单纯性肥胖儿童血清瘦素水平与血糖及血脂变化的关系

目的 研究单纯性肥胖儿童血清瘦素水平与血糖、胰岛素抵抗及血脂异常的关系。方法 采用放射免疫分析法、酶法对42对7-10岁肥胖及健康对照儿童进行血清瘦素、胰岛素水平及血糖、血脂水平的测定。结果 肥胖及对照儿童瘦素水平分别为2．74-45．125μg/L和0．53-10．18μg/L，经对数转换后肥胖组平均水平非常显著高于体重正常组。血清瘦素水平与体重指数(BMI)、腰臀围比(WHR)及体脂百分比均呈显著正相关关系。83％的肥胖儿童有瘦素抵抗，肥胖瘦素敏感组与体重正常组的血糖、胰岛素及血脂水平均差异无显著性，而肥胖瘦素抵抗组总胆固醇、甘油三酯(TG)、低密度脂蛋白胆固醇及胰岛素水平均显著高于体重正常组，肥胖瘦素敏感与瘦素抵抗儿童年龄、性别分布及BMI、WHR的差异无显著性，但瘦素抵抗组TG显著高于瘦素敏感组，高密度脂蛋白胆固醇显著低于瘦素敏感组。结论 肥胖儿童即存在瘦素抵抗，瘦素抵抗与代谢综合征及心血管疾病的危险因素密切相关，可作为筛查高危肥胖儿童的有用指标。

Relationship between serum levels of leptin and glucose,lipids in simple obese children

OBJECTIVE: To investigate the relationship between fasting serum levels of leptin, glucose, insulin resistance, lipids in simple obese children. METHODS: Fasting serum levels of leptin and insulin (Fins) were measured by RIA in 42 obese and 42 normally-weighted children matched on age, sex and height, and their total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) were analyzed with enzymatic methods. HOMA-IR and LDL-C were calculated. RESULTS: Serum level of leptin was (2.74 - 45.12) micro g/L and (0.53 - 10.18) micro g/L in obese and normally-weighted children, respectively, with an average level of leptin (log) significantly higher in obese group than that in control group (P < 0.001). Serum level of leptin was positively correlated with BMI, WHR and percentage of body fat. Of obese children, 83% were leptin resistant. Serum levels of TC, TG, LDL-C and insulin were significantly higher in obese leptin-resistant group than those in normally-weighted control group, but no significant difference in them between obese leptin-sensitive group and its normally-weighted control group was observed. Significantly higher serum levels of TG and lower HDL-C were observed in obese leptin-resistant group, as compared with those in obese leptin-sensitive group. CONCLUSIONS: A big difference in serum level of leptin between obese and normally-weighted children was found, suggesting most obese children were resistant to endogenous leptin. Leptin resistance correlated significantly with the risk of metabolic syndrome and cardiovascular disease, indicating serum level of leptin could be used as an indicator in screening obese children at high risk.