肥胖儿童血清vaspin水平与胰岛素敏感性及糖脂代谢的关系

目的:探讨肥胖儿童血清vaspin水平与胰岛素敏感性及糖脂代谢的关系.方法:收集肥胖儿童34例(肥胖组),男22例,女12例.并随机抽取同年龄健康查体的儿童30例为对照组,男20例,女10例.测定所有受试者体格参数、血清vaspin、血脂、空腹血糖(FPG)及空腹胰岛素(FINS)水平.计算体质指数(BMI)、腰臀比(WHR)、体脂百分比(BF％)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)及致动脉粥样硬化指数(AI).比较2组儿童的上述指标,并对肥胖儿童血清vaspin水平与体格参数及糖脂代谢各指标进行相关分析.结果:肥胖组儿童vaspin、腰围(WC)、BMI、BF％、收缩压(SBP)、舒张压(DBP)、FPG、FINS、HOMA-IR、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、LDL-C/高密度脂蛋白胆固醇(HDL-C)、(TC-HDL-C)/HDL-C均明显高于对照组,而HDL-C、ISI低于对照组.vaspin与BMI、WC、WHR、BF％、TG、FINS、HOMA-IR、(TC-HDL-C)/HDL-C呈正相关,与ISI、HDL-C呈负相关,与年龄、DBP、SBP、FPG、LDL-C、LDL-C/HDL-C、TC无明显相关性.结论:vaspin水平升高可能是胰岛素抵抗的代偿性反应；在肥胖儿童早期,其水平测定可用于评价肥胖程度及胰岛素抵抗程度,并评估成年后发生心脑血管疾病的危险性.

Association between Serum Vaspin Concentration and Insulin Sensitivity,Glucose and Lipid Metabolism in Obese Children

Objective: To investigate the relationship between serum vaspin concentration and insulin sensitivity, glu cose and lipid metabolism in obese children. Methods: A total of 34 obese children (22 males and 12 females) were enrolled in this trial. And other randomly selected 30 cases (20 males and 10 females) of normal healthy children were taken as control. The physical index, the serum vaspin level, serum lipids, fasting plasma glucose (FPG) and fasting insulin (FINS) were measured using standard instruments and procedures. And the body mass index (BMI), waist-hips-ratio (WHR), body fat % (BF%), homeostasis model assessment-estimated insulin resistance (HOMA-IR) index, insulin sensitivity index (ISI) and ath-erosclerotic index (AI) were calculated according to suitable formula. The Physical index such as anthropometric weight, serum lipids, AI and ISI were compared between two groups. The relationship between serum vaspin concentration and insulin sensitivity, glucose and lipid metabolism was analyzed. Results: The values of vaspin, waist circumference (WC), BMI, BF%, systolic blood pressure (SBP), diastolic blood pressure (DBP), FPG, FINS, HOMA-IR, low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), LDL-C/high density lipoprotein cholesterol (HDL-C), total cholesterol (TC)-HDL-C/HDL-C were significantly higher in obese group than those of control group. But levels of HDL-C and ISI were much lower in obese group than those of control group. There was a significant positive correlation between the vaspin concentration and BMI , WC , WHR , BF% , TG , FINS , HOMA-IR and TC-HDL-C/HDL-C. A positive correlation was found between the vaspin concentra tion, ISI and HDL-C. There was no significant relationship between age,DBP, SBP, FPG, LDL-C, LDL-C/HDL-C and TC. Conclusion: The increased vaspin level may be a compensatory response to insulin resistance. The serum vaspin concentration was strongly associated with obesity and atherogenic index. Monitoring serum vaspin levels may have a very important value for understanding the degree of obesity and insulin resistance.