肥胖儿童运动减肥治疗前后的瘦素抵抗血脂及炎症状态分析

李成万; 姜东林; 乔健; 孙钧铭; 黄建萍; 陈海平; 朱虹

PDF(974 KB)

中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (1) : 40-42.

论著·儿童保健

肥胖儿童运动减肥治疗前后的瘦素抵抗血脂及炎症状态分析

李成万，姜东林，乔健，孙钧铭，黄建萍，陈海平，朱虹

作者信息 +

Changes of leptin resistance, blood lipids and inflammatory response before and after the exercise therapy in children with obesity

LI Cheng-Wan, JIANG Dong-Lin, QIAO Jian, SUN Jun-Ming, HUANG Jian-Ping, CHEN Hai-Ping, ZHU Hong

Author information +

文章历史 +

摘要

目的：研究显示C-反应蛋白（CRP）、瘦素(Lp)、可溶性瘦素受体(sLR) 及多种血脂成分均参与了肥胖的发生发展。本研究旨在探讨运动减肥治疗前后肥胖儿童瘦素抵抗、血脂及炎症状态的改变，以期明确运动对肥胖儿童内分泌环境的影响。方法：对51例12岁肥胖儿童进行为期2月的运动减肥治疗，观察血清高敏C反应蛋白（hs-CRP）、Lp、sLR、甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平变化。40例健康体检儿童作为对照组。结果：肥胖儿童组血清Lp、TG、TC、LDL-C和hs-CRP水平及体重指数（BMI）均显著高于对照组（均P<0.01），sLR水平低于对照组（P<0.05）。运动减肥治疗后肥胖儿童组血清hs-CRP、Lp、TC、TG和LDL-C水平及BMI与治疗前比较显著下降（P<0.05）。相关性分析显示肥胖儿童血清Lp水平与血脂及hs-CRP呈显著正相关（P<0.05）；Lp、hs-CRP与sLR呈显著负相关（P<0.05）；hs-CRP与血脂呈显著正相关（P<0.01）。结论：肥胖儿童已存在瘦素抵抗及血脂和炎症状态的改变，运动减肥治疗可不同程度地改善这些改变。［中国当代儿科杂志，2010，12（1）：40-42］

Abstract

OBJECTIVE: Some research has shown that C-reactive protein (CRP), leptin, soluble leptin receptor (sLR) and blood lipids are involved in the development of obesity. This study aimed to investigate the changes of leptin resistance, blood lipids and inflammatory response before and after the exercise therapy in children with obesity. METHODS: Fifty-one obese children at ages of 12 years received an exercise therapy for 2 months. The levels of serum leptin, sLR, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (hs-CRP) were measured before and after the exercise therapy. Forty normal children served as the control group. RESULTS: Compared with the control group, serum levels of leptin, TG, TC, LDL-C and hs-CRP and the body mass index (BMI) in the obese group increased (P<0.01), while the serum level of sLR decreased significantly (P<0.05). The levels of hs-CRP, leptin, TC, TG, LDL-C and BMI in the obese group were significantly reduced after the exercise therapy (P<0.05). In the obese group, the serum leptin level was positively correlated with the levels of blood lipids and hs-CRP (P<0.05); serum levels of leptin and hs-CRP were negatively correlated with the sLR level (P<0.05); the hs-CRP level was positively correlated with the levels of blood lipids (P<0.01). CONCLUSIONS: Leptin resistance and the changes of blood lipids and inflammatory response are found in children with obesity. Exercise therapy can partially improve these changes.［Chin J Contemp Pediatr, 2010, 12 (1):40-42］

导出引用

李成万, 姜东林, 乔健, 孙钧铭, 黄建萍, 陈海平, 朱虹. 肥胖儿童运动减肥治疗前后的瘦素抵抗血脂及炎症状态分析[J]. 中国当代儿科杂志. 2010, 12(1): 40-42

LI Cheng-Wan, JIANG Dong-Lin, QIAO Jian, SUN Jun-Ming, HUANG Jian-Ping, CHEN Hai-Ping, ZHU Hong. Changes of leptin resistance, blood lipids and inflammatory response before and after the exercise therapy in children with obesity[J]. Chinese Journal of Contemporary Pediatrics. 2010, 12(1): 40-42

中图分类号： R723.14

参考文献

［1］中国肥胖问题工作组．中国学龄儿童青少年超重、肥胖筛查体质指数值分类标准［J］．中华流行病学杂志，2004，25(2)：97-102．
［2］热娜·买买提，林方梅，多力坤·木扎帕尔．乌鲁木齐市4所幼儿园学龄前儿童单纯性肥胖的影响因素［J］．中国当代儿科杂志，2008，10(1)：73-76．
［3］Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al．Obesity and the metabolic syndrome in children and adolescents［J］．N Engl J Med, 2004, 350(23)：2362-2374．
［4］肖云武，黄雪梅，邓映霞，龙辉，成放群，翦辉，等．儿童肥胖与C-反应蛋白、瘦素、胰岛素敏感指数的相关性研究［J］．中国当代儿科杂志，2006，8(1)：24-26．
［5］Hills AP, King NA, Armstrong TP．The contribution of physical activity and sedentary behaviours to the growth and development of children and adolescents：implications for overweight and obesity［J］．Sports Med，2007，37(6)：533-545．
［6］刘纪清，李国兰．实用运动处方［M］．哈尔滨：黑龙江科学技术出版社，1993：250．
［7］Li YP, Yang XG, Zhai FY, Piao JH, Zhao WH, Zhang J, et al．Disease risks of childhood obesity in China［J］．Biomed Environ Sci，2005，18（6）：401-410．
［8］吴静，莫娟，黄超文，彭烈武，徐丽，杨晓春，等．长沙市开福区小学生肥胖现状及影响因素分析［J］．中国当代儿科杂志，2008，10(2)：231-235．
［9］Hattori Y, Matsumura M, Kasai K. Vascular smooth muscle cell activation by C-reactive protein［J］．Cardiovasc Res, 2003, 58(1)：186-195．
［10］Ouchi N, Kihara S, Funahashi T, Nakamura T, Nishida M, Kumada M, et al．Reciprocal association of C-reactive protein with adiponectin in blood stream and adipose tissue［J］．Circulation, 2003, 107(5)：671-674．
［11］Kieffer TJ, Heller RS, Leech CA, Holz GG, Habener JF. Leptin suppression of insulin secretion by the activation of ATP-sensitive K+ channels in pancreatic beta-cells［J］．Diabetes, 1997, 46(6)：1087-1093．
［12］Unger RH, Zhou YT, Orci L. Regulation of fatty acid homeostasis in cells：novel role of leptin［J］．Proc Natl Acad Sci USA, 1999, 96(5)：2327-2332．
［13］Wallace AM, McMahon AD, Packard CJ, Kelly A, Shepherd J, Gaw A, et al．Plasma leptin and the risk of cardiovascular disease in the west of Scotland Coronary Prevention Study(WOSCOPS) ［J］．Circulation, 2001, 104(25)：3052-3056．
［14］Dandona P, Aljada A, Mohanty P, Ghanim H, Hamouda W, Assian E, et al．Insulin inhibits intranuclear nuclear factor kappaB and stimulates IkappaB in mononuclear cells in obese subjects：evidence for an antiinflammatory effect?［J］．J Clin Endocrinol Metab, 2001, 86(7)：3257-3265．
［15］Xu JW, Morita I, Ikeda K, Miki T, Yamori Y．C-reactive protein suppresses insulin signaling in endothelial cells：role of spleen tyrosine kinase ［J］．Mol Endocrinol, 2007, 21(2)：564-573．