不同肥胖测量指标对心脏代谢性疾病预测价值的比较

目的 探索不同肥胖测量指标对高血压、糖尿病及血脂异常的预测价值.方法 2013 ～2014年期间,采用整群随机抽样的方法,对全国4个县开展了心血管病危险因素调查,实际入选5402人,有效数据4704人.利用该资料分析体重指数、腰围、臀围、腰臀比、腰围身高比、身体脂肪率及内脏脂肪指数对高血压、糖尿病和血脂异常的预测价值.结果 经单因素分析发现,内脏脂肪指数对高血压的预测价值较高,ROC曲线下面积达到0.67（95％ CI：0.65～0.69）,而腰围对糖尿病及血脂异常的预测价值较高,ROC曲线下面积分别达到0.66（95％ CI：0.63～0.69）和0.67（95％ CI：0.65～0.68）.Logistic回归调整年龄、性别、体力活动、吸烟、饮酒及教育程度因素后发现身体脂肪率对高血压（标准化OR =1.71,95％ CI：1.57～1.87）和血脂异常（标准化OR=1.88,95％ CI：1.72～2.06）的预测效果较好;而对于糖尿病来说,腰围的预测效果较好（标准化OR=1.62,95％ CI：1.45 ～1.80）.结论 本次调查发现身体脂肪率对我国35～64岁中年人群高血压和血脂异常的预测效果较好,而腰围对于糖尿病的预测效果较好.     

血清廋素与男性骨密度、体脂的关系

目的:探讨血清瘦素(leptin)与男性骨密度(BMD)及体脂之间的关系.方法:用ELISA测定350例20～80岁健康男性血清瘦素浓度;采用DXA仪测定BMD(腰椎、髋部及全身)及体成分(体脂及瘦体质量);以10种回归数学模型分别拟合瘦素与年龄、体质量指数,体脂及各部位骨密度的关系,选择最优拟合曲线.结果:血清瘦素与年龄以S型曲线回归模型拟合程度最好,其决定系数(R2)最大(R2=0.104,P＜0.009);而与体质量、体指数以复合回归模型拟合程度最好(分别R2=0.296,P＜0.001;R2=0.304,P＜0.001;R2=0.22,P＜0.001).血清瘦素与总体脂,体脂百分比相关(R2=0.461,P＜0.001;R2=0.448,P＜0.001).血清瘦素与腰椎前后位、腰椎侧位、股骨颈、髋部总体BMD显著相关(分别R2=0.115,P=0.005;R2=0.102,P=0.007;R2=0.098,P=0.01;R2=0.112,P=0.002).逐步多重线性回归分析显示瘦素不是男性各部位骨密度的独立影响因素.结论:血清瘦素浓度与男性体脂显著相关,但不是中国男性各部位骨密度的独立预测因子.     

Cut-off values for anthropometric variables that confer increased risk of type 2 diabetes mellitus and hypertension in Iraq

BACKGROUND: Body mass index (BMI) is often used to reflect total body fat amount (general obesity), whereas waist circumference (WC), waist-to-hip ratio (WHpR) or waist-to height ratio (WHtR) is used as a surrogate of body fat centralization (central obesity). The purpose of the present study was to identify cut-offs for BMI and upper-body adiposity (WC, WHpR, and WHtR) that, associated with increased risk of type 2 DM and hypertension in Iraqi adults, would be consistent with overweight and central adiposity. METHODS: This was a community-based cross-sectional survey for establishing cut-off values for BMI and upper-body adiposity (WC, WHpR or WHtR) associated with increased risk of type 2 DM and hypertension from one district in Southern Iraq, Basrah (Abu-Al-khasib). The total number of persons involved was 12,986 (6693 men and 6293 women), aged 45.6 +/- 15.7 years. RESULTS: The cut-off point in men associated with increased risk of type 2 DM and hypertension were BMI 25.4 and 24.9, WC 90 and 95 cm, WHpR 0.92 for both and WHtR 0.52 and 0.55, respectively. For women, the cut-off point associated with increased risk of type 2 DM and hypertension were BMI 26.1 and 26.5, WC 91 and 95 cm, WHpR 0.91 for both, and for WHtR 0.56 and 0.59, respectively. The best index for association with type 2 DM was WHpR with cut-off point of 0.92 for men and 0.91 for women. For hypertension, the best index is WHtR (with cut-off point of 0.55 for men and 0.59 for women), whereas the least reliable index was the BMI for both type 2 DM and hypertension. CONCLUSIONS: Our finding showed that, in Iraqi adults, WHpR has the strongest association with type 2 DM and WHtR for hypertension.     

女性2型糖尿病病人血清瘦素水平及其与代谢因素的关系

①目的　观察初诊女姓 2型糖尿病 (DM )病人血清瘦素 (LPT)水平 ,探讨其与年龄、体质量指数、糖代谢、脂代谢、尿酸代谢及其他激素的关系。②方法　采用放射免疫分析法 (RIA)和酶联免疫吸附法 (ELISA)测定初诊未经治疗 1 1 1例 2型糖尿病病人 (男 5 6例 ,女 5 5例 )及 96例正常人 (男 4 8例 ,女 4 8例 )空腹血清LPT、睾酮(TT)、雌二醇 (E2 )、真胰岛素、血糖、血清胆固醇、三酰甘油和尿酸水平。③结果　女性DM组血清瘦素水平明显低于女性对照组 (F =1 7.985 ,P <0 .0 1 ) ;DM组及对照组中 ,女性血清瘦素水平明显高于男性 (F =34.6 0 8、5 3.72 1 ,P <0 .0 1 ) ;绝经后女性DM组与绝经前女性DM组瘦素水平比较 ,差异无显著性 (P >0 .0 5 ) ;女性DM组血清瘦素水平与体质量指数、胰岛素浓度、腰臀围比值及尿酸水平呈正相关 (t =4 .0 75～ 1 1 .72 5 ,P <0 .0 1、0 .0 5 ) ,与空腹血糖及血清睾酮水平呈负相关 (t=- 3.94 6、- 2 .30 5 ,P <0 .0 5 )。④结论　女性 2型糖尿病病人血清瘦素水平较正常女性明显降低 ;女性 2型糖尿病病人血清瘦素水平与体质量指数、脂肪分布、胰岛素浓度、睾酮、血糖及血尿酸相关 ;雌激素不是影响瘦素的主要因素 ;瘦素参与了女性 2型糖尿病病人的糖代谢及尿酸代谢     

Activity, adiposity and weight change in Jamaican adults

OBJECTIVE: Populations in developing countries are particularly vulnerable to the development of obesity in the period of rapid transition to a more modernized lifestyle. We sought to determine the relationship between activity energy expenditure (AEE), adiposity and weight change in an adult population undergoing rapid socio-economic transition. METHODS: Total daily energy expenditure (TDEE) was measured using the doubly labelled water method, resting energy expenditure (REE) using indirect calorimetry and AEE calculated as the difference between TDEE and REE, in adults from a working class community in Spanish Town, Jamaica. During six years of follow-up, weight was measured between one and four times. Mixed effects regression modelling was used to test for association between components of the energy budget and weight change. RESULTS: Men (n = 17) weighed more but women (n = 18), had significantly more body fat, 38.5% vs 24.5%, respectively (p < 0.01). Men had higher levels of EE, particularly AEE after adjustment for body weight, 66.3 versus 46.4 kJ/kg.d for men and women, respectively (p < 0.001). At baseline, adjusted AEE was inversely associated with body fat in men and women, r = -0.46 and r = -0.48, respectively (p < 0.05). Mean rate of weight change was + 1.1 and + 1.2 kg/year for men and women, respectively. No component of EE, ie TDEE, REE or AEE, significantly predicted weight change in this small sample. CONCLUSIONS: These results suggest an important role for AEE in maintaining low levels of adiposity. The lack of association between EE and weight change, however, suggests populations in transition are at risk of obesity from environmental factors (eg dietary) other than simply declining physical activity levels.     

Serum leptin levels and adiposity in adult Chinese: a preliminary observation

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2型糖尿病与糖耐量低减病人血清瘦素水平的变化及其相关因素

①目的　探讨初诊的 2型糖尿病 (DM )与糖耐量低减 (IGT)病人血清瘦素水平的变化及其与年龄、性别、体质量指数 (BMI)、糖代谢、脂代谢以及其他激素的关系。②方法　采用放射免疫分析法 (RIA)和酶联免疫吸附法 (ELISA) ,检测了初诊未经治疗的 77例 2型糖尿病病人 ,32例IGT病人及 5 2例正常人的空腹血清瘦素、睾酮(TT)、雌二醇 (E2 )和真胰岛素 ;同时测定血糖、血清胆固醇、三酰甘油和尿酸。③结果　女性 2型糖尿病组及IGT组血清瘦素水平明显低于女性对照组 (F =9.14 8,P <0 .0 0 1) ;各组肥胖者血清瘦素水平明显高于非肥胖者 (F =31.0 11,6 .84 2 ,Z =4 .2 2 0 ,P <0 .0 0 1,0 .0 1) ;各组女性血清瘦素水平明显高于男性 (F =2 5 .812～ 71.4 31,P <0 .0 0 1,0 .0 1) ;女性 2型糖尿病绝经后病人组与绝经前病人组瘦素水平比较差异无显著性 (F =0 .16 2 ,P >0 .0 5 ) ;2型糖尿病组及IGT组血清瘦素水平与BMI ,胰岛素浓度、腰围呈正相关 (P <0 .0 1,0 .0 5 ) ,与睾酮、空腹血糖及胰岛素敏感指数呈负相关 (P <0 .0 1,0 .0 5 )。④结论　女性 2型糖尿病及IGT病人体内瘦素的合成较男性病人更易受血糖和胰岛素调控的影响 ;2型糖尿病及IGT病人血清瘦素水平与性别、BMI,腰围、胰岛素浓度、睾酮等多种因素相关 ;雌激     

不同方药对多囊卵巢综合征高瘦素血症的影响

 目的 观察不同方药对多囊卵巢综合征（patients with polycystic ovary syndrome,PCOS）患者血清瘦素（leptin）的影响。方法 选择PCOS患者共43例（PCOS组），其中肾阴虚证患者25例，采用滋阴降火方药治疗（滋肾阴组），脾气虚证患者18例，采用健脾益气方药治疗（补脾气组）；年龄相同健康女性20例（对照组）。各组分别检测体重指数（BMI）、腰臀比（WHR）、腰围（WC）及血清Leptin、睾酮（T）、胰岛素（INS）的浓度，比较PCOS组和对照组之间，以及PCOS各组治疗前后各项指标的差异。结果 治疗前PCOS组的BMI、WHR、WC，及血清Leptin、T、INS水平均明显高于对照组（P＜0.01）；去除BMI、WHR、WC的影响后仍有显著性差异；43例PCOS患者中有33例的血清Leptin升高，但在两种证型之间分布无显著性差异（P＞0.05）；治疗后PCOS组（滋肾阴组、补脾气组）BMI、WHR、WC无明显变化，而血清Leptin、T、INS水平较治疗前降低（P＜0.05－P＜0.01）；其中滋肾阴组的血清T、INS水平较治疗前降低（P＜0.05～P＜0.01）；补脾气组的血清INS水平较治疗前有显著降低（P＜0.01）。滋肾阴组、补脾气组的血清leptin较治疗前有下降趋势，但无统计意义（P＞0.05）；结论 血清Leptin水平异常增高是PCOS的发生发展中不可忽略因素，不同方药均有降调血清Leptin水平趋势，且能改善PCOS患者的高睾酮血症、高胰岛素血症状态，至于Leptin、T、INS因果问题，还有待进一步深入研究。     

Type 2 diabetes is associated with increased bone mineral density in Mexican-American women

BACKGROUND: Our purpose was to determine whether type 2 diabetes is associated with altered bone mineral density (BMD) and whether fasting serum insulin levels are correlated with BMD. METHODS: In a population-based family study of Mexican-Americans, we obtained measurements of BMD, diabetes status (by 2-h oral glucose tolerance test), obesity, and serum insulin concentrations in 600 subjects from 34 families. Analyses were stratified by sex and conditioned on the pedigree structure to account for residual correlations among related individuals. RESULTS: Women with diabetes had significantly higher BMD at hip than women without diabetes (p=0.03) even after adjustment for age, body mass index (BMI), and menopause status. BMD at spine was also higher in diabetic women than in nondiabetic women, although the association was no longer statistically significant after adjustment for BMI. Diabetes was not associated with BMD in men. In nondiabetic men and women, insulin levels were significantly correlated with BMD after adjustment for age and other lifestyle covariates, but correlations were diminished and were no longer statistically significant after further adjustment for body mass index. CONCLUSIONS: These results suggest that Mexican-American women with type 2 diabetes have higher BMD compared to their nondiabetic counterparts, with the association independent of obesity at hip, although not at spine or forearm. Increased BMD was also correlated with serum insulin levels, although this association was not independent of obesity. Longitudinal studies may be required to better define the mechanisms underlying the observed association between BMD and diabetes.     

Association of leptin with insulin resistance, body composition, and lipid parameters in postmenopausal women and men in type 2 diabetes mellitus

OBJECTIVE: To determine the association of leptin with insulin resistance, body composition, and lipid parameters in postmenopausal women and men with type 2 diabetes mellitus (T2DM). METHODS: This study was conducted in 158 patients (87 postmenopausal women and 71 men) with T2DM, and 99 healthy controls (52 postmenopausal women and 47 men). Type 2 diabetes mellitus patients were selected consecutively from the outpatient Endocrinology Service of Cumhuriyet University Hospital, Sivas, Turkey from April 2002 to March 2005. We collected demographic, leptin, insulin resistance, and lipid and body composition parameters. RESULTS: Serum leptin levels of females were significantly higher than those of men in both T2DM, and healthy participants. The basal metabolic rate, fat free mass, and total body water of males, were lower than those of females. In both T2DM and healthy participants, leptin was positively correlated with insulin resistance and body composition parameters in both gender. Serum leptin levels of females were higher compared with males in the same BMI, independent of T2DM. CONCLUSION: Leptin was associated with insulin, insulin resistance, and body composition parameters (body mass index, basal metabolic rate, body weight, %fat, and fat mass) in participants, with or without T2DM in both genders. Type 2 diabetes mellitus seemed more effective on insulin resistance than obesity. We suggest that the female gender, and fat mass, and not T2DM might have significant influence on leptin levels in age.     

Metabolic consequences of childhood obesity--a preliminary report

INTRODUCTION: Childhood obesity is increasing in Sri Lanka. Obesity related morbidity is mainly associated with the metabolic syndrome (MetS) and non-alcoholic steatohepatitis (NASH). Recent studies have shown these serious health consequences in obese children. OBJECTIVES: The objectives of our study were to document the presence of MetS and NASH in obese Sri Lankan children, to correlate the fat mass (FM) with the waist circumference (WC) and the body mass index (BMI), and to compare the association of the WC, BMI and the WHR (waist-hip ratio) with the metabolic derangements. METHOD: Children attending the Obesity Clinic at Lady Ridgeway Hospital, Colombo, from November 2004 to September 2005 were studied. The relevant sociodemographic data, anthropometric measurements and examination findings were documented. After a 12-hour overnight fast, blood was taken for estimation of lipid profile, serum insulin, liver enzymes and blood glucose. The oral glucose tolerance test (OGTT) was done in children over 5 years of age. Fatty infiltration of the liver was assessed by identifying specific features on ultrasonography and the degree of infiltration was given a score. We modified the International Diabetes Federation (IDF) 2004 guidelines to define MetS. NASH was defined as fatty infiltration of the liver associated with a raised serum ALT. RESULTS: Seventy children (40 boys) were studied. The mean (SD) age was 9.7 (2.5) and 9.3 (3.0) years for boys and girls respectively. Mean BMI was 25.9 in both groups. All patients had a WC > 98th percentile. MetS was found in 13 of the 63 (21%) children on whom all criteria were assessed. Sixty children had ultrasonography and NASH was seen in 11 (18%). The correlation of the percentage FM was greater with the BMI (r = 0.80; p < 0.001) than with the WC (r = 0.56; p < 0.001), but the WC was more significantly associated with the metabolic derangements than either BMI or WHR. CONCLUSIONS: Serious metabolic abnormalities are found in obese Sri Lankan children and the WC is a reliable indicator of these derangements.     

瘦素和多囊卵巢综合征(PCOS)伴非酒精性脂肪肝(NAFLD)相关性的临床观察

 目的  通过对多囊卵巢综合征(polycystic ovary syndrome,PCOS)人群中伴非酒精性脂肪肝(non-acoholic fatty liver disease,NAFLD)的分析,探讨瘦素与PCOS伴NAFLD之间的关系。方法  收集35例PCOS伴有NAFLD的患者为脂肪肝组,同期选择35例PCOS不伴NAFLD的患者为非脂肪肝组,健康女性志愿者20例为对照组。所有受试者进行相关问卷调查建立个人病例档案,测量身高(height,H)、体重(weight,W)、体重指数(body mass index,BMI)、腰围(waist circumference,WC)、臀围(hip circumference,HC)及腰臀比(wasit hip ratio,WHR);检测血清睾酮(testosterone,T)、泌乳素(prolactin,PRL)、卵泡刺激素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E2)、瘦素、空腹血糖(fasting blood sugar,FBG)、空腹胰岛素(fasting insulin,FINS)、餐后2 h血糖(2 h postprandial blood glucose,2hPBG)、稳态模型胰岛素抵抗指数(homeostatic model assessment for insulin resistance,HOMA-IR)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)及丙氨酸转氨酶(alanine transaminase,ALT)等指标。结果  两组PCOS的瘦素、W、BMI、WHR、T、LH、LH/FSH、FINS、PBG、HOMA-IR、LDL-C各项指标均高于对照组(P<0.05),FSH显著低于对照组（P<0.05）;而PCOS伴NAFLD的瘦素、W、BMI、WC、HC、WHR、FINS、PBG、HOMA-IR、TG、LDL-C、ALT较不伴NAFLD显著升高(P<0.05),HDL-C显著降低(P<0.05)。脂肪肝组的瘦素水平与年龄、W、BMI、WC、HC、WHR、FINS、HOMA-IR及TG呈均显著正相关性(P<0.01),与HDL-C呈显著负相关性(P<0.01),控制与体脂有关的如W、BMI、WC、HC、WHR,脂肪肝组的瘦素水平与HOMA-IR、TG仍有显著正相关性(P<0.01)。结论  瘦素水平异常与PCOS伴NAFLD的形成密切相关,及早重视瘦素干预,对于防治PCOS伴NAFLD有重要意义。     

正常妊娠妇女及新生儿脐血瘦素水平测定及其相关意义

目的探讨正常妊娠妇女血清及新生儿脐血瘦索水平及其相关意义。方法采用放射免疫法测定对照组的43例正常未妊娠妇女、观察组的135例妊娠妇女血清瘦素水平及61例新生儿脐血瘦素水平。分别测定两组妇女的身高、体重、血压、新生儿体重、身长．计算BMI．并分析其与瘦素之间的关系。结果（1）两组妇女血清瘦素水平与其BMI呈极显著性正相关．与其收缩压、舒张压和平均动脉压均无显著性相关。（2）随着孕周的增加,正常妊娠妇女血清瘦素水平呈上升趋势。（3）正常妊娠妇女血清瘦素水平与新生儿出生体重、BMI、新生儿脐血瘦素水平无明显相关性。（4）新生儿脐血瘦素水平与新生儿出生体重、BMI呈显著正相关。结论（1）妊娠期瘦素水平均较妊娠前明显升高．且随着孕周的增加,瘦素水平的变化趋势呈逐渐上升的势态,（2）新生儿脐血瘦素水平明显低于母体分娩时水平．它仅反映新生儿体内的脂肪组织含量．而与其母亲的脂肪组织含量或瘦索水平无关。     

饮食治疗与抗氧化膳食补充剂对非酒精性脂肪性肝病的效果评价

背景　非酒精性脂肪性肝病（NAFLD）已成为我国第一大慢性肝脏疾病,并带来严重疾病负担。由于缺乏有效的药物,饮食治疗是NAFLD最基础也是最重要的方法。但对于如何实施营养治疗,开展效果监测与评价,目前仍欠缺具体指导与规范。目的　探讨实施个体化精准营养治疗及在此基础上加用抗氧化膳食补充剂“葡萄籽提取物”对NAFLD患者的人体成分、肝脏硬度、肝功能及炎症等指标的影响。方法　采用便利抽样法选择2018年4月-2019年7月广东省人民医院营养科及消化科脂肪肝亚专科门诊就诊的NAFLD患者100例为研究对象,按就诊顺序号随机分为饮食治疗组（n=50）和饮食治疗+抗氧化膳食补充剂组（简称：饮食治疗+补充剂组,n=50）,饮食治疗组由营养专科医师按“改良限碳限能量低血糖负荷平衡膳食”原则给予患者个体化营养治疗,饮食治疗+补充剂组在饮食治疗组基础上,加用“葡萄籽提取物”2片/d。试验过程中9例患者脱落：饮食治疗组4例,饮食治疗+膳食补充剂组5例,予以剔除。记录患者的性别、年龄、身高、体质量、体质指数（BMI）、颈围、腰围、臀围、身体脂肪重量（FM）、肌肉质量（MM）、基础代谢率（BMR）、内脏脂肪等级（VFR）、肝脏硬度、受控衰减参数（CAP）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、谷氨酰转肽酶（GGT）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、游离脂肪酸（FFA）、总25羟基维生素D〔25（OH）D〕、超氧化物歧化酶（SOD）、超敏C反应蛋白（hs-CRP）、脂质蓄积指数（LAP）等指标,并比较两组间及治疗前后有无差异。结果　剔除9例脱漏患者,最终91例患者完成了试验。两组患者治疗后BMI、颈围、腰围、臀围低于治疗前（P<0.05）。饮食治疗组患者治疗后体质量、FM、BMR、VFR、LAP、CAP、ALT、GGT、hs-CRP低于治疗前（P<0.05）;饮食治疗+补充剂组患者治疗后体质量、FM、VFR、LAP、肝脏硬度、CAP、ALT、GGT、TG、FFA、hs-CRP低于治疗前,HDL-C、SOD高于治疗前（P<0.05）。饮食治疗+补充剂组患者治疗后FFA低于饮食治疗组,SOD高于饮食治疗组（P<0.05）。结论　由营养医师制定并实施个体化精准营养治疗方案,定期跟踪随访,对NAFLD患者的各项指标的改善有明显作用,加用抗氧化膳食补充剂对改善NAFLD患者血脂代谢,降低FFA,升高SOD方面与饮食治疗有协同作用。     

Newborn birth weight correlates with placental zinc, umbilical insulin-like growth factor I, and leptin levels in preeclampsia

BACKGROUND: The aim of the present study was to determine whether newborn birth weights were associated with insulin-like growth factor I (IGF-I), zinc, and leptin in preeclamptic and normotensive pregnancies. METHODS: This study was done cross-sectionally and included 15 women with moderate preeclampsia (PE group) and 11 normotensive pregnant women (NT group) of similar gestational age. Maternal and umbilical cord serum levels of zinc, IGF-I, IGF binding proteins (IGFBPs), leptin, and placental zinc were assessed in each group. RESULTS: As compared with the NT group, the PE group had significantly (p <0.05) lower newborn birth weight [3.33 (3.11-3.55) vs. 2.80 (2.40-3.17) kg], maternal IGF-I [303 (276-364) vs. 198 (153-244) ng/mL], and umbilical IGF-I [87 (71-126) vs. 44 (26-98) ng/mL]. In addition, low IGFBP-3 and high IGFBP-1 were observed in the PE group. In the PE group, birth weight correlated positively with placental zinc (rho = 0.56, p = 0.04), maternal IGF-I (rho = 0.76, p = 0.004), umbilical cord IGF-I (rho = 0.75, p = 0.005), and umbilical cord leptin (rho = 0.61, p = 0.02) levels. Stepwise multiple regression analysis showed that among these variables, umbilical IGF-I was the major predictor of birth weight. In the NT group, birth weight did not correlate with any of these variables. CONCLUSIONS: The present study indicates that moderate preeclampsia is associated with low newborn birth weight, IGF-I, IGFBP-3, and high IGFBP-1 without significant changes in zinc and leptin levels. In addition, umbilical IGF-I was the major predictor of newborn birth weight.     

Body fat at birth and cord blood levels of insulin, adiponectin, leptin, and insulin-like growth factor-I in small-for-gestational-age infants

BACKGROUND: Low birthweight has been associated with an increased risk of obesity, insulin resistance, and diabetes in adulthood. The aim of this study was to evaluate IGF-I, adiponectin, insulin levels, and body fat in small-for-gestational-age (SGA) infants at birth. METHODS: We performed a transverse comparative study in SGA and appropriate-for-gestational-age (AGA) infants. The study was conducted at the Hospital of Gynecology and Obstetrics in Leon, Mexico. Weight, length, and percent of body fat were evaluated during the first 48 h of birth. Glucose, insulin, leptin, adiponectin, and IGF-I levels in cord blood were measured. RESULTS: We studied 100 infants (50 SGA and 50 AGA). A history of diabetes in a second-degree relative was higher in SGA infants than in AGA infants (48.0 vs. 30.0%, respectively; p = 0.03). Glucose, adiponectin, insulin and IGF-I levels were similar between the groups. Leptin levels and percentage of body fat were lower in SGA than AGA (15.3 vs. 23.4 ng/mL; p = 0.003, 11.1 vs. 12.7%; p <0.001, respectively). Logistic regression analysis showed that length, percentage of body fat, and leptin levels were positively associated with birthweight. However, leptin levels were not independent of percentage of body fat. CONCLUSIONS: Low body fat and leptin levels, but no evidence of increased metabolic risk at birth, were found in SGA infants.     

中国女性血清瘦素浓度与年龄的关系及 与其他种族女性的比较

目的：调查中国长沙地区成年女性血清瘦素(leptin)浓度与年龄的关系,建立女性瘦素参考值,并分析其与其他种族的差异。方法：采用酶联免疫吸附法(ELISA)试剂盒,测定690例成年健康女性(年龄20~81岁)的血清瘦素浓度。美国非西班牙白人、非西班牙黑人和美国墨西哥女性的血清瘦素水平从文献获得。结果：血清瘦素水平随年龄而增加(r=0.224, P＜0.01),采用3次回归模型拟合优度最佳。瘦素浓度与体质量(r=0.574)和体质量指数(r=0.618)呈显著正相关。体质量正常组、超体质量组和肥胖组,瘦素浓度的几何平均值分别为(8.94±1.82),(17.6±1.89)和(34.7±1.69) μg/L,3组之间呈明显梯度差异（ P＜0.01）。绝经前组、围绝经组和绝经后组瘦素浓度分别为(9.68±1.81),(11.7±1.89)和(11.4±2.21) μg/L,绝经前组显著低于围绝经组和绝经后组（ P＜0.05）。体质量正常组(n=539)血清瘦素浓度的参考值为5.30~12.6 μg/L,本组女性瘦素浓度与年龄的拟合曲线显著低于美国非西班牙白人、非西班牙黑人和美国墨西哥女性。 结论：该研究证实,中国成年女性血清瘦素浓度增高与年龄增长呈正相关,中国成年女性血清瘦素浓度参考值5.30~12.6 μg/L,中国成年女性血清瘦素浓度与美国非西班牙白人、非西班牙黑人和美国墨西哥女性存在显著的种族差异。     

人体血清载脂蛋白A-IV水平与肥胖、瘦素的相关性探讨

目的：探讨血清载脂蛋白A-IV（apolipoproteinA-IV,apoA-IV）水平与肥胖、瘦素（leptin）的相关性。方法：选取山东省济南市城市居民和淄博市某农村居民共617名，受试者禁食12～14h，于早晨7～9时空腹抽取肘静脉血5ml，静置30h，3000r/min离心15min后分离血清，立即分装于eppendorf管中，置-70℃保存待用，测定血清leptin和apoA-IV浓度；受试者禁食12～14h，于清晨空腹测量体重、BMI、BF%及WHR等多项指标，观察血清apo A-IV水平与肥胖和leptin的关系。结果：山东人血清apoA-IV水平与体脂含量呈负相关（男性r=-0.182，女性r=-0.147），但与体脂分布无相关性。血清apoA-IV水平与leptin水平无相关性。结论：肥胖者血清apoA-IV水平降低，leptin不是主要影响因素。     

脂肪肝脂代谢与体脂构成和消脂素的关系

目的 探讨脂肪肝患者的脂代谢与体脂构成和消脂素（leptin)的关系。方法 观测了76例脂肪肝患者及30例正常对照者的血清leptin、血脂、血糖、胰岛素（INS）、C－肽（C－P）水平,并进行了比较。同时将血清leptin与体脂含量评估指标（BMI,WHR,％Fat)等做了相关分析。结果 脂肪肝组leptin水平及TC、TG含量明显高于正常对照组（P＜0．01）,leptin及血脂的增高与体脂含量成正比。空腹INS,C－P水平明显高于正常对照组（P＜0．01）,口服葡萄糖（75g)2h后增高更加显著（P＜0．001）。结论 脂肪肝患者多存在有leptin抵抗、高胰岛素血症,且与脂代谢紊乱密切相关;体脂的含量和分布是血浆leptin的独立影响因素。     

Prediction of Abdominal Visceral Obesity From Body Mass Index, Waist Circumference and Waist-hip Ratio in Chinese Adults： Receiver Operating Characteristic Curves Analysis

Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific fact