肥胖儿童血清高敏C反应蛋白、瘦素、可溶性瘦素受体和胰岛素的水平及意义

目的探讨肥胖儿童血清高敏C反应蛋白、瘦素、可溶性瘦素受体及胰岛素的水平变化及临床意义。方法对64例12岁肥胖儿童进行血清高敏C反应蛋白（high-sensitivity C-reactive pro-tein,hs-CRP）、瘦素（leptin,Lp）、可溶性瘦素受体（soluble leptin receptor,sLR）及胰岛素（Insulin,INS）的水平测定,与48例健康体检儿童进行对照比较。其中,血清Lp、INS采用放射免疫分析法（RIA）测定,sLR采用酶联免疫吸附试验法检测,hs-CRP采用电化学发光免疫法测定。结果肥胖儿童组血清hs-CRP、Lp、INS水平及BMI均显著高于对照组（均P〈0.01）,sLR水平低于对照组（P〈0.05）;相关性分析显示肥胖儿童血清hs-CRP水平与Lp、INS、BMI之间均呈显著性正相关性（r=0.575,P〈0.01;r=0.504,P〈0.01;r=0.685,P〈0.01）,与sLR呈显著性负相关性（r=-0.339,P〈0.01）;Lp与INS、BMI之间呈显著性正相关性（r=0.352,P〈0.01;r=0.503,P〈0.01）,与sLR呈显著性负相关性（r=-0.467,P〈0.01）,sLR与BMI呈显著性负相关性（r=-0.398,P〈0.01）。结论肥胖儿童已存在炎症状态的改变及瘦素、胰岛素抵抗,且三方面密切相关。对这些血清学指标的检测,有助于儿童肥胖状态的监控和治疗。

The clinical significance of serum high-sensitivity C-reactive protein, leptin, soluble leptin receptor and Insulin in obese children

Objective To evaluate the clinical significance of serum high-sensitivity C-reactive protein （hs-CRP）, leptin（Lp）, soluble leptin receptor（sLR） and Insulin（INS） in the obese children. Methods hs- CRP, Lp, sLR, INS and body mass index（BMI） were determined in 48 healthy individuals as control group and 64 obese children. They were all 12 years old. Serum Lp, INS levels were measured by radio Y （RIA）, sLR levels were measured by enzyme-linked immunosorbent assay（ELISA） And hs-CRP levels were measured by electrochemiluminescence. Results Compared with control group, there were statistical significances for the levels of hs-CRP, Lp, sLR and INS in the groups of obese children. The results of correlation analysis show that hs-CRP had a positive correlation with Lp, INS and BMI （r = 0. 575, P 〈 0.01;r = 0. 504, P 〈 0.01; r = 0. 685, P 〈 0.01）. Lp, hs-CRP, BMI had negative correlation with sLR（ r = - 0.467, P 〈 0.01 ; r = -0.339, P 〈 0. 01; r = -0. 398, P 〈 0.01）. And Lp had a positive correlation with INS and BMI （ r = 0. 352, P〈0.01;r=0. 503, P〈0.01）. Conclusion There are changes of inflammation and leptin, insulin resistance in the obese children. To measure these marker may be helpful to monitor and treat childhood obesity.