单纯性肥胖儿童血清脑源性神经营养因子表达的变化及意义

目的观察单纯性肥胖儿童和健康正常体重儿童血清脑源性神经营养因子(BDNF)质量浓度的差异,探讨BDNF与儿童肥胖及瘦素抵抗、胰岛素抵抗的关系。 方法南京军区福州总医院儿科等于2004年5月至2005年5月应用酶联免疫法检测单纯性肥胖儿童(37例)和健康儿童(31例)血清BDNF质量浓度与胰岛素(INS)浓度，应用放射免疫法检测血清瘦素(LEP)质量浓度。比较两组儿童血清BDNF、INS、LEP的差异，分析血清BDNF质量浓度与血清LEP质量浓度和INS浓度的关系。 结果(1)两组儿童的体重指数(BMI)、BDNF、INS及LEP均差异显著(BMI：F=175.05，P<0.01；BDNF：F=12.35，P<0.01；INS：F=21.71，P<0.01；LEP：F=48.89，P<0.01)，肥胖组BMI、INS及LEP均明显高于健康组，而肥胖组BDNF明显低于健康组。(2)影响LEP的因素依次为BMI、丙氨酸转氨酶(ALT)、BDNF(R2=0.5946，F=0.31，P<0.01)；影响INS的因素依次为BMI、BDNF(R2=0.2647，F=11.34，P<0.01)。去除BMI、ALT影响后，BDNF与LEP、INS负相关(BDNF与LEP：r=-0.2455，P<0.05；BDNF与INS：r=-0.2878，P<0.05)。 结论(1)肥胖儿童血清BDNF缺乏，未发现“BDNF抵抗”的特点。(2)学龄前儿童血清LEP、INS受BMI影响最大，还受血清BDNF影响。BDNF是二者独立的负相关因素。

Changes and significance of the expression of brain derived neurotrophic factor in children with simple obesity.

AbstractObjectiveTo observe the difference of serum BDNF levels between simple obesity children and healthy children with normal weight,and explore the relativities between BDNF and human obesity and leptin resistance and insulin resistance. MethodsFrom May 2004 to May 2005,37 children with simple obesity and 31 health controls were enrolled into the study in the Department of Pediatrics of Fuzhou General Hospital.Serum BDNF and insulin levels were detected by ELISA ，serum leptin concentrations were examined by radioimmunoassay.The differences of serum BDNF levels and INS and LEP between simple obesity and healthy children were compared,the relativities between serum BDNF levels and INS and LEP were analyzed. Results(1)Compard with the healthy children,obese children significantly expressed higher BMI (P<0.01)and higher serum leptin levels (P<0.01)and higher serum insulin levels (P<0.01)and lower serum BDNF levels (P<0.01).(2)The most important factors influencing serum leptin level were listed as follows:BMI>ALT>BDNF (R2=0.5946，F=30.31，P<0.01)；The most important factors influencing serum insulin level were listed as follows:BMI>BDNF(R2=0.2647，F=11.34，P<0.01). Conclusion(1) Obese children lack BDNF,and they don’t characterize “BDNF resistance”.(2) Both children’s serum leptin and insulin levels are greatly affected by BMI and serum BDNF levels.And serum BDNF levels are their independent factors which are negatively correlated with them.It shows that administering BDNF may lighten the leptin resistance and insulin resistance in obese children.