肥胖症儿童血清抵抗素水平与胰岛素抵抗关系的研究

目的探讨肥胖症儿童血清抵抗素水平与高胰岛素血症和(或)胰岛素抵抗的关系。方法采用酶联免疫法测定34例肥胖儿童,31例正常对照的血清抵抗素水平。分析血清抵抗素与体重指数、体脂百分比、腰臀比及空腹血糖、空腹胰岛素水平、胰岛素抵抗指数、胰岛β细胞功能指数的相关关系。结果(1)肥胖组及对照组抵抗素浓度(对数转换值3.1±0.5)高于对照组(对数转换值2.7±0.8)(P<0.05)。(2)抵抗素与性别、年龄、收缩压、舒张压无相关关系;与体重指数、体脂百分比、腰臀比呈正相关(相关系数分别为r=0.299、0.304、0.322,P<0.01);与空腹血糖及空腹胰岛素水平呈正相关(相关系数为r=0.299和r=0.303,P<0.05);与胰岛素抵抗指数呈正相关(r=0.324,P<0.01),与胰岛β细胞功能指数无相关关系。(3)多元逐步回归分析表明,胰岛素抵抗指数为影响抵抗素最为显著的因素(R2=0.105);标准化偏回归系数0.279(P<0.01)。结论肥胖症儿童血清抵抗素水平较正常儿童增高,并与肥胖程度,脂肪分布密切相关。抵抗素可能与肥胖症儿童发生高胰岛素血症和(或)胰岛素抵抗有关。

Serum resistin concentration and insulin resistance in obese children

OBJECTIVE: Obesity is an important risk factor of insulin resistance and type 2 diabetes. Adipocyte is a cell that can actively secrete a series of factors to regulate the pathway responsible for energy balance. Resistin is one of these factors. The purpose of this study was to investigate possible correlation between resistin and certain parameters, including body parameters and other parameters of glucose metabolism and roles of resistin in hyperinsulinemia or insulin resistance in obese children. METHODS: The serum resistin concentration was measured in 34 obese children (18 boys, 16 girls; age 8.9-15.9 years) and 31 normal subjects (16 boys, 15 girls; age 7.8-14.5 years) by using ELISA. Anthropometric parameters, fasting glucose and insulin were measured in all subjects. Insulin resistance was assayed by homeostasis model assessment ratio (HOMA-R). Beta cell function was determined by using homeostasis model assessment beta cell (HOMA-beta). Correlation analysis was performed between resistin and other parameters. RESULTS: (1) The serum resistin concentration (common logarithmic transformation) was 3.1 +/- 0.5 in obese subjects and 2.7 +/- 0.8 in normal subjects. (P < 0.05). (2) The serum resistin concentration was not significantly correlated with sex, age, systolic and diastolic blood pressures, but was positively correlated with BMI, percent body fat (BF%), waist-hip ratio (WHR) (r = 0.299, r = 0.304, r = 0.322, P < 0.01); and positively correlated with fasting glucose, insulin, HOMA-R (r = 0.299, r = 0.303, r = 0.324, P < 0.05), but not significantly correlated with HOMA-beta. (3) Multiple linear regression analysis showed that only HOMA-R was the factor that significantly influenced resistin, R(2) = 0.105, the standard partial coefficient was 0.279 (P < 0.01). CONCLUSIONS: The serum resistin concentration in obese children were higher than that in normal children. The serum resistin concentration significantly correlated with the degree of obesity and the distribution of fat. Resistin is probably related to occurrence of hyperinsulinemia and/or insulin resistance in obese children.