探讨单纯性肥胖儿童血浆游离脂肪酸水平

发布时间：2019-04-28 10:33

【摘要】：目的：现单纯性肥胖逐渐成为儿童常见病，其导致的脂肪沉积、胰岛素抵抗可增加儿童糖尿病的发病率。故本课题对单纯性肥胖儿童血浆游离脂肪酸（Freefatty acid，FFA）浓度水平进行探讨，并分析FFA与胰岛素抵抗(Insulinresistance，IR)的相关性，以助改善当代儿童体质情况。方法：本实验选取2013年9月至2014年3月间，在大连医科大学附属第二临床医院儿科住院的7-14周岁儿童作为研究对象，常规测量体重、身高，并计算其相应的体重指数（Body mass index，BMI），依照2004年中国肥胖问题工作组制定的中国学龄儿童青少年超重、肥胖筛查体重指数(BMI)分类标准进行筛选。共有45名儿童，分为单纯性肥胖组25例，体质正常组20例，并排除了感染及其他非感染性疾病的影响。空腹采集静脉血标本，用全自动生化分析仪测定其空腹血糖（FPG）、甘油三酯（TG）及总胆固醇（TC）的浓度，用放射免疫方法测定其空腹血胰岛素（FINS）的浓度，采用ELISA方法测定血清中游离脂肪酸水平。用稳态模型胰岛素抵抗指数（Homeostasis model assessment-insulin resistance，HOMA-IR）评价胰岛素敏感性，计算HOMA-IR=FPG×FINS/22.5。结果： 1．单纯性肥胖组儿童的BMI（28.77±3.63）kg/m2，明显高于对照组BMI（16.99±1.48）kg/m2，两组间差异具有显著统计学意义（P＜0.01）。 2.肥胖组儿童血清空腹血糖（FPG）浓度（4.77±0.32）mmol/L，对照组儿童FPG（4.58±0.38）mmol/L，两组间差异无统计学意义（P=0.082）。肥胖组儿童血清空腹胰岛素（FINS）浓度为（19.32±7.68）uU/ml，高于正常对照组儿童血清FINS（8.56±2.26）uU/ml，两组间差异有显著统计学意义（P＜0.01）。肥胖组儿童胰岛素抵抗指数（HOMA-IR）为（4.11±1.68），，高于正常对照组儿童HOMA-IR（1.74±0.48），两组间差异有显著统计学意义（P＜0.01）。 3.肥胖组儿童血清游离脂肪酸(FFA)浓度（9.18±3.08）ng/ml，明显高于正常对照组儿童血清FFA浓度（4.90±1.75）ng/ml，两组间差异有显著统计学意义（P＜0.01）。肥胖组儿童的甘油三酯（TG）浓度（1.52±0.61）mmol/L、总胆固醇（TC）浓度（4.26±0.60）mmol/L，均高于对照组TG浓度（0.82±0.22）mmol/L、TC浓度（3.75±0.47）mmol/L，差异均有显著统计学意义（P＜0.01）。 4.肥胖组儿童血清空腹胰岛素、胰岛素抵抗与BMI呈正相关（相关系数r=0.795，0.798），且具有显著统计学意义（P＜0.01）。 5.肥胖组儿童血清FFA和BMI、HOMA-IR分别呈正相关（相关系数分别为r=0.677，0.841），上述相关性均有显著统计学意义（P＜0.01）。结论： 1.单纯性肥胖儿童血清游离脂肪酸浓度明显高于体质正常儿童。 2.单纯性肥胖儿童胰岛素抵抗指数明显高于体质正常儿童，且与BMI呈正相关，提示单纯性肥胖儿童易发生胰岛素抵抗。 3.单纯性肥胖儿童血清游离脂肪酸水平与胰岛素抵抗指数呈正相关，提示游离脂肪酸参与了胰岛素抵抗的发生。
[Abstract]:Aim: simple obesity has gradually become a common disease in children, which leads to fat deposition and insulin resistance can increase the incidence of diabetes in children. Therefore, the level of plasma free fatty acid (Freefatty acid,FFA) in children with simple obesity was discussed, and the correlation between FFA and insulin resistance (Insulinresistance,IR) was analyzed in order to improve the physique of contemporary children. Methods: from September 2013 to March 2014, 7-year-old 14-year-old children hospitalized in the Department of Pediatrics, affiliated to Dalian Medical University, were selected as subjects, and their weight and height were measured routinely. The corresponding body mass index (Body mass index,BMI) was calculated and screened according to the (BMI) classification standard of overweight and obesity screening for Chinese school-age children and adolescents established by the China Obesity working Group in 2004. A total of 45 children were divided into simple obesity group (n = 25) and normal physique group (n = 20). Infection and other non-infectious diseases were excluded. Fasting venous blood samples were collected and their fasting blood glucose levels of (FPG), triglyceride (TG) and total cholesterol (TC) were measured by automatic biochemical analyzer, and their fasting blood insulin (FINS) concentrations were measured by radioimmunoassay. The levels of free fatty acids in serum were determined by ELISA. Insulin sensitivity was evaluated by homeostasis model insulin resistance index (Homeostasis model assessment-insulin resistance,HOMA-IR), and HOMA-IR=FPG 脳 FINS/22.5. was calculated. Results: 1. BMI (28.77 卤3.63) kg/m2, in simple obesity group was significantly higher than that in BMI (16.99 卤1.48) kg/m2, group (P < 0.01). 2. There was no significant difference in serum fasting blood glucose (FPG) concentration (4.77 卤0.32) mmol/L, between the two groups (P < 0.082). There was no significant difference between the two groups in FPG (4.58 卤0.38) mmol/L, in the control group (P < 0.05). The fasting insulin (FINS) concentration in obese children was significantly higher than that in normal controls (19.32 卤7.68 uU/ml, vs 8.56 卤2.26 uU/ml, P < 0.01). The insulin resistance index (HOMA-IR) of obese children was (4.11 卤1.68), which was higher than that of normal children (1.74 卤0.48). There was significant difference between the two groups (P < 0.01). 3. The serum free fatty acid (FFA) concentration in obese children was significantly higher than that in normal controls (9.18 卤3.08 ng/ml, vs 4.90 卤1.75 ng/ml, P < 0.01). Triglyceride (TG) concentration (1.52 卤0.61) mmol/L, total cholesterol (TC) concentration (4.26 卤0.60) mmol/L, in obese children was higher than that in control group (0.82 卤0.22) mmol/L,. There was significant difference in TC concentration between (3.75 卤0.47) mmol/L, and (3.75 卤0.47) mmol/L, (P < 0.01). 4. Fasting insulin and insulin resistance were positively correlated with BMI in obese children (r = 0.795, 0.798). 5. There was a positive correlation between serum FFA and BMI,HOMA-IR in obese children (r = 0.677, 0.841, respectively). All of the above correlations were statistically significant (P < 0.01). Conclusions: 1. The serum free fatty acid concentration of simple obese children was significantly higher than that of normal children. 2. The insulin resistance index of simple obese children was significantly higher than that of normal children, and there was a positive correlation between insulin resistance and BMI, suggesting that simple obese children were prone to insulin resistance. 3. There was a positive correlation between serum free fatty acid level and insulin resistance index in children with simple obesity, suggesting that free fatty acid was involved in the occurrence of insulin resistance.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R723.14

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