儿童青少年脂肪细胞因子与肥胖度的关系研究

探讨儿童青少年血中胰岛素、瘦素、脂联素和抵抗素水平与肥胖程度的关系。 方法　选择2004年北京市儿童青少年代谢综合征（BCAMS）调查总样本中的3511例（男1790例，女1721例） 6～18岁儿童青少年为研究对象，依据体重指数值分类标准将所有研究对象分为正常体重组1626例、超重组655例和肥胖组1230例。利用酶联免疫吸附试验法（ELISA）检测研究对象空腹血脂肪细胞因子水平。采用协方差分析比较超重组、肥胖组与正常体重组间脂肪细胞因子的差异；不同肥胖程度对预测脂肪细胞因子异常的作用采用多因素Logistic回归分析。结果　超重、肥胖组儿童血中胰岛素、瘦素水平高于正常体重组，并随着肥胖程度的增加而升高，且具有明显的男女性别差异；脂联素水平则随着肥胖程度的增加而降低；抵抗素水平仅见肥胖组与正常体重组儿童比较差异有统计学意义。采用多因素Logistic回归模型调整年龄、性别和青春发育期，以正常体重组为参照，进行对比分析。结论　儿童青少年血中胰岛素、瘦素、脂联素水平与肥胖程度密切相关，脂肪细胞因子异常检出率随着体重的增加而升高，因此，在儿童青少年时期控制体重、降低肥胖程度对预防“儿童成人慢性病”至关重要。

Relationship between adipocytokines and adiposity in children and adolescents.

To explore the relationship between adipocytokines and the degree of obesity in children and adolescents. Methods　Based on the Beijing child and adolescent metabolic syndrome （BCAMS） study in 2004， 3511 children （1790 boys and 1721 girls） aged 6～18 were recruited. In this study， participants were categorized into three groups： 1626 cases in normal weight group（non-obese group）， 655 cases in overweight  group and 1230 cases in obese group， according to the sex， age and specific body mass index（BMI） . The levels of  adipocytokines  were measured by sensitive， specific double - antibody sandwich enzyme - linked immunosorbent assays （ELISA） . Analysis of covariance and multiple binary logistic regression analysis were performed in statistical analysis. Results　The levels of plasma insulin and serum leptin in overweight group and obese group were higher than those in non-obese group， and they increased with the increase of the degree of obesity. There were significant differences in sex.The level of serum adiponectin decreased as the degree of obesity increased. There was higher serum resistin level only in obese group than that in non- obese group.After adjustment for sex，age and pubertal development in multiple binary Logistic regression analysis ， the odds ratios  （OR ） and 95% confidence intervals of overweight and obesity were 4.38（3.37～5.70） and 12.75（10.11～16.08） for predicting hyperinsulinemia， respectively， 10.42（7.46～14.57） and 41.53 （30.23～57.07） for hyperleptinaemia， respectively， 1.88（1.50～2.35） and 2.81（2.33～3.39） for  ypoadiponectinaemia， respectively， 1.07（0.86～1.34） and 1.32（1.10～1.57） for hyperresistinaemia ， respectively. Conclusion　The levels of plasma insulin， serum leptin and adiponectin in children and adolescents may be intimately related to degree of obesity. The abnormal rates of their levels  increase as the weight of children increases. The prevention and management of obesity in children and adolescents should be of great importance to the prevention of  chronic diseases in manhood.