不同体质指数儿童青少年瘦素、脂联素、FGF-21与胰岛素抵抗的相关性分析

目的:探究不同体质指数（BMI）儿童青少年脂肪炎性因子瘦素（LEP）、脂联素（APN）、人成纤维细胞生长因子-21(FGF-21)与胰岛素抵抗（IR）的相关性。方法:收集7～16岁12 476例儿童青少年体检资料，根据BMI分为肥胖、超重及正常组；选取30例志愿者为研究对象，检验空腹血糖、胰岛素和血清LEP、APN、FGF-21等，计算胰岛素抵抗指数（HOMA-IR）并分析LEP、APN、FGF-21与之的相关性。结果:与正常组相比，两组LEP明显升高，肥胖组HOMA-IR、FGF-21明显升高，APN明显降低；与超重组相比，肥胖组HOMA-IR、LEP与FGF-21明显升高（P<0.05）。Pearson相关分析提示HOMA-IR与LEP、FGF-21呈正相关(r=0.563、0.301；P<0.05）；与ANP呈负相关（r=-0.376；P<0.001）。结论:儿童青少年肥胖易产生胰岛素抵抗，可能与脂肪组织分泌脂肪炎性因子有关，检测血清LEP、APN、FGF-21可以为预测胰岛素抵抗提供参考。

Relations of IR to LEP,APN and FGF-21 among children with different BMIs

Objectives: To explore the relations of IR to the levels of leptin (LEP), adiponectin (APN) and fibroblastic growth factor-21 ( FGF-21) among children with different BMIs. Methods: The physical reports of 12 476 children from 7 to 16 years old were selected. According to BMI, overweight group, obesity group and normal group were set as test groups, with 30 volunteers being selected as study subjects to each group respectively. The fasting blood-glucose, insulin and serum LEP, APN AND FGF-21 of these study subjects were tested to figure out HOMA-IR and its relations to LEP, APN, FGF-21. Results: Compared with normal group, the levels of LEP were significantly higher in both overweight and obesity group, and the levels of HOMA-IR and FGF-21 in obesity group increased significantly, but its levels of APN decreased sharply; Compared with overweight group, the levels of HOMA-IR, LEP and FGF-21 among obesity group increased markedly (P﹤0.05). Pearson correlation analysis showed that HOMA-IR was positively associated with LEP and FGF-21 (r=0.563, 0.301; P﹤0.05), but was negatively correlated with APN level (r=-0.376;P﹤0.001). Conclusion: Children obesity can lead to IR, which may result from adipose tissue secreting inflammatory cytokines. Test serum LEP, APN and FGF-21 can provide reference for prognosing IR.