observation group(P>0.05).After intervention,visfatin,TC,TG,LDL-C,fasting blood glucose and HOMA-IR in the observation group were significantly lower than those before intervention,while HDL-C was significantly higher than those before intervention,the differences were statistically significant(P<0.05).Conclusion There are no significant changes in brain natriuretic peptide and cardiac myosin before and after the intervention of simple obesity in children,and the visfatin and indexes of lipid glucose metabolism are improved,the indexes of visfatin and lipid glucose metabolism are related to the degree of obesity,and visfatin is closely related to lipid glucose metabolism.