男性儿童瘦素抵抗对成年后健康状况的影响

doi:10.6040/j.issn.1671-7554.0.2018.789

摘要/Abstract

摘要： 目的探讨男性儿童瘦素抵抗(LR)对成年后健康状况的影响。方法对19年前参加血清瘦素水平与早发肥胖关系研究的LR儿童进行随访。9例LR男性儿童为LR组,随机选择与LR组同龄的正常体质量的28例男性人员为正常对照组(NC组)。LR组检测身高、体质量、腰围、血压,空腹抽血检测胰岛素(FINS)、血糖、血脂、肝肾功能等生化指标,并行腹部彩超检查、腹部脂肪测定,调查个人及父母疾病史;NC组检测身高、体质量、血压,空腹抽血检测FINS、血糖、血脂、肝肾功能,行腹部彩超检查。比较LR组和NC组肥胖、高血压等代谢性疾病的患病率。结果 LR组中心型肥胖(腰围≥90 cm)患病率100%,腹腔内脂肪面积(209.79±55.46)cm²,胰岛素抵抗指数(HOMA-IR)9.42±8.00,一级亲属(父母一方)2型糖尿病患病率100%;LR组收缩压、舒张压明显高于NC组(P=0.001 1, P=0.000 5);LR组空腹血糖(FBG)、甘油三酯(TG)、血尿酸(UA)明显高于NC组(P=0.005 0, P=0.029 8, P<0.001);LR组谷氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)明显高于NC组(P=0.003 1, P=0.027 1, P<0.001);LR组脂肪肝患病率明显高于NC组(P<0.001)。结论 LR男性儿童成年后表现为肥胖和胰岛素抵抗,2型糖尿病、脂代谢紊乱、肿瘤以及肝功能受损风险高;LR男性儿童可预测一级亲属罹患2型糖尿病的风险。

关键词: 瘦素抵抗, 肥胖, 胰岛素抵抗, 男性

Abstract: Objective To investigate the impacts of leptin resistance(LR)developed in boyhood on the health condition of young adults. Methods Subjects of a previous study conducted by us 19 years ago on the relationship between serum leptin level and early onset obesity were followed up. LR group included 9 subjects who had LR in their childhood. The normal control(NC)group consisted of 28 adults randomly selected from people with normal body mass index who came for health examination in our hospital during the same period. The control group was of the same age as LR group. Height, weight, waist circumference, blood pressure, fasting blood insulin(FINS), glucose, blood lipids, liver and kidney functions were examined in both groups. The visceral fat was determined and parents’ histories of diseases were collected in LR group. The incidence of metabolic diseases such as obesity and hypertension was compared between the two groups. Results In the LR group, the incidence of central obesity(waist circumference ≥90 cm)was 100%, visceral fat area was(209.79±55.46)cm², index of insulin resistance(HOMA IR)was 9.42±8.00 and first-degree relatives incidence of type 2 diabetes was 100%. The systolic and diastolic pressures were significantly higher in LR group than in NC group(P=0.001 1, P=0.000 5, respectively). The levels of FBG, triglyceride(TG)and uric 山东大学学报 (医学版)56卷10期 -王敏,等.男性儿童瘦素抵抗对成年后健康状况的影响 \=-acid(UA)were significantly higher in LR group than in NC group(P=0.005 0, P=0.029 8, P<0.001). The levels of glutamic-pyruvic transaminase(ALT), glutamic oxalacetic transaminase(AST)and glutamyltranspeptidase(GGT)were significantly higher in LR group than in NC group (P=0.003 1, P=0.027 1, P<0.001). The incidence of fatty liver was significantly higher in LR group than in NC group(P<0.001). Conclusion Boys with early onset obesity and LR tend to develop severe obesity and insulin resistance when they grow up. Besides, they have high risks of type 2 diabetes, dyslipidemia, cancer and liver dysfunction. LR in children can predict the risk of type 2 diabetes in the first-degree relatives.

Key words: Leptin resistance, Obesity, Insulin resistance, Male

中图分类号:

R589.2

王敏,王春花,刘鸿丽,何志良,崔薇薇,王磊,刘杰军. 男性儿童瘦素抵抗对成年后健康状况的影响[J]. 山东大学学报 (医学版), 2018, 56(10): 114-118.

WANG Min, WANG Chunhua, LIU Hongli, HE Zhiliang, CUI Weiwei, WANG Lei, LIU Jiejun. Impacts of leptin resistance developed in boyhood on the health condition of young adults[J]. Journal of Shandong University (Health Sciences), 2018, 56(10): 114-118.

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