兒童青少年脂肪炎性因子與胰島素抵抗的相關(guān)性研究
發(fā)布時間：2018-11-09 08:19
【摘要】：目的:了解天津市大港油田地區(qū)兒童青少年超重、肥胖流行情況;初步探索兒童青少年超重、肥胖與高脂血癥、高尿酸血癥及2型糖尿病的關(guān)系;探究不同體質(zhì)指數(shù)(BMI)兒童青少年脂肪炎性因子瘦素(LEP)、脂聯(lián)素(APN)、人成纖維細胞生長因子-21(FGF-21)與胰島素抵抗(IR)的相關(guān)性。方法:對天津大港油田地區(qū)所有中小學12476例7-16歲兒童及青少年(小學一年級~高中一年級)進行問卷調(diào)查,記錄性別、年齡,測量身高(m)、體重(kg),應(yīng)用公式計算BMI(BMI=kg/m2)。排除既往糖尿病、甲狀腺功能亢進癥、甲狀腺功能減退癥、垂體功能減退癥、庫欣氏綜合征等影響糖代謝的疾病病史以及近期生活中有重大應(yīng)激事件對象。家長簽署知情同意書接受臨床血液生化指標化驗共計876人(男性478例,女性398例)。根據(jù)《中國學齡兒童青少年超重、肥胖篩查體重指數(shù)值分類標準》診斷超重及肥胖。將876人根據(jù)BMI分為正常組、超重組及肥胖組3組,比較3組間空腹血糖、尿酸、血脂的差異�？紤]性別、年齡因素,每組隨機選取30例(男:女=1:1),檢驗空腹血糖、胰島素和血清LEP、APN、FGF-21,計算胰島素抵抗指數(shù)(HOMA-IR)并分析LEP、APN、FGF-21與之的相關(guān)性。結(jié)果與討論:1.天津市大港油田區(qū)兒童青少年超重和肥胖患病率分別為15.01%和11.97%,超重肥胖率為26.98%;超重男生1260人,占67.31%,女生612人,占32.69%;肥胖男生999人,占66.91%,女生494人,占33.09%,兒童青少年超重、肥胖患病率男性明顯高于女性;隨著年齡的增長,男性、女性兒童青少年出現(xiàn)肥胖率下降的趨勢。2.抽血化驗共計876人(男性478例,女性398例)顯示,超重組118人(男:女=80:38)的總膽固醇、尿酸、甘油三酯均明顯高于正常組643人(男:女=317:326)(P0.05),高密度脂蛋白膽固醇明顯低于正常組(P0.05);肥胖組115人(男:女=81:34)的總膽固醇、尿酸、甘油三酯均明顯高于正常組643人(男:女=317:326)(P0.05),高密度脂蛋白膽固醇明顯低于正常組(P0.05);而且,肥胖組尿酸明顯高于超重組(P0.05)�？崭寡侨M見差異無統(tǒng)計學意義(P=0.338),但隨著兒童青少年BMI增加,產(chǎn)生胰島素抵抗風險越高(P0.05)。表明兒童青少年肥胖或者超重更易導(dǎo)致高脂血癥、高尿酸血癥及胰島素抵抗。3.LEP水平超重組、肥胖組均顯著高于正常組,且肥胖組大于超重組大于正常組(p0.05);APN水平肥胖組顯著低于正常組(p0.05),但與超重組以及超重組和正常組無明顯差異(p0.05);肥胖組的FGF-21水平顯著高于超重組及正常組(p0.05),超重和正常組無明顯差異(p0.05)。表明肥胖兒童青少年存在LEP、FGF-21高表達及APN低表達;Pearson相關(guān)分析提示HOMA-IR與LEP、FGF-21呈正相關(guān)(r=0.563、0.301;P0.05);與ANP呈負相關(guān)(r=-0.376;P0.05)。表明肥胖兒童青少年產(chǎn)生IR與脂肪組織分泌脂肪炎性因子LEP、APN、FGF-21紊亂有關(guān)。結(jié)論:1.天津市大港油田地區(qū)兒童青少年正處于超重、肥胖的流行階段;2.兒童青少年肥胖既是一種獨立的疾病,也是高尿酸血癥、高脂血癥、2型糖尿病、動脈粥樣硬化及代謝綜合征等成年期高發(fā)疾病的危險因素;3.兒童青少年肥胖易產(chǎn)生胰島素抵抗,可能與脂肪組織分泌脂肪炎性因子紊亂有關(guān),檢測血清LEP、APN、FGF-21可以在脂肪組織功能紊亂和異常分布方面,為預(yù)測胰島素抵抗提供更為準確性和特異性的參考。
[Abstract]:Objective: To study the prevalence of overweight and obesity among children in Dagang oilfield in Tianjin, and to explore the relationship between overweight, obesity and hyperlipidemia, hyperuricemia and type 2 diabetes in children. To explore the correlation between leptin, APN, human fibroblast growth factor-21 (FGF-21) and insulin resistance (IR) in children with different body mass index (BMI). Methods: A survey of 1,476 children and adolescents aged 7 to 16 in all primary and middle schools in Dagang oil field of Tianjin (first grade of primary school to first year of high school) was investigated. The sex, age, height (m) and body weight (kg) were recorded, and BMI (BMI = kg/ m2) was calculated using the formula. The history of diseases, such as previous diabetes, hyperthyroidism, hypothyroidism, hypopituitarism, and Cushing's syndrome, has been excluded, as well as major stress event objects in recent life. The parents signed the informed consent form to receive a total of 876 clinical blood biochemical indicators (478 male and 398 female). According to the criteria for classification of overweight and obesity screening weight index of children in Chinese school-age children> the diagnosis of overweight and obesity. 876 people were divided into 3 groups of normal group, super-recombinant and obese group according to BMI, and the difference of fasting blood glucose, uric acid and blood fat among 3 groups was compared. The relationship between LEP, APN, FGF-21 and LEP, APN, and FGF-21 was analyzed in 30 cases (male: female = 1: 1), fasting blood glucose, insulin and serum LEP, APN, FGF-21, and insulin resistance index (HOMA-IR). Results and Discussion: 1. The prevalence of overweight and obesity among children in Dagang oilfield in Tianjin is 15.01% and 11.97%, respectively. The obesity rate of overweight is 26. 98%. The overweight male is 1260, accounting for 67. 31%, female 612, 32. 69%, obese male 999, 66. 91%, female 494, 33. 09%, children and adolescents are overweight, The prevalence of obesity was significantly higher in men than in women; with the increase in age, the prevalence of obesity among male and female children was declining. The total cholesterol, uric acid and triglyceride of the super-recombinant 118 (male: female = 80: 38) were significantly higher than those in the normal group (male: female = 317: 326) (P <0.05), and the high-density lipoprotein cholesterol was lower than that of normal group (P0.05). The total cholesterol, uric acid and triglyceride of 115 in the obese group (male: female = 81: 34) were significantly higher than those in the normal group (male: female = 317: 326) (P0.05), and the high-density lipoprotein cholesterol was significantly lower than that in the normal group (P0.05); and the uric acid in the obese group was significantly higher than that of the super-recombinant (P0.05). There was no significant difference in fasting blood glucose (P = 0.338), but with the increase of BMI, the higher the risk of insulin resistance (P0.05). The results showed that the obesity and overweight of children were more likely to cause hyperlipidemia, hyperuricemia and insulin resistance. The level of FGF-21 in the obese group was significantly higher than that of the normal group (p0.05), and there was no significant difference between the overweight and the normal group (p0.05). The results showed that there were LEP, FGF-21 high expression and low APN in obese children, and the Pearson correlation analysis suggested that HOMA-IR was positively correlated with LEP and FGF-21 (r = 0.563, 0.301; P0.05); negative correlation with ANP (r =-0.376; P0.05). It was found that the effect of IR on the secretion of fat-inflammatory factors, LEP, APN, and FGF-21 in obese children. Conclusion: 1. Children and adolescents in Dagang oilfield in Tianjin are in the epidemic stage of overweight and obesity. The obesity of children and adolescents is not only an independent disease, but also a risk factor for hyperuricemia, hyperlipidemia, type 2 diabetes, atherosclerosis and metabolic syndrome. The obesity of the children is apt to produce the insulin resistance, and may be related to the secretion of the fat inflammatory factor disorder in the adipose tissue. The detection of serum LEP, APN and FGF-21 can provide more accurate and specific reference for predicting the insulin resistance in terms of the function disorder and the abnormal distribution of the adipose tissue.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.8
本文編號：2319865
[Abstract]:Objective: To study the prevalence of overweight and obesity among children in Dagang oilfield in Tianjin, and to explore the relationship between overweight, obesity and hyperlipidemia, hyperuricemia and type 2 diabetes in children. To explore the correlation between leptin, APN, human fibroblast growth factor-21 (FGF-21) and insulin resistance (IR) in children with different body mass index (BMI). Methods: A survey of 1,476 children and adolescents aged 7 to 16 in all primary and middle schools in Dagang oil field of Tianjin (first grade of primary school to first year of high school) was investigated. The sex, age, height (m) and body weight (kg) were recorded, and BMI (BMI = kg/ m2) was calculated using the formula. The history of diseases, such as previous diabetes, hyperthyroidism, hypothyroidism, hypopituitarism, and Cushing's syndrome, has been excluded, as well as major stress event objects in recent life. The parents signed the informed consent form to receive a total of 876 clinical blood biochemical indicators (478 male and 398 female). According to the criteria for classification of overweight and obesity screening weight index of children in Chinese school-age children> the diagnosis of overweight and obesity. 876 people were divided into 3 groups of normal group, super-recombinant and obese group according to BMI, and the difference of fasting blood glucose, uric acid and blood fat among 3 groups was compared. The relationship between LEP, APN, FGF-21 and LEP, APN, and FGF-21 was analyzed in 30 cases (male: female = 1: 1), fasting blood glucose, insulin and serum LEP, APN, FGF-21, and insulin resistance index (HOMA-IR). Results and Discussion: 1. The prevalence of overweight and obesity among children in Dagang oilfield in Tianjin is 15.01% and 11.97%, respectively. The obesity rate of overweight is 26. 98%. The overweight male is 1260, accounting for 67. 31%, female 612, 32. 69%, obese male 999, 66. 91%, female 494, 33. 09%, children and adolescents are overweight, The prevalence of obesity was significantly higher in men than in women; with the increase in age, the prevalence of obesity among male and female children was declining. The total cholesterol, uric acid and triglyceride of the super-recombinant 118 (male: female = 80: 38) were significantly higher than those in the normal group (male: female = 317: 326) (P <0.05), and the high-density lipoprotein cholesterol was lower than that of normal group (P0.05). The total cholesterol, uric acid and triglyceride of 115 in the obese group (male: female = 81: 34) were significantly higher than those in the normal group (male: female = 317: 326) (P0.05), and the high-density lipoprotein cholesterol was significantly lower than that in the normal group (P0.05); and the uric acid in the obese group was significantly higher than that of the super-recombinant (P0.05). There was no significant difference in fasting blood glucose (P = 0.338), but with the increase of BMI, the higher the risk of insulin resistance (P0.05). The results showed that the obesity and overweight of children were more likely to cause hyperlipidemia, hyperuricemia and insulin resistance. The level of FGF-21 in the obese group was significantly higher than that of the normal group (p0.05), and there was no significant difference between the overweight and the normal group (p0.05). The results showed that there were LEP, FGF-21 high expression and low APN in obese children, and the Pearson correlation analysis suggested that HOMA-IR was positively correlated with LEP and FGF-21 (r = 0.563, 0.301; P0.05); negative correlation with ANP (r =-0.376; P0.05). It was found that the effect of IR on the secretion of fat-inflammatory factors, LEP, APN, and FGF-21 in obese children. Conclusion: 1. Children and adolescents in Dagang oilfield in Tianjin are in the epidemic stage of overweight and obesity. The obesity of children and adolescents is not only an independent disease, but also a risk factor for hyperuricemia, hyperlipidemia, type 2 diabetes, atherosclerosis and metabolic syndrome. The obesity of the children is apt to produce the insulin resistance, and may be related to the secretion of the fat inflammatory factor disorder in the adipose tissue. The detection of serum LEP, APN and FGF-21 can provide more accurate and specific reference for predicting the insulin resistance in terms of the function disorder and the abnormal distribution of the adipose tissue.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.8
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