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目的探讨血清脂联素水平与高胰岛素血症和(或)胰岛素抵抗的联系。方法采用酶联免疫法测定2004-02—2004-12在天津医科大学总院就诊的34例肥胖儿童和31例正常对照的血清脂联素水平。分析血清脂联素与人体参数、体脂分布及糖代谢中各指标的相关关系。结果(1)肥胖组脂联素水平低于对照组(P<0.001)。(2)脂联素与性别、年龄无相关关系;与收缩压、舒张压呈负相关(相关系数分别为r=-0.369,r=-0.405,P<0.01);与BMI、腰臀比和SF呈负相关(相关系数分别为r=-0.330,r=-0.282和r=-0.350,P<0.01);与空腹血糖、空腹胰岛素水平呈负相关(相关系数r=-0.264和r=-0.357,P<0.01);与HOMA-R呈负相关(P<0.01),与HOMA-β无相关关系。(3)多元回归分析表明,HOMA-R是影响脂联素最为显著的因素,R2=0.122;标准化偏回归系数-0.369(P<0.01)。结论肥胖症儿童血清脂联素水平较正常儿童降低。血清脂联素水平的变化,是影响空腹血糖、空腹胰岛素水平、HOMA-R的重要因素。低脂联素血症可能参与胰岛素抵抗的发生。

The serum adiponectin levels and insulin resistance in obese children

??To study the relationship between serum adiponectin levels and hyperinsulinemia/insulin resistance. MethodsThe serum adiponectin levels were measured in 34 obeses children and 31 normal subjects by ELISA.We also measured the anthropometrics of all subjects,assessed insulin resistance by homeostasis model assessment ratio (HOMA??R),assessed ?? cell function by homeostasis model assessment ?? cell (HOMA????),and calculated the correlativity between adiponectin and other parameters. Results(1) The serum adiponectin levels in obese subjects were lower than normal subjects(P<0??001).(2)The serum adiponectin levels were not significantly correlated with sex and age,but were negatively correlated with SBP,DBP,BMI,WHR and SF (r=-0??369,r=-0??405,r=-0??330,r=-0??282 and r= -0??350??P<0??01),and negatively correlated with fasting glucose,fasting insulin and HOMA??R ( r=-0??264,r=-0??357and r=-0??370,P<0??05).They were not significantly correlated with HOMA????.(3)Multiple linear regression analysis was used to determine correlation coefficient between adiponectin and various parameters.Only HOMA??R entered the equation.For adiponectin,R2=0??122,the standard partial coefficient being -0??369(P<0??01). ConclusionSerum adiponectin levels are lower in obesity children compared with normal ones.Serum adiponectin levels are negatively correlated with fasting glucose,fasting insulin and HOMA??R.The hypoadiponectinemia may be associated with insulin resistance.