本文選題：氧化應(yīng)激 + 脂肪因子　； 參考：《青島大學(xué)》2014年博士論文

【摘要】：目的研究肥胖兒童氧化應(yīng)激(oxidative stress OS)水平及其與肥胖相關(guān)代謝異常的關(guān)系,進(jìn)一步探討OS對(duì)脂肪細(xì)胞代謝的調(diào)節(jié)作用。方法選擇2013年12月~2014年7月于我院兒童保健門(mén)診就診的62例單純性肥胖癥兒童為研究對(duì)象,并根據(jù)年齡、性別等基線情況選取同期46名健康兒童作為對(duì)照組。肥胖組中男性36人,女性26人;年齡6~12歲(平均9.12±3.23歲)。對(duì)照組中男性26人,女性20人;年齡6~12歲(平均8.78±2.94歲)。所有研究對(duì)象近2周無(wú)感染;體格檢查、B超、內(nèi)分泌相關(guān)檢查排除內(nèi)分泌、遺傳代謝性疾病及中樞神經(jīng)系統(tǒng)疾病引起的繼發(fā)性肥胖;無(wú)心、肝、腎等基礎(chǔ)疾病,排除佝僂病。體重指數(shù)(BMI)≥P95為肥胖。所有研究對(duì)象按照標(biāo)準(zhǔn)方法測(cè)量血壓、身高、體重,按公式計(jì)算體重指數(shù)(BMI)。禁食10小時(shí),抽取外周靜脈血,測(cè)定甘油三酯(TG)、總膽固醇(TC),高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及空腹血糖(FBG)、C-反應(yīng)蛋白(CRP)。采用酶聯(lián)免疫吸附法(ELISA)測(cè)定血8-異前列腺素F2a(8-iso-PGF2a)、25羥維生素D(25-(OH)D、瘦素(Leptin)、腫瘤壞死因子-a(TNF-a),白細(xì)胞介素-6(IL-6),化學(xué)比色法測(cè)定超氧化物歧化酶(SOD),放射免疫法測(cè)定血清胰島素(Insulin)。采用SPSS13.0統(tǒng)計(jì)軟件進(jìn)行方差分析及多元線性回歸分析。以p0.05為有統(tǒng)計(jì)學(xué)意義。結(jié)果肥胖兒童與健康兒童相比,肥胖兒童8-iso-PGF2α升高、SOD明顯降低,差異有顯著性(p0.01);TNF-a、IL-6、CRP明顯增高(p0.01或0.05);胰島素、胰島素抵抗指數(shù)明顯增高(p0.01或0.05),而空腹血糖肥胖組與對(duì)照組比較,無(wú)明顯升高,差異無(wú)顯著性(p0.05);25-(OH)D明顯降低,瘦素明顯升高(p0.01),差異有顯著性。以血25-(OH)D≥50nmol/L為正常標(biāo)準(zhǔn),25-(OH)D50nmol/L為維生素D缺乏。肥胖兒童維生素D缺乏42例(67.7%),對(duì)照組10例(21.7%),肥胖組較對(duì)照組維生素D缺乏明顯增高,x2=22.384差異有顯著性(p0.01)。用自我平衡模型分析計(jì)算胰島素抵抗指數(shù)(HOMA-IR),62例肥胖兒童中發(fā)生胰島素抵抗人數(shù)為36例。對(duì)胰島素抵抗肥胖兒童和無(wú)胰島素抵抗肥胖兒童的8-iso PGF2a、SOD、TNF-a、IL-6及CRP、BMI、25-(OH)D、瘦素進(jìn)行比較,胰島素抵抗肥胖兒童BMI、瘦素、8-iso PGF2a、TNF-a、IL-6及CRP明顯增高明顯增高,差異有顯著性(p0.01),而25-(OH)D、SOD水平明顯降低。作氧化應(yīng)激與肥胖相關(guān)代謝指標(biāo)及BMI的散點(diǎn)圖,發(fā)現(xiàn)8-iso-PGF2α與瘦素、TNF-a、25-(OH)D及BMI有明顯線性趨勢(shì),其中瘦素、BMI及TNF-a呈與8-iso-PGF2α正相關(guān),25-(OH)D與8-iso-PGF2α呈負(fù)相關(guān)。以8-iso-PGF2a為應(yīng)變量,以BMI、TC、TG、HDL-C、LDL-C、HOMA-IRT、TNF-a、25-(OH)D及Leptin為自變量,進(jìn)行多元回歸分析,得出以下線性模型:8-iso-PGF2a=10.511-0.136[25-(OH)D]+1.15TNF-a.結(jié)論肥胖兒童存在氧化應(yīng)激水平的增高,并與脂肪細(xì)胞多種代謝相關(guān)。肥胖兒童維生素D代謝水平降低,存在瘦素抵抗和炎癥細(xì)胞因子水平增高等多種脂肪代謝紊亂。因此,提高機(jī)體抗氧化能力、補(bǔ)充維生素D可能會(huì)減少肥胖并發(fā)癥、降低兒童肥胖的發(fā)生。
[Abstract]:Objective to study the level of oxidative stress and its relationship with obesity related metabolic abnormalities in obese children, and to explore the role of OS in the regulation of adipocyte metabolism.Methods from December 2013 to July 2014, 62 children with simple obesity were selected and 46 healthy children in the same period were selected as control group according to the baseline of age and sex.In obesity group, there were 36 males and 26 females, aged from 6 to 12 years (mean 9.12 鹵3.23 years old).In the control group, there were 26 males and 20 females, aged 612 years (mean 8.78 鹵2.94 years).All subjects had no infection in the last 2 weeks; physical examination, B-ultrasound, endocrine related examination excluded endocrine, genetic metabolic diseases and secondary obesity caused by central nervous system diseases; basic diseases such as heart, liver, kidney, and rickets were excluded.Body mass index (BMI) 鈮，

本文編號(hào)：1733601