中小学肥胖儿童CTRP3、CTRP9水平与糖脂代谢及胰岛素抵抗的相关性

Correlations between CTRP3 and CTRP9 levels and glucose and lipid metabolism and insulin resistance in obese children in primary and secondary schools

目的探讨中小学肥胖儿童血清补体C1q/肿瘤坏死因子相关蛋白(CTRP)3、CTRP9水平与糖脂代谢及胰岛素抵抗的相关性。方法选取2022年3月至2023年9月驻马店市中医院收治的中小学肥胖儿童80例为肥胖组,年龄8~14岁;同期选取中小学超重儿童76例为超重组,年龄8~14岁;同期选取中小学正常体重儿童82例为对照组,年龄8~14岁。收集3组儿童的一般资料(性别、年龄、收缩压、舒张压、腰围、臀围等);采用化学发光免疫法检测空腹胰岛素(FINS)水平,采用葡萄糖氧化酶法检测空腹血糖(FBG)水平,并计算稳态模型胰岛素抵抗指数(HOMA-IR);应用全自动生化分析仪检测总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平;采用酶联免疫吸附试验(ELISA)检测血清CTRP3、CTRP9水平。采用Pearson相关法分析肥胖儿童血清CTRP3、CTRP9与血糖、血脂指标及胰岛素抵抗的相关性;采用多因素logistic回归分析儿童肥胖的影响因素。采用单因素方差分析、SNK-q检验和χ^(2)检验。结果肥胖组腰围、臀围、TC、TG、LDL-C、FINS、FBG、HOMA-IR水平均高于对照组和超重组,且超重组均高于对照组(均P<0.05)。肥胖组HDL-C水平均低于对照组和超重组,且超重组低于对照组(均P<0.05)。肥胖组血清CTRP3[(190.36±60.22)μg/L]、CTRP9[(101.15±26.49)μg/L]水平均低于对照组[(304.83±72.51)μg/L、(152.87±30.96)μg/L]和超重组[(236.75±64.71)μg/L、(124.13±27.89)μg/L],且超重组均低于对照组(均P<0.05)。中小学肥胖儿童血清CTRP3与CTRP9呈正相关(P<0.05),且二者与HDL-C均呈正相关(均P<0.05),与TC、TG、LDL-C、FINS、FBG、HOMA-IR均呈负相关(均P<0.05)。FINS为中小学儿童肥胖的危险因素(P<0.05),CTRP3、CTRP9均为中小学儿童肥胖的保护因素(均P<0.05)。结论血清CTRP3、CTRP9水平降低与中小学儿童肥胖密切相关,可反映儿童糖脂代谢紊乱和胰岛素抵抗。

Objective To investigate the correlations between serum complement C1q/tumor necrosis factor-related protein(CTRP)3 and CTRP9 levels and glucose and lipid metabolism and insulin resistance in obese children in primary and secondary schools.Methods A total of 80 obese children in primary and secondary schools,aged 8-14 years,who were treated in Zhumadian TCM Hospital from March 2022 to September 2023,were selected as the obese group.During the same period,76 overweight children aged 8-14 years in primary and secondary schools were selected as the overweight group,82 normal weight children aged 8-14 years were selected as the control group.The general data(gender,age,systolic blood pressure,diastolic blood pressure,waist circumference,hip circumference,etc.)of the children in the three groups were collected.The fasting insulin(FINS)level was detected by chemiluminescence immunoassay,the fasting blood glucose(FBG)level was detected by glucose oxidase assay,and the homeostasis model assessment insulin resistance(HOMA-IR)was calculated.The levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C)were measured by automatic biochemical analyzer.Serum CTRP3 and CTRP9 levels were detected by enzyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was used to analyze the correlations between serum CTRP3 and CTRP9 levels and blood glucose,blood lipids,and insulin resistance in obese children.Multivariate logistic regression analysis was used to analyze the influencing factors of childhood obesity.One-way analysis of variance,SNK-q test,andχ^(2)test were used.Results The levels of waist circumference,hip circumference,TC,TG,LDL-C,FINS,FBG,and HOMA-IR in the obese group were higher than those in the control group and the overweight group,and those in the overweight group were higher than those in the control group(all P<0.05).The HDL-C in the obese group was lower than that in the control group and the overweight group,and that in the overweight group was lower than that in the control group(all P<0.05).Serum CTRP3[(190.36±60.22)μg/L]and CTRP9[(101.15±26.49)μg/L]levels in the obese group were lower than those in the control group[(304.83±72.51)μg/L and(152.87±30.96)μg/L]and the overweight group[(236.75±64.71)μg/L and(124.13±27.89)μg/L];those in the overweight group were lower than those in the control group(all P<0.05).There was a positive correlation between CTRP3 and CTRP9 in serum of obese children(P<0.05).Both were positively correlated with HDL-C(both P<0.05),and were negatively correlated with TC,TG,LDL-C,FINS,FBG,and HOMA-IR(all P<0.05).FINS was a risk factor for obesity in primary and secondary school children(P<0.05),and CTRP3 and CTRP9 were protective factors for obesity in primary and secondary school children(both P<0.05).Conclusion The decrease of serum CTRP3 and CTRP9 levels is closely associated with obesity in primary and secondary school children,which can reflect the disorder of glucose and lipid metabolism and insulin resistance in children.