Apo A5、Alarin、C5a在单纯肥胖儿童高胰岛素血症中评估价值及临床意义

Evaluation value and clinical significance of Apo A5,Alarin,and C5a for hyperinsulinemia in obese children

目的探讨载脂蛋白A5(Apo A5)、脂肪因子Alarin、补体C5a(C5a)在单纯肥胖儿童高胰岛素血症(HINS)中评估价值及意义。方法根据是否有HINS将2020年9月至2023年8月我院收治的302例单纯肥胖儿童分为HINS组、无HINS组,比较两组基线数据与血清Apo A5、Alarin、C5a水平,对相关数据进行统计分析。结果HINS组有糖尿病家族史患儿占比及FINS高于无HINS组(P<0.05);HINS组Apo A5低于无HINS组,Alarin、C5a高于无HINS组(P<0.05);相关性分析显示,Apo A5与FINS呈负相关(r=-0.759,P<0.05),Alarin、C5a与FINS呈正相关(r=0.816、0.829,P<0.05);Apo A5与Alarin、C5a呈负相关(r=-0.841、-0.827,P<0.05),Alarin与C5a呈正相关(r=0.860,P<0.05);线性回归分析显示,控制了糖尿病家族史等混杂因素后,Apo A5、Alarin、C5a仍与单纯肥胖儿童HINS呈显著的相关性(P<0.001);Apo A5、Alarin、C5a评估HINS的AUC依次为0.705、0.725、0.717,Apo A5+Alarin+C5a评估HINS的AUC最高为0.932,敏感度为79.17%,特异度为94.17%(P<0.05)。结论Apo A5、Alarin、C5a是单纯肥胖儿童HINS独立相关影响因素,联合检测三者水平有望成为预测HINS的一个有效方案,三者或可为儿童肥胖及HINS的预防提供新思路。

Objective To evaluate the value and clinical significance of apolipoprotein A5(Apo A5),adipokine Alarin and complement C5a(C5a)for hyperinsulinemia(HINS)in obese children.Methods 302 cases of simple obese children admitted to our hospital from September 2020 to August 2023 were divided into HINS group and non-HINS group according to whether HINS occurred.The baseline data and serum levels of APOA5,Alarin and C5a were compared between the two groups,and the relevant data were statistically analyzed.Results Compared with the non-HINS group,children in the HINS group have a higher proportion in family history of diabetes and fasting insulin levels(FINS);Apo A5 in the HINS group was lower than that in the non-HINS group,while alarin and C5a were higher than those in the non-HINS group(P<0.05).Correlation analysis showed that Apo A5 was negatively correlated with FINS(r=-0.759,P<0.05),while alarin and C5a were positively correlated with FINS(r=0.816,0.829,P<0.05);Apo A5 was negatively correlated with alarin and C5a(r=-0.841,-0.827,P<0.05),while alarin was positively correlated with C5a(r=0.860,P<0.05);Partial correlation analysis showed that after controlling for confounding factors such as family history of diabetes,Apo A5,Alarin and C5a were still significantly correlated with HINS in obese children(P<0.001).The AUC of HINS assessed by Apo A5,Alarin and C5a was 0.705,0.725 and 0.717,respectively.The AUC of HINS assessed by Apo A5+Alarin+C5a was up to 0.932,with a sensitivity of 79.17%and a specificity of 94.17%(P<0.05).Conclusion Apo A5,Alarin and C5a are independent related factors of HINS in simple obese children.Combined detection of the three parameters is expected to become an effective scheme for predicting HINS,which may provide a new idea for the prevention of obesity and HINS in children.