儿童青少年脂肪炎性因子与胰岛素抵抗的相关性研究
发布时间：2018-11-09 08:19
【摘要】：目的:了解天津市大港油田地区儿童青少年超重、肥胖流行情况;初步探索儿童青少年超重、肥胖与高脂血症、高尿酸血症及2型糖尿病的关系;探究不同体质指数(BMI)儿童青少年脂肪炎性因子瘦素(LEP)、脂联素(APN)、人成纤维细胞生长因子-21(FGF-21)与胰岛素抵抗(IR)的相关性。方法:对天津大港油田地区所有中小学12476例7-16岁儿童及青少年(小学一年级~高中一年级)进行问卷调查,记录性别、年龄,测量身高(m)、体重(kg),应用公式计算BMI(BMI=kg/m2)。排除既往糖尿病、甲状腺功能亢进症、甲状腺功能减退症、垂体功能减退症、库欣氏综合征等影响糖代谢的疾病病史以及近期生活中有重大应激事件对象。家长签署知情同意书接受临床血液生化指标化验共计876人(男性478例,女性398例)。根据《中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准》诊断超重及肥胖。将876人根据BMI分为正常组、超重组及肥胖组3组,比较3组间空腹血糖、尿酸、血脂的差异。考虑性别、年龄因素,每组随机选取30例(男:女=1:1),检验空腹血糖、胰岛素和血清LEP、APN、FGF-21,计算胰岛素抵抗指数(HOMA-IR)并分析LEP、APN、FGF-21与之的相关性。结果与讨论:1.天津市大港油田区儿童青少年超重和肥胖患病率分别为15.01%和11.97%,超重肥胖率为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%,儿童青少年超重、肥胖患病率男性明显高于女性;随着年龄的增长,男性、女性儿童青少年出现肥胖率下降的趋势。2.抽血化验共计876人(男性478例,女性398例)显示,超重组118人(男:女=80:38)的总胆固醇、尿酸、甘油三酯均明显高于正常组643人(男:女=317:326)(P0.05),高密度脂蛋白胆固醇明显低于正常组(P0.05);肥胖组115人(男:女=81:34)的总胆固醇、尿酸、甘油三酯均明显高于正常组643人(男:女=317:326)(P0.05),高密度脂蛋白胆固醇明显低于正常组(P0.05);而且,肥胖组尿酸明显高于超重组(P0.05)。空腹血糖三组见差异无统计学意义(P=0.338),但随着儿童青少年BMI增加,产生胰岛素抵抗风险越高(P0.05)。表明儿童青少年肥胖或者超重更易导致高脂血症、高尿酸血症及胰岛素抵抗。3.LEP水平超重组、肥胖组均显著高于正常组,且肥胖组大于超重组大于正常组(p0.05);APN水平肥胖组显著低于正常组(p0.05),但与超重组以及超重组和正常组无明显差异(p0.05);肥胖组的FGF-21水平显著高于超重组及正常组(p0.05),超重和正常组无明显差异(p0.05)。表明肥胖儿童青少年存在LEP、FGF-21高表达及APN低表达;Pearson相关分析提示HOMA-IR与LEP、FGF-21呈正相关(r=0.563、0.301;P0.05);与ANP呈负相关(r=-0.376;P0.05)。表明肥胖儿童青少年产生IR与脂肪组织分泌脂肪炎性因子LEP、APN、FGF-21紊乱有关。结论:1.天津市大港油田地区儿童青少年正处于超重、肥胖的流行阶段;2.儿童青少年肥胖既是一种独立的疾病,也是高尿酸血症、高脂血症、2型糖尿病、动脉粥样硬化及代谢综合征等成年期高发疾病的危险因素;3.儿童青少年肥胖易产生胰岛素抵抗,可能与脂肪组织分泌脂肪炎性因子紊乱有关,检测血清LEP、APN、FGF-21可以在脂肪组织功能紊乱和异常分布方面,为预测胰岛素抵抗提供更为准确性和特异性的参考。
[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.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.8
本文编号：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.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.8
【参考文献】
相关期刊论文 前10条
1 OGDEN C L;CARROLL M D;LAWMAN H G;孙莹;;文献快报(6):美国1988—2014年儿童青少年肥胖趋势[J];中国学校卫生;2016年06期
2 李恒涛;王根在;杜金龙;林束珠;王春燕;朱洪庆;;单纯性肥胖儿童血清瘦素、胰岛素抵抗、内分泌激素及血脂与生长发育的关系研究[J];中国妇幼健康研究;2016年S1期
3 赵菊兰;夏天;李荣;李艳伟;;单纯性肥胖患者血清脂联素、血清瘦素与肾损伤的相关性分析[J];天津医科大学学报;2016年01期
4 侯冬青;赵小元;刘军廷;陈芳芳;闫银坤;程红;杨平;单馨影;米杰;;儿童青少年肥胖与成年后糖尿病的关联分析[J];中华预防医学杂志;2016年01期
5 赵丽云;刘素;于冬梅;何宇纳;于文涛;贾凤梅;;我国居民膳食营养状况与《中国食物与营养发展纲要(2014—2020年)》相关目标的比较分析[J];中国食物与营养;2015年08期
6 张科文;于丽娟;张小薇;;镇江市润州区3～7岁儿童超重肥胖情况调查分析[J];中国医药指南;2011年06期
7 李新华;廖兵荣;刘健;谭红专;黄文繁;克瓦库;刘薇;黄昕;文师吾;;长沙和深圳市儿童肥胖症患病率与危险因素研究(英文)[J];中南大学学报(医学版);2010年01期
8 米杰;程红;侯冬青;段佳丽;滕红红;王友发;;北京市2004年2-18岁儿童青少年超重和肥胖流行现状[J];中华流行病学杂志;2006年06期
9 李明;颜虹;Michael J·Dibley;常素英;David Sibbritt;;2004年西安市11~17岁青少年超重和肥胖现状及其相关因素[J];中国医学科学院学报;2006年02期
10 孙桂香,武光林,谷奕,齐秀英,黄乐,赵彦,秘学文,杨斌;天津地区儿童肥胖病发病率及影响因素的研究[J];天津医药;2004年10期
相关会议论文 前1条
1 何卫龙;赵广才;李远强;;广州市区8-18岁儿童青少年超重肥胖情况调查与分析[A];体质研究与健康促进论文集[C];2006年
，本文编号：2319865
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2319865.html
最近更新
教材专著
