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肥胖儿童血清vaspin水平与胰岛素敏感性及糖脂代谢的关系

高芳芳1,刘戈力2,杨箐岩1,郑荣秀1,姜丽红2,魏莹1,鲍鹏丽1   

  1. 1. 天津医科大学总医院
    2. 天津医科大学总医院儿科
  • 收稿日期:2011-09-22 修回日期:2011-12-25 出版日期:2012-08-15 发布日期:2012-08-15
  • 通讯作者: 刘戈力

Association between serum vaspin concentrations and insulin sensitivity, glucose and lipid metabolism in the obese children

  • Received:2011-09-22 Revised:2011-12-25 Published:2012-08-15 Online:2012-08-15

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摘要： 摘要：目的：探讨肥胖儿童血清vaspin水平与胰岛素敏感性及糖脂代谢的关系。方法：收集2010年2月-2011年2月期间于我院儿科内分泌门诊就诊的肥胖儿童34例，男22例，女12例。并随机抽取同年龄健康查体的正常对照儿童30例，男20例，女10例。测定所有受试者体格测量参数、血清vaspin、血脂、FPG及FINS水平。计算体重指数（body mass index, BMI）、腰臀比（Waist-hips-ratio, WHR）、体脂百分比（body fat %, BF%）、胰岛素抵抗指数（HOMA-IR）、胰岛素敏感指数（ISI）及致动脉粥样硬化指数（AI）。比较两组儿童体格测量参数、血脂、AI、胰岛素敏感性评价指标、vaspin浓度及对肥胖儿童血清vaspin水平与体格测量参数及糖脂代谢各指标进行相关分析。结果：肥胖组儿童腰围（waist circumference, WC）、BMI、BF%、SBP、DBP、FPG、FINS、HOMA-IR、LDL-C、TG、vaspin、LDL-C/HDL-C、（TC-HDL-C）/HDL-C均明显高于对照组，而HDL-C、ISI低于对照组。vaspin与BMI、WC、WHR、BF%、TG、FINS、HOMA-IR、（TC-HDL-C）/HDL-C、DBP、WC、WHR、FINS呈正相关，与ISI、HDL-C呈负相关，与年龄、性别、DBP、SBP、FPG、LDL-C、LDL-C/HDL-C、TC无明显相关性。多元线性回归分析示BF%是vaspin水平的独立危险因素。结论：肥胖儿童血清vaspin水平升高与胰岛素抵抗、糖脂代谢紊乱及致动脉粥样硬化指数具有密切的关系，作为一种胰岛素增敏型脂肪细胞因子，其水平升高可能是胰岛素抵抗的代偿性反应，推测肥胖儿童早期vaspin水平的测定可以用于评价肥胖程度及胰岛素抵抗程度，进一步可以评估成年后发生心脑血管疾病的危险性。

关键词: 肥胖, 内脏脂肪组织特异性丝氨酸蛋白酶抑制剂, 儿童, 胰岛素敏感性, 糖脂代谢

Abstract: Objective: To investigate the relationship between serum vaspin concentrations and insulin sensitivity, glucose and lipid metabolism in the obese children. Methods: A total of 34 obese children (22 males and 12 females) were enrolled in this trial. And another randomly selected 30 cases of normal healthy children were taken as control. Fasting venous blood samples were collected for the determination of the serum vaspin level by Enzyme-linked immunosorbent assay (ELISA). The Physical index such as anthropometric weight, height and the FPG, FINS were measured using standard instruments and procedures, and the body mass index (BMI), Waist-hips-ratio (WHR), body fat % (BF%), HOMA-IR, ISI and AI were calculated according to suitable formula. the relationship between serum vaspin concentrations and insulin sensitivity, glucose and lipid metabolism was analyzed. Results: The vaspin, WC, BMI, BF%, SBP, DBP, FPG, FINS, LDL-C, TG, LDL-C/HDL-C, (TC-HDL-C)/HDL-C, HOMA-IR of the obese group were much higher, while the HDL-C, ISI were much lower than the control group. There is a significant positive correlation between the vaspin concentrations and BMI, WC, WHR, BF%, TG, FINS, HOMA-IR, (TC-HDL-C)/HDL-C, DBP, While a negatively correlated with HDL-C, ISI. Multiple linear regression suggests that BF% is an independent risk factor for the serum vaspin concentrations. Conclusion: The serum vaspin concentration was strongly associated with obesity and atherogenic index. Monitoring the serum vaspin levels may have a very important value for understanding the degree of obesity and insulin resistance.

Key words: obese, vaspin, children, insulin sensitivity, glucose and lipid metabolism