肥胖儿童脂肪细胞因子与血管内皮功能损伤

肥胖儿童已存在动脉粥样硬化样病理改变 ,血管内皮功能紊乱是其早期表现。已有证据显示 ,脂肪组织起源的血浆蛋白对血管内皮功能有直接效应 ,包括瘦素、脂联素、白介素 6、纤溶酶原激活物抑制剂 1等。该文旨在探讨是否脂肪组织与血管之间存在脂肪细胞 -血管调节轴 ,直接调控肥胖儿童早期动脉粥样硬化的形成 ,进而推测脂肪细胞因子可能是连接脂肪组织含量与血管内皮功能的分子机制之一。     

肥胖儿童脂肪细胞因子与血管内皮功能损伤

肥胖儿童已存在动脉粥样硬化样病理改变，血管内皮功能紊乱是其早期表现。已有证据显示，脂肪组织起源的血浆蛋白对血管内皮功能有直接效应，包括瘦素、脂联素、白介素-6、纤溶酶原激活物抑制剂-1等。该文旨在探讨是否脂肪组织与血管之间存在脂肪细胞一血管调节轴，直接调控肥胖儿童早期动脉粥样硬化的形成，进而推测脂肪细胞因子可能是连接脂肪组织含量与血管内皮功能的分子机制之一。     

单纯性肥胖儿童血脂水平与血管内皮功能的相关性研究

目的: 探讨单纯性肥胖儿童(SOC) 血脂水平和血管内皮功能变化及两者相关性。方法: SOC和正常对照组儿童各50例。应用免疫比浊法测定他们血清脂蛋白(a) 〔Lp(a)〕、载脂蛋白AⅠ(apoAⅠ)、载脂蛋白B (apoB); 用酶法测定其总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C) 等。用高分辨率电脑超声诊断仪测定肱动脉舒缩率。结果: SOC血清TG、TC、LDL-C、Lp(a)、apoB均明显高于对照组的(P值均<0 .05或<0 .01), 而HDL-C、apoAⅠ均明显低于对照组的(P均<0. 05)。中、重度SOC各项指标与轻度的比较差异均有显著性(P<0. 05或<0. 01)。SOC反应性充血性肱动脉舒缩率(DF% ) 明显低于对照组的(P<0. 01 )。SOCDF%与血清TG、TC、LDL-C、Lp(a)、apoB成直线正相关(P<0 05或<0. 01), 与血清HDL-C、apoAⅠ成直线负相关(P值均<0. 01 )。结论: SOC由于脂质代谢紊乱及血管内皮依赖性舒张功能障碍, 使其发生AS的危险性明显增加。应针对SOC存在的脂质代谢紊乱及血管内皮功能障碍予早期干预。     

2型糖尿病血清内脏脂肪素与肿瘤坏死因子-α及血管内皮功能的关系

目的 探讨2型糖尿病(T2DM)患者血清内脏脂肪素(visfatin)与糖脂代谢、肿瘤坏死因子-α(TNF-α)及血管内皮功能的关系.方法 选择59例T2DM患者作为T2DM组及23例健康体检者作为对照组,采用酶联免疫吸附法检测空腹血清visfatin和TNF-α水平,同时测定糖脂代谢指标,并测定部分T2DM患者(26例)及对照组(15例)内皮依赖性舒张功能(FMD),计算体质指数(BMI)、腰臀比(WHR)、稳态模型胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β).结果 对照组visfatin和TNF-α水平分别为(18.99±8.19) μg/L和(21.80±6.86) ng/L,T2DM组分别为(34.80±9.37)μg/L和(33.57±10.15) ng/L.与对照组比较,T2DM组visfatin、TNF-α明显升高,FMD明显下降,差异均有统计学意义(P＜0.05),其血清visfatin水平与BMI、WHR、log10空腹胰岛素(FINS)、log10HOMA-IR、TNF-α呈正相关(r值分别为0.643、0.389、0.532、0.546、0.666,P＜0.01),与FMD呈负相关(r=-0.505,P＜0.01).结论 2型糖尿病患者血清visfatin水平升高,可能与肥胖、胰岛素抵抗、炎症反应、血管内皮功能受损有关.     

儿童青少年外周动脉顺应性、血管内皮功能的年龄变化规律及与心血管疾病危险因素的关系

目的 探讨儿童青少年外周动脉顺应性和内皮功能的年龄变化规律及其与肥胖相关测量指标和心血管疾病危险因素的关系。方法 在上海市闵行区儿童青少年血压流行病学调查人群中选取7~17岁体重正常和超重/肥胖者,分别采用动脉硬化检测仪、Endopat2000无创内皮功能检测仪测定动脉顺应性、血管内皮功能,测量肱踝脉搏波速度(baPWV)、充血反应指数(RHI)及体格、血压和空腹血生化指标。分析baPWV、RHI随年龄的变化规律。对相关测量指标进行年龄标准化以及偏态分布的指标正态化转换后,使用简单线性相关分析观察baPWV、RHI与肥胖相关测量指标、心血管疾病危险因素的关系。结果 452名体重正常和94名超重/肥胖者完成动脉顺应性和血管内皮功能检测,其中299名(54.76%)为男性。简单线性相关分析显示,正常体重者中baPWV、RHI与年龄呈弱正相关关系(r=0.33,P<0.01;r=0.36,P<0.01)。baPWV与标准化(z_)BMI(r=0.13,P=0.002)、SBP(r=0.20,P<0.01)、DBP(r=0.27,P<0.01)、TG(r=0.11,P=0.010)、胰岛素(r=0.21,P=0.004)、胰岛素抵抗指数(r=0.21,P=0.005)呈正相关关系,与HDL-C呈负相关关系(r=-0.09,P=0.039)。RHI与z_BMI呈正相关关系(r=0.10,P=0.018),与DBP呈弱的负相关关系(r=-0.10,P=0.016),与其他测量指标无显著性相关。baPWV在男性略高于女性,而RHI无性别差异。结论 baPWV、RHI测量值在7~17岁间随年龄增长整体呈上升趋势,提示动脉顺应性和血管内皮功能在此期间处在不断发育的过程。动脉顺应性的变化与心血管疾病危险相关测量指标的变化具有相关性,而血管内皮功能则仅在超重/肥胖儿童中表现出提前发育的现象,与血压、胰岛素抵抗等心血管疾病的危险因素未表现出相关性。对儿童青少年人群心血管疾病危险的早期评估,测量动脉顺应性可能比血管内皮功能指标更敏感。     

腹膜透析患者内脏脂肪和血管内皮功能的关系

目的探讨腹膜透析患者内脏脂肪与血管内皮功能的关系。方法收集88例腹膜透析患者的一般临床资料,采用多频生物电阻抗分析(BIA)法和血流介导的肱动脉扩张(FMD)法分别评估总体脂肪率、内脏脂肪和血管内皮功能。结果腹透患者中有44.3%超重或肥胖,腹透患者脂肪的分布与年龄、性别相关,多元回归分析表明内脏脂肪量和糖负荷是内皮功能的独立影响因素(调整的R2=0.180,P<0.01)。结论内脏脂肪是腹透患者血管内皮功能的独立预测因素。     

幼年肥胖大鼠血管内皮细胞功能障碍与炎症因子的关系

【目的】探讨高脂饮食诱导的肥胖大鼠血管内皮细胞功能障碍与炎症因子的关系。【方法】18只三周龄断乳期雄性SD大鼠随机分为高脂饲料喂养的肥胖组和普通饲料喂养的对照组,高脂组10只,对照组8只,共喂养12周,然后处死全部大鼠,测定lee指数;脂肪湿重;空腹血糖(fasting plasma glucose,FPG);血脂指标:总胆固醇(totalcholesterol,TC)、甘油三酯(triglycerides,TG)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high densitylipoprotein,HDL);血管内皮因子:血清一氧化氮(nitric oxide,NO);C反应蛋白(C-reactive protein,CRP)及IL-6。【结果】肥胖组大鼠lee指数、脂肪湿重、CRP、IL-6、TG及FPG高于对照组(P<0.05或<0.01),而NO和HDL明显低于对照组(P<0.01),直线相关分析显示CRP和IL-6与NO呈负相关(P<0.05)。【结论】肥胖大鼠存在血管内皮功能损伤及糖脂代谢紊乱,脂肪细胞分泌的CRP、IL-6等炎症因子在肥胖发病过程中...     

彩色多普勒超声对单纯性肥胖青少年血管内皮功能及内膜的研究

【目的】探讨肥胖青少年血管内皮功能及动脉内膜形态学改变程度和相关因素。【方法】应用彩色多普勒超声(color doppler flow imaging,CDFI)分别检测单纯性肥胖青少年组40例和正常青少年组40例的血管内皮功能(FMD)及颈总动脉(CCA)、股动脉(FA)的内膜中层厚度(intima-media thickness,IMT)、内径(N)、SM峰值流速、DM峰值流速,并测定体质指数(body mass index,BMI)。【结果】肥胖组FMD较正常对照组明显降低(P<0.01),与BMI呈负相关;肥胖组IMT较正常对照组明显增厚(P<0.01),与BMI呈正相关;肥胖组FMD与肥胖组IMT呈负相关。肥胖组N、SM峰值流速、DM峰值流速与正常对照组比较差异均无显著性(P>0.05)。【结论】肥胖组青少年的血管内皮及颈总动脉、股动脉内膜具有不同程度早期动脉粥样硬化(AS)的改变,变化程度与BMI有关。     

肥胖儿童胰岛素抵抗与血管内皮功能损伤关系的研究

目的判断肥胖儿童胰岛素抵抗与血管内皮功能损伤的关系。方法肥胖176例、超重58例、正常45例三组儿童,B超检测颈动脉内中膜层厚度（TMT）和舒张功能;化验生化指标和血管慢性炎症指标,计算胰岛素抵抗指数和敏感指数。结果三组间比较,动脉粥样硬化危险因素、部分慢性炎症指标、TMT（F=3．209,P=0．046）、颈动脉血管弹性（F=6．576,P=0．002）有显著性差别。胰岛素敏感指数与动脉粥样硬化危险因素、IMT（R=-0．201,P=0．010）、可溶性细胞间黏附分子1（R=-0．197,P=0．010）、脂联素（R=0．419,P=0．000）密切相关;随着胰岛素敏感指数的降低,动脉粥样硬化的危险冈素和血管损伤逐渐增加。多元回归分析IMT与腹型肥胖程度、平均血压,胰岛素抵抗指数、高密度脂蛋白胆固醇有关。结论肥胖儿童早期动脉粥样硬化已经启动,预防成人心脑血管疾病应该从预防儿童肥胖做起。     

营养性肥胖大鼠氧应激水平的改变

目的观察营养性肥胖大鼠氧应激、抗氧化能力的改变。方法20只断乳的SD雄性大鼠(75~80g)随机分两组,每组10只。膳食诱导肥胖组(DIO组)喂饲高脂饲料,对照组喂饲基础饲料,10周后取血及睾周、肾周脂肪组织。用ELISA法检测血浆8-表氧-前列腺素2α(8-epi-PGF2α)、二硫代双硝基苯甲酸法测血浆抗氧化酶GPX(谷胱甘肽过氧化物酶)活性、黄嘌呤氧化酶法测血浆SOD(超氧化物歧化酶)活性,HPLC(高效液相色谱仪)测血浆维生素E并经血脂校正。同时测血浆空腹血糖、胰岛素、三酰甘油(TG)、总胆固醇(TCHL)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等糖脂代谢指标。结果高脂喂养10周后,DIO组的各项肥胖指标(体重、腹部脂肪/体重、Lee’s指数)均高于对照组(P<0.01);血浆8-epi-PGF2α增高,SOD和GPX活性、经血脂校正后的血浆维生素E水平显著降低(P<0.05)。另有脂代谢紊乱,空腹血糖与胰岛素也显著高于对照组。结论高脂喂养肥胖大鼠模型显示血脂升高并伴有胰岛素抵抗;氧应激水平增高而抗氧化能力下降。     

不同肥胖易感性大鼠体内的氧化应激反应

目的观察不同肥胖易感性大鼠的氧化应激反应和抗氧化能力的差异。方法 40只雄性Wistar大鼠(200～220g)随机分为高脂饲料组(30只)和正常对照组(10只),高脂饲料组大鼠给予高脂饲料6周后依据体重增加量筛选出肥胖易感(OP)大鼠和肥胖抵抗(OR)大鼠各10只,OP组和OR组大鼠继续喂养高脂饲料,正常对照组大鼠给予基础饲料,13周末处死大鼠,采集样本,测定血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)以及空腹血糖(FBG)、胰岛素、甘油三酯(TG)、总胆固醇(TC)、游离脂肪酸(FFA)等指标。结果 OP组大鼠SOD含量显著低于OR组和正常对照组;OP组大鼠GSH-Px水平显著低于OR组;OP组MDA浓度显著高于正常对照组;同时OP组总能量摄入、体脂含量、血糖、血脂、血清胰岛素、胰岛素敏感指数(ISI)和游离脂肪酸水平都与OR组大鼠的差异有显著性,而OR组大鼠与正常对照组相比的差异无显著性。结论与肥胖抵抗大鼠相比,肥胖易感大鼠的氧化应激水平增高,抗氧化能力降低,血糖血脂升高并出现胰岛素抵抗。     

Barriers and facilitators to childhood obesity prevention among culturally and linguistically diverse (CALD) communities in Victoria,Australia

Objective: Childhood obesity is rising among culturally and linguistically diverse (CALD) groups who show poor engagement in obesity prevention initiatives. We examined the barriers and facilitators to the engagement of CALD communities in obesity prevention initiatives. Methods: We used the nominal group technique to collect data from 39 participants from Vietnamese, Burmese, African, Afghani and Indian origins living in disadvantaged areas of Victoria, Australia. Data analysis revealed ranked priorities for barriers and facilitators for CALD community engagement in obesity prevention initiatives. Results: CALD parents identified key barriers as being: competing priorities in the post‐migration settlement phase; language, cultural and program accessibility barriers; low levels of food and health literacy; junk food advertisement targeting children; and lack of mandatory weight checks for schoolchildren. Key facilitators emerged as: bicultural playgroup leaders; ethnic community groups; and school‐based healthy lunch box initiatives. Conclusion: This study has identified several policy recommendations including: the implementation of robust food taxation policies; consistent control of food advertising targeting children; improving CALD health literacy using bicultural workers; and matching health promotional materials with CALD community literacy levels. Implications for Public Health: These recommendations can directly influence public health policy to improve the engagement of CALD communities in obesity prevention services and ultimately reduce the widening obesity disparities in Australia.     

Child feeding practices and perceptions of childhood overweight and childhood obesity risk among mothers of preschool children

Aim: The present study assessed the relationship between maternal attitudes, beliefs and child feeding practices. It was hypothesised that: (i) maternal control over feeding would increase when mothers perceived their children as over‐ or underweight and were concerned about the weight status of their children; and (ii) mothers would express more concern about their daughters' weight, and report higher levels of control over feeding as a result. Methods: Participants included 112 mothers and their children aged 2–6 years who were attending swim lessons at a Central Coast swim school. Mothers completed the Child Feeding Questionnaire to assess maternal attitudes, beliefs and control over child feeding. Child and maternal body mass indexes were measured. Correlational analyses, t‐tests and multiple regression analyses were performed. Results: Mothers reported a high overall level of control in child feeding, and a low level of concern for child weight. Child overweight and obesity were marginally lower than reported in previous studies. Mothers reported more concern for their daughters' weight, but did not report increased control over feeding based on child gender. Pressure to eat was negatively associated with maternal education, suggesting a link between socioeconomic status and child feeding practices. Mothers displayed higher levels of parental control over obese than normal‐weight children, suggesting that they accurately assessed the weight status at the obese level. Conclusion: Mothers may be able to detect obesity in their children, but not overweight. Mothers may also be unconcerned about their sons' weight, and this discrepancy should be investigated in clinical and educational settings. Nutrition education and child obesity prevention and treatment programs should take maternal attitudes, perceptions and child feeding practices into account when planning interventions.     

Impact of fish intake on oxidative stress when included into a moderate energy-restricted program to treat obesity

Background The role of some nutritional factors and hypocaloric diets on oxidative balance is a matter of debate, especially related to the prevention and treatment of obesity and co-morbidities. Aim of the study The aim was to investigate the antioxidant capacity of different energy restricted diets in the treatment of obesity, paying emphasis to the effect of incorporating omega-3 fatty acids with or without other seafood components. Methods The study was a randomized 8-weeks parallel intervention trial prescribed to lose weight, which was implemented in 276 subjects aged 31.4 ± 5.4 y.o. following four different balanced hypocaloric diets (TEE-30%): fish-restricted (control), cod and salmon based diets and DHA+EPA supplemented administration. At baseline (day 0) and at the end of the trial (day 56), anthropometry, dietary intake, erythrocyte membrane fatty acid content, circulating malondialdehyde (MDA) and plasma antioxidant status (AOP) were determined. Results Overall, percent weight loss was −5.8 ± 3.2% (P < 0.001) and the AOP statistically increased after the energy restriction period (P = 0.015), basically due to the seafood-based diets. In contrast, MDA statistically only decreased (P = 0.026) after the cod-based diet intake with no changes after the other nutritional treatments. In fact, the cod-based intervention statistically decreased oxidative stress when expressed as the MDA/AOP ratio (P = 0.006). Conclusions A moderate calorie-restricted cod-based diet was found as a useful strategy to lose weight, which was accompanied by a specific improvement on oxidative stress markers. The low saturated fat content and the seafood protein source of this diet may be important factors involved in these findings.     

利维爱对绝经后妇女血管内皮功能的影响

目的 :探讨绝经后妇女激素替代治疗 (HRT)对血管内皮功能的影响。方法 :12 0例绝经后妇女随机分为A、B两组 (各 6 0例 ) ,分别服利维爱 (Tibolone ,欧加农制药有限公司 ) 2 .5mg和维生素B610mg,每天 1次 ,疗程 6个周期。另选 30例 2 5～ 4 5岁健康育龄妇女作为正常对照。监测服药前后患者的血浆 6 酮 前列腺素F1α(6 K PGF1α)、血栓素B2 (TXB2 )、一氧化氮 (NO)和内皮素 (ET)水平。结果 :绝经后妇女 6 K PGF1α和NO显著降低 ,而TXB2 和ET显著升高。A组服药后 6 K PGF1α和NO显著升高 ,TXB2 和ET显著降低。B组服药前后 6 K PGF1α、TXB2 、NO和ET无明显改变。结论 :HRT使绝经后妇女的 6 K PGF1α和NO升高 ,TXB2 和ET降低 ,提示HRT可能改善此类人群的血管内皮功能。     

食品甜味剂与儿童肥胖

儿童肥胖严重危害儿童身心健康,其流行态势日趋严峻.儿童肥胖大多数仍为单纯性肥胖,与不良饮食行为息息相关,尤其能量摄入过多或膳食结构失调(如高糖高脂).近几十年随着超加工食品的普遍,食品甜味剂种类更为丰富,应用范围更广,消费量剧增.虽然食品甜味剂使用历史由来已久,大多数被认为是安全的;但越来越多证据显示,无论是天然甜味剂...