肥胖儿童代谢综合征代谢紊乱与血清高敏C反应蛋白关系探讨

目的研究对肥胖儿童人群中代谢综合征(MS)与血清高敏C-反应蛋白(hs-CRP)之间的关系,探讨hs-CRP在MS发病机制中的作用及在MS诊断、评价中的可能。方法选取2006年6月至2008年3月在天津医科大学总医院儿科门诊确诊的肥胖儿童109例,根据腰围、血压、血脂及糖耐量指标将患儿分为MS组非MS组,进行人体参数测量并收集临床基本资料,测定hs-CRP、血脂,进行口服糖耐量试验和胰岛素释放试验。对上述资料进行统计学分析。结果血清hs-CRP水平MS组高于非MS组(P<0.05);Sperman相关分析提示hs-CRP水平与体重指数(BMI)、腰围、腰围/身高比值(WHtR)、非酒精性脂肪肝情况、胰岛素抵抗指数(HOMA-IR)及MS组分数呈正相关(P<0.05),与血浆HDL-C水平呈负相关(P<0.05)。回归分析表明WHtR(OR=2.708,P<0.05)、BMI(OR=1.169,P<0.05)及腰围(OR=1.145,P<0.05)为hs-CRP水平的显著影响因素。结论提示慢性炎症反应和胰岛素抵抗可能共同参与MS的发病及进展过程,血清hs-CRP水平可作为预计和评价儿童MS的有效指标之一。

Relationship between metabolic disturbance and hs-CRP in obese children with metabolic syndrome

Objective To investigate the correlation of metabolic syndrome (MS) with serum hs-C reaction protein (hs-CRP) in obese children to realize the role of hs-CRP in progress process of MS and investigate whether the serum hs-CRP could be available in the diagnosis,evaluation and intervence of children metabolic syndrome.Methods Our study included 57 children and adolescents diagnosed with obesity.Child-specific definition made by R.Weiss was used to identify MS in these subjects.We measured their serum hs-CRP,OGTT and made insulin release test and serum lipid profiles,then calculated the parameters of insulin resistance,following the measuring of anthropometrics measurements and blood pressure.All the data were analyzed.Results Serum hs-CRP of children with MS was higher than subjects without(P<0.05).The serum hs-CRP concentration was positively correlated with BMI,WC,WHtR,SBP,DBP,HOMA-IR,NAFLD and nMSc(P<0.05),and negatively correlated with HDL-C(P<0.05).The consequence of Logistic regression analysis showd WHtR(OR=2.708,P<0.05),BMI(OR=1.169,P<0.05)and WC(OR=1.145,P<0.05)were the correlation factors of serum hs-CRP.Conclusion It is confirmed that the chronic low-grade inflammation and insulin resistance may participate in the incidence and progress process of metabolic syndrome.The hs-CRP concentration can be used as available indicator for diagnosis and prediction of metabolic syndrome.