儿童肥胖与C-反应蛋白瘦素胰岛素敏感指数的相关性研究

目的：探讨儿童肥胖与超敏C反应蛋白(hsCRP)、瘦素(LP)、胰岛素敏感指数(ISI)的相关性。方法：抽样调查湘潭市13702名2～18岁儿童及青少年，将69名肥胖自愿者及30名年龄、性别相匹配的自愿受试者分为两组，分别测体重指数(BMI)、hsCRP，LP，空腹血糖(FPG)、空腹胰岛素(INS)，计算ISI，比较两组差异及各指标的相关性。结果：肥胖组hsCRP，INS，LP显著高于对照组(P<0.01)，ISI显著低于对照组(P<0.01)；BMI与hsCRP，LP，INS呈显著正相关(P<0.05～0.01)，与ISI呈显著负相关(P<0.01)，hsCRP与FPG，INS呈显著正相关(P<0.05～0.01)，与ISI呈显著负相关(P<0.01)；LP与INS，BMI呈显著正相关(P<0.01)，与ISI呈显著负相关(P<0.01)。结论：肥胖儿童存在胰岛素抵抗(IR)及瘦素抵抗(LR)，同时CRP，LP等炎症因子在肥胖发病过程中起重要作用。

Correlation of obesity with C-reactive protein, leptin and insulin sensitive index in children

Objective To study the correlation between obesity and hypersensitive C-reactive protein (hsCRP), leptin, and insulin sensitive index (ISI) in children. Methods The subjects included 69 obese volunteers and 30 age and gender-matched normal volunteers who were recruited from 13 702 children aged 2 to 18 years in Xiangtan City by sampling survey. The body mass index (BMI), hsCRP, leptin, fasting plasma glucose (FPG), and fasting insulin (INS) were tested, and then the ISI was calculated. The results between the obese and normal children were compared. The correlation between the parameters was evaluated. Results The values of hsCRP, leptin and INS in obese children were significantly higher than those in the normal controls (P<0.01), but the ISI in obese children was significantly lower than that in normal controls (P<0.01).The BMI was significantly positively correlated with the values of hsCRP, leptin and INS (r=0.225, P<0.05; r=0.776, P<0.01; r=0.568, P<0.01), but was significantly negatively correlated with the ISI (r=-0.889, P<0.01). There was a positive correlation between the value of hsCRP and the values of FPG and INS (r=0.429, P<0.01; r=0.206, P<0.05), and there was a negative correlation between the value of hsCRP and the ISI (r=-0.889, P<0.01). The value of leptin significantly positively correlated with the values of INS and BMI, and significantly negatively correlated with the ISI.Conclusions Insulin resistance and leptin resistance exist in obese children. The inflammatory factors such as CRP and leptin may be involved in the pathogenesis of obesity.