血管紧张素转化酶基因插入/缺失多态性及β3肾上腺素能受体基因Trp64Arg多态性对胎儿宫内发育及新生儿胰岛素敏感性的影响

目的 探讨血管紧张素转化酶(angiotensin converting enzyme,ACE)基因插入/缺失(insertion/deletion,I/D)多态性及B3-肾上腺素能受体(β3-adrenalgic receptor,β3-AR)基因Trp64Arg多态性对胎儿宫内发育和新牛儿胰岛素敏感性的影响.方法 将入选296例新生儿分为2组,适于胎龄儿组222例,小于胎龄儿组74例,于生后3d哺乳前检测血糖、胰岛素,计算HOMA-IR值评估胰岛素敏感性,应用PCR-RFLP方法分析β3-AR基因Trp64Arg多态性及ACE基因I/D多态性(202例),比较不同基因型组的孕周、出生体重、出生体重百分位及胰岛素敏感性,应用SPSS 10.0软件进行统计学处理.结果 小于胎龄儿组HOMA-IR值(Ln对数转换后)为0.217±0.367,高于适于胎龄儿组0.001±0.378,差异有统计学意义(P相似文献   

Clinical features of the metabolic syndrome in adolescents: minor role of the Trp64Arg beta3-adrenergic receptor gene variant

Obesity and hypertension are increasing medical problems in adolescents. We evaluated the association between being overweight-particularly abdominal fat-and having hypertension and assessed the contribution of the Trp64Arg beta3-adrenergic receptor gene variant. In a population-based study, we determined family history, anthropometric variables, and arterial blood pressure of 934 high school students, out of whom we selected 121 normotensive and 54 hypertensive students. Biochemical measurements included circulating renin and angiotensin-converting enzyme activities, leptin, glucose, insulin and lipid levels, and beta3-adrenergic receptor genotypes. We used Mann-Whitney U test, chi2-test, and Spearman rank-order correlation. In the total population, hypertension prevalence increased across the entire range of body mass index (BMI) percentiles. In the sample, hypertensive students showed higher BMI, waist-to-hip ratio, triglycerides, and insulin resistance and lower HDL-cholesterol than normotensive students did. Age- and sex-adjusted systolic arterial blood pressure was correlated with BMI, waist-to-hip ratio, insulin resistance, and leptin. Leptin was correlated with BMI and homeostasis model assessment method. We found no association among hypertension, BMI, and leptin levels with beta3-adrenergic receptor genotypes. Especially in girls, the waist-to-hip ratio was, however, suggestively higher in Arg64 variant carriers than in noncarriers, independent of hypertension. In fact, there was a significantly (p < 0.01) higher frequency of carriers of the Arg64 variant across the waist-to-hip ratio quartiles. In adolescents of European origin, hypertension is associated with an increased degree of obesity among other characteristics of the metabolic syndrome; the Trp64Arg variant of the beta3-adrenergic receptor gene may favor the central adiposity gain.     

Effect of Trp64Arg mutation of the β3-adrenergic receptor gene and C161T substitution of the peroxisome proliferator activated receptor γ gene on obesity in Japanese children

OBJECTIVE: Obesity is a multifactorial syndrome influenced by both genetic and behavioral factors. Trp64Arg mutation of the beta3-adrenergic receptor (AR) gene and C161T substitution of the peroxisome proliferator-activated receptor (PPAR) gamma gene have been reported to be associated with obesity or lipid metabolism in adults. However, the effects of these mutations on children have not yet been clarified. For this reason, we studied the effects of Trp64Arg mutation of the beta3-AR gene and C161T substitution of the PPARgamma gene on obesity in Japanese children. SUBJECTS AND METHODS: In order to determine the effects of Trp64Arg mutation of the beta3-AR gene and C161T substitution of the PPARgamma gene on obesity in children, 105 obese Japanese children were screened by the polymerase chain reaction and restriction fragment-length polymorphism analysis. Plasma lipid, apolipo-protein (apo), glucose, insulin and leptin levels were also determined. RESULTS: Obese boys with Trp64Arg showed a higher obesity index and lower plasma levels of high-density lipoprotein cholesterol (HDL-C), apoA-I and apoA-II than those of them without the mutation. Obese boys with both mutations showed a higher plasma leptin level than those with only the beta3-AR gene mutation or PPARgamma gene mutation. No significant effect of these mutations was found in obese girls. CONCLUSION: All of these data suggest that Trp64Arg mutation of the beta3-AR gene might affect obesity and HDL metabolism in obese boys. In contrast, C161T mutation of the PPARgamma gene, by itself, is unlikely to influence obesity, lipid metabolism or plasma leptin levels.     

Trp64Arg polymorphism of the ADRB3 gene associated with maximal fat oxidation and LDL-C levels in non-obese adolescents

Objective

To analyze the association between the Trp64Arg polymorphism of the ADRB3 gene, maximal fat oxidation rates and the lipid profile levels in non-obese adolescents.

脂联素基因多态性变化与儿童单纯性肥胖的关系

目的：分析长沙市区儿童脂联素基因+45 位点单核苷酸多态性（SNP）基因型的分布频率,探讨其与儿童肥胖症的相关性。方法：随机抽取147例肥胖儿童及 118 例健康儿童,采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法检测脂联素基因 SNP+45 多态性位点、双抗体夹心 ELISA 测定血清脂联素。同时进行腰围（WC）、腰臀比（WHR）、体脂百分比（%BF）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、血清甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹胰岛素水平（FINS）、稳态模型胰岛素抵抗指数（HOMA-IR）的测定。结果：肥胖组和正常组的SNP + 45 多态性发生频率分别为 40.5% 和 25.4%,两组间基因型分布与等位基因频率差异均有统计学意义（P<0.05）。肥胖儿童中,TT 基因型与 TG、GG 型相比,其脂联素水平高,而 %BF、HOMA-IR、TC 和 LDL-C 水平低,差异有统计学意义（P<0.05）。结论：脂联素基因SNP+45 变异可能与儿童单纯性肥胖相关,T→G 突变可增加儿童肥胖症的发生,同时使脂联素水平下降。     

Leptin receptor gene Gln223Arg polymorphism is not associated with obesity and metabolic syndrome in Turkish children

The aim of the study was to investigate the relationship between leptin receptor gene (LEPR) Gln223Arg polymorphism and obesity in Turkish children. Ninety-two obese and 99 lean children (between 5-15 years) were included in the study. Twenty-three of the obese children were diagnosed with metabolic syndrome. Blood samples were collected for morning fasting blood glucose, insulin, leptin, and lipid level measurements. LEPR Gln223Arg polymorphism was analyzed by restriction fragment length polymorphism. Significant differences were observed in anthropometric measurements, fasting blood glucose, insulin, leptin, and lipid levels between obese and lean children. Serum leptin levels were markedly higher in obese children. No significant association was noted between Gln223Arg polymorphism and serum leptin, insulin and lipid levels. There were no differences in the genotype frequencies or allele distribution for Gln223Arg polymorphism among obese, obese with metabolic syndrome and lean children. Our findings suggest that there is no association between Gln223Arg polymorphism and obesity in Turkish children.     

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目的 探讨β3-肾上腺素能受体基因(p3-AR)Trp64Arg变异与新疆哈萨克族儿童肥胖的相关性.方法 选取乌鲁木齐周边地区95例6-12岁哈萨克族学龄肥胖儿童及87名非肥胖儿童,用限制性片段长度多态性方法检测被调查儿童的基因型,生化方法检测血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)水平,并测量身高、体重.结果 变异型等位基因(C)在被调查对象中出现的频率为0.194,其中男0.210,女0.160.肥胖儿童中变异等位基因(C)、Trp64Arg变异基因型的出现频率明显高于非肥胖者(P＜0.05).单纯性肥胖儿童与非肥胖儿童比较,血清TG、TC、LDL-C、ApoB水平均明显升高(P＜0.05).B3-AR不同基因型间血脂比较,差异无统计学意义(P>0.05).结论 哈萨克族学龄儿童中存在一定的B3-AR Trp64Arg变异,可能与哈萨克族儿童肥胖有关.     

Tangled relationship between insulin resistance and microalbuminuria in children with obesity

Childhood obesity represents a complex disease with a well-known cardiometabolic burden including fatty liver, type 2 diabetes, metabolic syndrome, and cardiovascular disease. From a pathogenic point of view, insulin resistance (IR) represents the key factor underlying the spectrum of these obesity consequences. As observed in adults, recent data supported the occurrence of microalbuminuria (MA) as marker of early kidney dysfunction and its potential link with cardiometabolic factors also in children with obesity. In fact, a well-documented pathophysiological hypothesis both in adults and children supported an intimate correlation with the major feature of obesity such as IR through the influence of insulin on renal hemodynamics. Based on the clinical and prognostic relevance of this relationship in daily practice (including an increased risk of chronic kidney disease development overtime), more scientific attention needs to be paid to the evaluation of early kidney damage in children with obesity. In this paper, we attempt to address three debated questions regarding the intriguing liaison between IR and MA in children with obesity: (1) What is the prevalence of pediatric MA? (2) What is the state of art of MA in children with obesity? and (3) Is there a link between IR and MA in children with obesity?     

单纯性肥胖儿童黑色棘皮症与胰岛素抵抗性及细胞因子的关系

目的 探讨单纯性肥胖儿童的黑色棘皮症(AN)和体质量指数、胰岛素抵抗性、瘦素、血浆酶原纤维蛋白溶解原活化抑制剂(PAI-1)的关系。方法 单纯性肥胖儿童38例,其中AN阳性17例,测量身高、体质量、腹围、臀围,同时测血胰岛素、瘦素、空腹血糖、PAI-1。结果 AN阳性者肥胖度、腹围、空腹胰岛素、自动动态平衡标准评价胰岛素抵抗指数(HOMA-R)关系有显著差异,AN与体脂肪率间无关。AN阳性肥胖儿中均升高,PAI-1 40μg／L以上,瘦素30 μg／L以上者均为AN阳性。结论　单纯性肥胖儿童,特别是伴AN阳性肥胖儿,要特别注意随访观察2型糖尿病和冠状动脉疾病的发生和发展。     

Influence of obesity and insulin resistance on left atrial size in children

BACKGROUND: Left atrial (LA) enlargement has been linked to obesity and insulin resistance in adults. OBJECTIVE: The purpose of this study was to determine the association in children between LA area and: (i) different components of the metabolic syndrome including obesity (OB), measures of body mass index (BMI) and waist circumference (WC), homeostasis model assessment-insulin resistance (HOMA-IR, proinsulin), and blood pressure (BP); and (ii) left ventricular mass (LVM) and diastolic function, measured using echo Doppler. METHODS AND RESULTS: Eighty-four (44 females) subjects, [40 OB (BMI>95%), 28 overweight (BMI>85%)], 16 non-OB (BMI<85%)] aged 9+/-2.24 yrs were matched for sex and age. BMI, WC, BP, Tanner stage, and Mode M, 2-dimensional and Doppler transmitral echocardiography were assessed. A standard oral glucose tolerance test (OGTT) was done, measuring glucose, insulin, and proinsulin concentrations. Hypertension was only present in OB subjects (25%). Significant univariate association (p<0.001) was found between LA area and height (r=0.52), age (r=0.45), Tanner stage (r=0.45), BMI (r=0.66), WC (r=0.70), systolic BP (r=0.52), diastolic BP (r=0.53), proinsulin (r=0.36), and HOMA-IR (r=0.36). In the multivariate regression analysis, independent variables were entered in a stepwise fashion: initially, gender (p=0.006) and Tanner stage (p=0.011) were still significant independent correlates of LA area after adjusting for age, gender, and Tanner stage. Subsequently, incorporation of WC showed that WC (p=0.018) was a significant independent correlate of LA area. A larger model constructed to test the significance of adjustment factors, including WC, BP, LVM, and HOMA-IR showed that WC (p<0.001) was the only significant independent variable. CONCLUSION: LA enlargement is present in childhood and is related to abdominal OB and insulin resistance, suggesting that children with central OB are at increased risk for cardiovascular disease.     

Relation of circulating oxidized LDL to obesity and insulin resistance in children

Kelly AS, Jacobs DR Jr, Sinaiko AR, Moran A, Steffen LM, Steinberger J. Relation of circulating oxidized LDL to obesity and insulin resistance in children. Introduction: Circulating oxidized low‐density lipoprotein (LDL), a marker of oxidative stress, is associated with obesity, insulin resistance, metabolic syndrome, and cardiovascular disease in adults. However, little is known about its relation to insulin resistance and cardiovascular risk factors in children. The purpose of this study was to assess the relation of oxidative stress, measured by circulating oxidized LDL, with measures of adiposity and insulin resistance in children. Methods: Oxidized LDL, measures of body fatness (body mass index: BMI, percent body fat, waist circumference, percent trunk fat, abdominal visceral and subcutaneous fat), insulin resistance with euglycemic insulin clamp (Mlbm), blood pressure, and blood lipids were obtained in 78 children. Oxidized LDL was compared between normal weight children (BMI < 85th percentile) and overweight/obese children (BMI ≥ 85th percentile) and levels were evaluated for associations with body fatness and insulin resistance. Results: Oxidized LDL levels were significantly higher in overweight/obese vs. normal weight children (p < 0.0001). Oxidized LDL was significantly correlated with BMI, percent body fat, waist circumference, percent trunk fat, abdominal visceral fat, and abdominal subcutaneous fat (all p‐values <0.0001). Moreover, oxidized LDL was negatively correlated with Mlbm, even after adjustment for adiposity (p < 0.01). Conclusions: Oxidized LDL is significantly associated with adiposity and with insulin resistance, independent of body fatness, in children. Oxidative stress may be independently related to the development of insulin resistance early in life, especially in obese youth.     

配对盒 4 基因 R192S、R192H 多态性与儿童青少年肥胖的研究

目的研究配对盒4(PAX4)基因rs3824004(574CA;R192S)、rs2233580(575GA;R192H)多态性与儿童青少年肥胖及代谢指标的相关性。方法随机选取103例肥胖儿童,平均年龄(10.82±2.57)岁,体质指数(BMI)(26.82±4.57)kg/m2;同期体检的100例正常体质量儿童为对照组,年龄(10.60±2.84)岁,BMI(16.79±2.13)kg/m2。测量并比较两组血压、体格指标以及血代谢指标。肥胖组儿童行口服葡萄糖耐量试验(OGTT)和胰岛素释放试验,计算稳态模型胰岛素抵抗指数(HOMA-IR)和总体胰岛素敏感指数(WBISI)。应用聚合酶链反应(PCR)检测PAX4 rs3824004、rs 2233580多态性,分析多态位点的等位基因频率和基因型频率及组间差异,以及不同基因型与代谢指标的相关性。结果肥胖组的身高、体质量、BMI、收缩压、舒张压、腰围、臀围、腰围身高比(WHt R)、空腹血糖(FPG)、总胆固醇(TC)、低密度脂蛋白(LDL)、三酰甘油(TG)、丙氨酸转氨酶(ALT)及天冬氨酸转氨酶(AST)均高于对照组,高密度脂蛋白(HDL)低于对照组;差异均有统计学意义(P0.05)。基因分布频率符合Hard-Weinberg平衡,rs3824004肥胖组和对照组的A等位基因频率分别为4.9%和5.0%,CA基因型频率分别为9.7%和10.0%;两组差异均无统计学意义(P0.05)。rs 2233580肥胖组的GA基因型频率为25.2%,高于对照组(11.0%);A等位基因频率为12.6%,也高于对照组(5.5%),差异均有统计学意义(P0.05)。rs2233580 GA基因型的BMI及腰围高于GG基因型,差异均有统计学意义(P0.05),但logistic回归分析显示PAX 4 rs 2233580基因型与代谢指标并无相关性(P均0.05)。肥胖组PAX 4 rs 2233580不同基因型间HOMA-IR和WBISI差异无统计学意义(P均0.05)。结论 PAX 4 rs 2233580影响BMI及腰围,可能参与儿童肥胖的发生,但不是儿童青少年肥胖发生的独立影响因素。     

Prevalence of the insulin resistance syndrome in obesity

Aims: To assess prevalence of the insulin resistance syndrome (IRS: obesity, abnormal glucose homoeostasis, dyslipidaemia, and hypertension) in obese UK children and adolescents of different ethnicities and to assess whether fasting data is sufficient to identify IRS in childhood obesity. Methods: A total of 103 obese (BMI >95th centile) children and adolescents 2–18 years of age referred for assessment underwent an oral glucose tolerance test, measurement of fasting lipids, and blood pressure determination. Main outcome measures were prevalence of components of IRS by modified WHO criteria, with IRS defined as ?3 components (including obesity). Results: There were 67 girls (65%). BMI z-score ranged from 1.65 to 6.15, with 72% having a z-score ?3.0. Abnormal glucose homoeostasis was identified in 46% (hyperinsulinism in 40%, impaired fasting glucose in 0.8%, impaired glucose tolerance in 11%). No subjects had silent type 2 diabetes. Dyslipidaemia was identified in 30% and hypertension in 32%. Thirty one per cent had obesity alone, 36% had two components, 28% had three, and 5% had all four components. Birth weight, BMI, and family history of IRS were not associated with risk of IRS. Higher age increased the risk of IRS; however the syndrome was seen in 30% of children under 12 years. The use of fasting glucose and insulin data for identifying IRS had a sensitivity of 88% and specificity of 100%. Conclusions: One third of obese children and adolescents have the IRS; however type 2 diabetes is rare. Obese children with the IRS may form a high risk group to whom scarce intervention resources should be targeted. Further work is needed to develop appropriate screening programmes for IRS components in significantly obese children.     

Prevalence of insulin resistance and its association with metabolic syndrome criteria among Bolivian children and adolescents with obesity

Background  

Obesity is a one of the most common nutritional disorder worldwide, clearly associated with the metabolic syndrome, condition with implications for the development of many chronic diseases.