肥胖儿童黑色棘皮病与脂肪因子和代谢综合征的关系

谭新睿; 张美真; 李敏; 肖延风

doi:10.7499/j.issn.1008-8830.2015.07.006

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中国当代儿科杂志 ›› 2015, Vol. 17 ›› Issue (7) : 672-676. DOI: 10.7499/j.issn.1008-8830.2015.07.006

论著·临床研究

肥胖儿童黑色棘皮病与脂肪因子和代谢综合征的关系

谭新睿, 张美真, 李敏, 肖延风

作者信息 +

Association between acanthosis nigricans and metabolic syndrome in children with obesity

TAN Xin-Rui, ZHANG Mei-Zhen, LI Min, XIAO Yan-Feng

Author information +

文章历史 +

摘要

目的了解肥胖伴黑色棘皮病(AN)患儿代谢特点及血清脂肪因子水平,探讨AN 对代谢综合征的预测价值。方法将2012 年2 月至2013 年6 月收治的109 名肥胖儿童分为伴AN 组(n=44)和无AN 组(n=65),同期选取年龄、性别相匹配的健康儿童做为对照组(n=47)。采用ELISA 法检测血脂联素、瘦素、肿瘤坏死因子α 和视黄醇结合蛋白4 的水平,并对代谢综合征的危险因素进行多元logistic 回归分析。结果肥胖伴AN 组腰臀比、收缩压、血甘油三酯、空腹胰岛素、胰岛素抵抗指数均较肥胖无AN 组和对照组升高(P<0.05)。肥胖伴AN 组和肥胖无AN 组脂联素水平均较对照组降低,肥胖伴AN 组瘦素水平较肥胖无AN 组和对照组明显升高(P<0.05)。Logistic 回归提示伴发AN(OR=3.469,95%CI:1.518~7.929)和高BMI(OR=7.108,95%CI:2.359~21.416)是代谢综合征的独立危险因素(P<0.05)。结论 AN 是胰岛素抵抗的皮肤标志,与脂肪因子分泌异常密切相关,降低AN 发生率和BMI 将减少代谢综合征的发生。

Abstract

Objective To investigate adipokines levels in obese children with acanthosis nigricans (AN) and to explore the relationship between AN and metabolic syndrome (MS). Methods A cross-sectional study was performed on 109 obese children and 47 age-and gender-matched normal controls. The obese children were divided into two groups with AN and without AN. Serum levels of adiponectin, leptin, TNF-α and retinol-binding protein 4 (RBP4) were measured using ELISA. Multiple logistic regression analysis was performed to estimate the association of clinical parameters with MS. Results Waist-hip ratio, systolic blood pressure, triglyceride, fasting insulin and insulin resistance index (HOMA-IR) were significantly higher in obese children with AN than in those without AN and normal controls (P<0.05). The obese children with AN and without AN had lower adiponectin levels than normal controls (P<0.05), on the contrary, the obese children with AN had higher leptin levels than those without AN and normal controls (P<0.05). Multiple logistic regression analysis revealed that AN (OR=3.469, 95%CI: 1.518-7.929) and BMI (OR=7.108, 95%CI: 2.359-21.416) were independent risk factors for MS. Conclusions As a visible marker of insulin resistance, AN is associated with abnormal adipokines secretion. Reducing the incidence of AN and losing weight may prevent obesity associated MS.

导出引用

谭新睿, 张美真, 李敏, 肖延风. 肥胖儿童黑色棘皮病与脂肪因子和代谢综合征的关系[J]. 中国当代儿科杂志. 2015, 17(7): 672-676 https://doi.org/10.7499/j.issn.1008-8830.2015.07.006

TAN Xin-Rui, ZHANG Mei-Zhen, LI Min, XIAO Yan-Feng. Association between acanthosis nigricans and metabolic syndrome in children with obesity[J]. Chinese Journal of Contemporary Pediatrics. 2015, 17(7): 672-676 https://doi.org/10.7499/j.issn.1008-8830.2015.07.006

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