摘要
目的 了解高敏C反应蛋白（hs-CRP）与肥胖及糖代谢异常儿童的体量指标及血清参数相关性；探讨hs-CRP与儿童肥胖患者及糖尿病或糖代谢异常的关系。方法 选择肥胖儿童70例作为研究对象，并选择正常儿童30例作为对照组（组1），根据OGTF试验将肥胖儿童分为不伴糖代谢异常组54例（组2）和糖代谢异常组16例（组3），测定体量指标及相关参数。结果 肥胖儿童hs-CRP水平2．44（0．01～14．6）mg／L，明显高于对照组[0．1（0．01-2．1）mg／L]。血糖和血脂于正常范围时，肥胖儿童的hs-CRP水平为2．4（0．01-9．0）mg／L，胰岛素抵抗指数（IRI）明显升高。糖脂代谢异常时，hs-CRP水平为2．6（0．1-14．6）mg／L。Pearson相关分析显示，血清hs-CRP水平与BMI、腰围、臀围、腰臀比呈正相关，其中与BMI的相关性最强，多元线性回归分析示，BMI是惟一与hs-CRP相关的指标。结论 肥胖儿童存在低度炎症状态和胰岛素抵抗。hs-CRP与BMI独立相关。hs-CRP和胰岛素抵抗指数的异常升高早于血糖和血脂，hs-CRP增高对糖脂代谢的异常有较好的预测能力。
Objective High-sensitivity C-reactive protein （hs-CRP） may predict the development of type 2 diabetes mellitus （ T2DM ）, metabolic syndrome （MS） and cardiovascular diseases （ CVD ） in adult, but few reports on relevant studies in children are available. The present study aimed to understand possible correlation between serum hs-CRP levels and some factors of obese children and adolescents with or without impaired glycometabolism. Methods Seventy obese children and adolescents （age 8-17 years） and 30 non-obese healthy controls （group 1,20 boys and 10 girls, mean age 12. 6 years） were enrolled into this study. The obese individuals were subdivided into two groups according to the results of oral glucose tolerance test： the obese subjects without IGR （ group 2, 54 cases, 43 boys and 11 girls, mean age 11.3 years） and the obese subjects with impaired glycometabolism （group 3, 16 cases, 8 boys and 8 girls, mean age 12.8 years）. The levels of serum parameters including hs-CRP, glucose, lipid, insulin, C-peptide and whole blood HbAlc were determined. SPSS 10.0 was used for statistical analysis. Results （1）There was significant increase of serum hs-CRP level in obese children and adolescents, the median was 2.44（0.01 ～ 14.6） rag/L; the level of control group was 0. 1 （ 0. 01 - 2. 1 ） mg/L （ 2 ） Some of the following parameters, such as fasting plasma glucose （FPG）, triglyceride （TG）, fasting insulin （FINS）, C-peptide （Cp） and insulin resistance index （IRI）, were found increased in group 2 and 3 as compared to group 1. When FPG and TG were still in normal range in group 2, the levels of hs-CRP and IRI were significantly higher than those in group 1, the level of hs-CRP was 2.4（0.01 -9.0） mg/L. While FPG and TG were abnormal in group 3, the level of hs-CRP was 2. 6（0. 1 - 14. 6） mg/L, but the difference had no statistical significance. （3） Pearson correlation analysis showed that there was a moderate correlation between serum hs-CRP and BMI （ r = 0. 414, P = 0. 000 ） . There was a low correlation between hs-CRP and waist circumference, hip circumference and waist to hip ratio （WHR）. The correlation of serum hs-CRP with blood pressure, TG, cholesterol, high density lipoprotein-eholesterol （HDL-C）, HbAle, FPG, FINS and Cp had no significant deviation. （4） Multiple linear regression analysis showed that body mass index （BMI） was the only indicator which had correlation with hs-CRP. Conclusion （ 1 ） There may be a chronic low-grade inflammation and insulin resistance in obese children. （2） The level of hs-CRP might be independently correlated with BMI in children. （ 3 ） Hs-CRP and IRI elevated before FPG and TG did, which may suggest that the low-grade inflammation and insulin resistance may be a pathogenic base of DM rather than the outcome of it. （4） The elevation of hs-CRP may help predict impaired glucose and lipid metabolism.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2006年第12期933-936,共4页
Chinese Journal of Pediatrics
基金
首都医学发展科研基金(2002-2005)
关键词
C反应蛋白质
肥胖症
儿童
葡萄糖代谢障碍
C-reactive protein
Obesity
Children
Glucose metabolism disorders
