单纯性肥胖外周血单核/巨噬细胞趋化因子与胰岛素抵抗的相关性研究

了解单纯性肥胖儿童外周血单核/巨噬细胞趋化因子与胰岛素抵抗相关参数的关系。方法　2006年5月至2008年5月广西医科大学第一附属医院儿科70 例确诊为单纯性肥胖儿童作为研究对象，30名健康体检儿童作为健康对照组。流式细胞仪测定外周血单核细胞CD68阳性率；酶联免疫吸附（ELISA）法测定血浆巨 噬细胞炎性蛋白-1α（MIP-1α）、单核细胞趋化蛋白-1（MCP-1）水平；放射免疫分析（RIA）法测定血浆脂联素（ADPN）、血浆胰岛素（Ins）浓度，计算体质 指数（BMI），按HOMA模型计算胰岛素抵抗指数（InRI），并与相关变量进行Pearson相关分析或偏相关分析。结果　单纯性肥胖组血浆MIP-1α、MCP-1水平高于 健康对照组，两组比较差异有统计学意义（P < 0.05）。两组外周血CD68阳性率比较差异无统计学意义（P > 0.05）。两组InRI比较差异有统计学意义 （P < 0.05）。单纯性肥胖组血浆MIP-1α、MCP-1水平分别与BMI、腰围（WC）和InRI呈正相关 （P < 0.05）。血ADPN分别与BMI、WC和InRI呈负相关（P < 0.05）。外 周血单个核细胞CD68阳性率与BMI、WC和InRI无相关性（ P > 0.05）。结论　单纯性肥胖患儿体内存在低程度炎症反应，肥胖儿童外周血单核/巨噬细胞趋化因子 与胰岛素抵抗及中心性肥胖相关，可以作为肥胖相关疾病的早期预测指标之一。

Relative analysis of plasma monocyte/macrophage chemoattractant protein and related parameters of insulin resisitance in children with simple

Objective　To investigate the correlations between plasma monocyte /macrophage chemoattractant protein and related parameters of insulin resisitance in children with simple obesity. Methods　70 children with simple obesity were enrolled as study group，30 healthy children as control group. Body mass index（BMI ）and waist circumference （WC）were detected as indices of obesity .Plasma levels of macrophage inflammatory protein-1α（MIP-1α）、monocyte chemoattractant protein-1（MCP-1 ）were measured by ELISA.The rate of CD68 positive cells in blood were detected by flow cytometry（FCM）： Plasma levels of insulin 、adiponectin were measured by RIA， Insulin resisitance index （InRI） were caculated by homeostasis model assessment of insulin resistance （HOMA-IR）. The associations between MIP-1α、MCP-1 levels and adiponectin and related parameters were analyzed with Pearson correlation analysis or partial correlation analysis．Results　The concentration of MIP-1α and MCP-1 in plasma in children with simple obesity were higher than that in control group. There was a significant difference between the two groups （P < 0. 05）. The rate of CD68 positive cells in blood of simple obesity had no significant difference between that in control group （P > 0.05）.The concentration of MIP-1α and MCP-1 in plasma had positive correlations with BMI and WC and InRI（P < 0. 05）. The concentration of adiponectin in plasma had negetive correlations with BMI and WC and InRI （P < 0. 05）. The rate of CD68+ cell in blood had no correlation with BMI and WC and InRI（P < 0. 05）.Conclusion　We found that a differential low-grade inflammation is associated with obesity of children .The levels of MIP-1α、MCP-1 in blood of obesity were associated with insulin resistance and abdominal obesity. The levels of plasma MIP-1α、MCP-1、adiponectin may predict the onset of obesity related complications.