兒童血清FGF21水平與代謝綜合征關(guān)系的初步研究
發(fā)布時(shí)間：2019-03-14 07:24
【摘要】：目的： 近年來(lái),由于成纖維細(xì)胞生長(zhǎng)因子21(FGF21)在動(dòng)物模型中改善糖脂代謝的良好效果,人們將其作為治療2型糖尿病的潛在藥物寄予厚望。然而,FGF21在人體中的病理生理作用尚不明確,部分研究顯示在肥胖、2型糖尿病患者體內(nèi)FGF21的水平增高,提示存在FGF21抵抗。本研究利用大樣本學(xué)齡兒童資料,觀察血清FGF21水平在兒童的分布及其影響因素,探討FGF21與兒童期肥胖及代謝綜合征(MS)的關(guān)系。 方法： 對(duì)來(lái)自2004年“北京兒童青少年代謝綜合征研究”中整群抽樣獲得的景山學(xué)校820名6-18歲學(xué)齡兒童,進(jìn)行體量指標(biāo)、Tanner分期、空腹血脂譜、空腹血糖、以及血清胰島素、瘦素、脂聯(lián)素、抵抗素和FGF21水平測(cè)定。FGF21采用雙抗體夾心放大酶聯(lián)免疫法檢測(cè)；兒童MS采用改良的美國(guó)國(guó)家膽固醇計(jì)劃成人治療小組第3次報(bào)告(ATPⅢ)中的定義進(jìn)行診斷。 結(jié)果： 1.血清FGF21水平在兩性無(wú)顯著性差異(P=0.082)。青春發(fā)育中期兩性FGF21水平均有增加趨勢(shì)。正常體重、超重和肥胖組兒童FGF21水平逐步升高,但無(wú)統(tǒng)計(jì)學(xué)意義。MS組與非MS組,具有MS組分或不具該組分組FGF21水平無(wú)顯著性差異。 2.全體對(duì)象中,FGF21與腰圍、體重指數(shù)(BMI)、體脂含量、收縮壓(SBP)、舒張壓(DBP)、空腹血糖、胰島素、血脂譜、瘦素、脂聯(lián)素、抵抗素的雙變量分析顯示,FGF21僅與舒張壓(r=0.08,P=0,023)、瘦素(1=0.085,P=0.015)及抵抗素(r=0.078,P=0.027)具有相關(guān)性,調(diào)整年齡、性別、BMI后,空腹血糖亦與FGF21顯著相關(guān)(r=0.074,P=0.038)。 3.將全體兒童按FGF21四分位數(shù)分組,可以看到各分組中肥胖兒童比例一致。兒童MS.MS各組分的發(fā)生率均表現(xiàn)為FGF21第1分位組較高,第2、第3分位較低,第4分位再度增高的J型曲線。全體對(duì)象中MS組分≥1個(gè)的比例組間比較具有統(tǒng)計(jì)學(xué)差異(P=0.016),肥胖兒童中MS發(fā)生比例亦具有統(tǒng)計(jì)學(xué)差異(P=0.044)。女孩中低脂聯(lián)素血癥的發(fā)生率隨FGF21四分位變化亦表現(xiàn)為上述J型曲線。 4.logistic回歸顯示,全體兒童中FGF21水平的升高(OR=I.681,P=0.041)或者降低(OR=I.924,P=0.009)均與兒童攜帶MS組分的風(fēng)險(xiǎn)增加顯著相關(guān),肥胖兒童中FGF21的升高與兒童罹患MS風(fēng)險(xiǎn)的增加顯著相關(guān)(OR=19.971,P=0.013),且這種風(fēng)險(xiǎn)度的增加獨(dú)立于兒童的年齡、性別和BMI。 結(jié)論： 兒童人群中FGF21水平與肥胖無(wú)顯著相關(guān)性。兒童人群中存在FGF21相對(duì)缺乏和FGF21抵抗兩種狀態(tài)。過(guò)低或過(guò)高的FGF21水平均與兒童不良代謝狀況相關(guān),提示全體兒童攜帶MS組分以及肥胖兒童罹患MS風(fēng)險(xiǎn)的增加。
[Abstract]:Aim: in recent years, fibroblast growth factor 21 (FGF21) has been regarded as a potential drug for the treatment of type 2 diabetes mellitus (T2DM) because of its good effect on improving glucose and lipid metabolism in animal models. However, the pathophysiological role of FGF21 in human remains unclear. Some studies have shown that the level of FGF21 in obese and type 2 diabetic patients is higher, suggesting the existence of FGF21 resistance. In this study, a large sample of school-age children was used to observe the distribution of serum FGF21 level in children and its influencing factors, and to explore the relationship between FGF21 and childhood obesity and metabolic syndrome (MS). Methods: 820 6-18-year-old school-age children from Jingshan School were selected from Beijing Children and adolescents Metabolic Syndrome study in 2004. The mass index, Tanner stage, fasting blood lipid spectrum and fasting blood glucose were measured. Serum insulin, leptin, adiponectin, resistin and FGF21 were measured. Children's MS was diagnosed using the definition contained in the modified American National cholesterol Program Adult treatment team's third report (ATP III). Results: 1. There was no significant difference in serum FGF21 level between male and female (P < 0. 082). There was an increasing trend of FGF21 levels in both sexes in the middle of puberty. The levels of FGF21 in children with normal weight, overweight and obesity increased gradually, but there was no significant difference between the MS group and the non-MS group. There was no significant difference in the FGF21 level between the MS group and the non-MS group. 2. In all subjects, bivariate analysis of FGF21 and waist circumference, body mass index (BMI), body fat content, systolic (SBP), diastolic blood pressure (DBP), fasting blood glucose, insulin, blood lipid spectrum, leptin, adiponectin, resistin showed that the blood glucose, insulin, lipid spectrum, leptin, adiponectin and resistin were measured by bivariate analysis. FGF21 was only correlated with diastolic blood pressure (r = 0.08, P < 0. 0023), leptin (0. 085, P < 0. 015) and resistin (r = 0. 078, P < 0. 027). After adjusting for age, sex and fasting blood glucose after BMI, fasting blood glucose was also significantly correlated with FGF21 (r = 0. 074, P < 0. 038). 3. All the children were grouped according to the FGF21 quartile, and the proportion of obese children in each group was the same. The incidence of each component of MS.MS in children was higher in FGF21 group 1, lower in 2nd and 3rd fractions, and increased again in 4th fraction. The proportion of MS 鈮，
本文編號(hào)：2439764
[Abstract]:Aim: in recent years, fibroblast growth factor 21 (FGF21) has been regarded as a potential drug for the treatment of type 2 diabetes mellitus (T2DM) because of its good effect on improving glucose and lipid metabolism in animal models. However, the pathophysiological role of FGF21 in human remains unclear. Some studies have shown that the level of FGF21 in obese and type 2 diabetic patients is higher, suggesting the existence of FGF21 resistance. In this study, a large sample of school-age children was used to observe the distribution of serum FGF21 level in children and its influencing factors, and to explore the relationship between FGF21 and childhood obesity and metabolic syndrome (MS). Methods: 820 6-18-year-old school-age children from Jingshan School were selected from Beijing Children and adolescents Metabolic Syndrome study in 2004. The mass index, Tanner stage, fasting blood lipid spectrum and fasting blood glucose were measured. Serum insulin, leptin, adiponectin, resistin and FGF21 were measured. Children's MS was diagnosed using the definition contained in the modified American National cholesterol Program Adult treatment team's third report (ATP III). Results: 1. There was no significant difference in serum FGF21 level between male and female (P < 0. 082). There was an increasing trend of FGF21 levels in both sexes in the middle of puberty. The levels of FGF21 in children with normal weight, overweight and obesity increased gradually, but there was no significant difference between the MS group and the non-MS group. There was no significant difference in the FGF21 level between the MS group and the non-MS group. 2. In all subjects, bivariate analysis of FGF21 and waist circumference, body mass index (BMI), body fat content, systolic (SBP), diastolic blood pressure (DBP), fasting blood glucose, insulin, blood lipid spectrum, leptin, adiponectin, resistin showed that the blood glucose, insulin, lipid spectrum, leptin, adiponectin and resistin were measured by bivariate analysis. FGF21 was only correlated with diastolic blood pressure (r = 0.08, P < 0. 0023), leptin (0. 085, P < 0. 015) and resistin (r = 0. 078, P < 0. 027). After adjusting for age, sex and fasting blood glucose after BMI, fasting blood glucose was also significantly correlated with FGF21 (r = 0. 074, P < 0. 038). 3. All the children were grouped according to the FGF21 quartile, and the proportion of obese children in each group was the same. The incidence of each component of MS.MS in children was higher in FGF21 group 1, lower in 2nd and 3rd fractions, and increased again in 4th fraction. The proportion of MS 鈮，
本文編號(hào)：2439764
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