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肥胖儿童体重减轻前后的高敏C反应蛋白、肿瘤坏死因子α及心血管危险因素

High-sensitive C-reactive protein, tumor necrosis factor alpha, and cardiovascular risk factors before and after weight loss in obese children.

作者信息

Reinehr Thomas, Stoffel-Wagner Birgit, Roth Christian L, Andler Werner

机构信息

Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, D-45711 Datteln, Germany.

出版信息

Metabolism. 2005 Sep;54(9):1155-61. doi: 10.1016/j.metabol.2005.03.022.

Abstract

To confirm the existence of obesity-induced inflammation and to clarify the association between such inflammation and other cardiovascular risk factors, we investigated the relationships between high-sensitive C-reactive protein (hsCRP), tumor necrosis factor alpha (TNF-alpha), obesity, blood pressure, lipids, and insulin resistance in a long-term follow-up of obese children. We compared the serum concentrations of hsCRP, TNF-alpha, high-density lipoprotein cholesterol, and triglycerides as well as blood pressure and the insulin resistance index (homeostasis model assessment [HOMA]) of 14 nonobese and 31 obese children. Furthermore, we studied the changes in these parameters in 16 obese children who lost weight and in 15 obese children without weight change over a 1-year period. In the obese children, blood pressure (P=.003), HOMA (P=.034), and triglyceride (P=.011), TNF-alpha (P=.015), and hsCRP (P<.001) levels were significantly higher, whereas high-density lipoprotein cholesterol concentrations were significantly (P=.015) lower compared with the nonobese children. Weight loss was associated with a significant decrease in hsCRP (P=.008) and triglyceride (P=.048) levels, HOMA (P<.001), and blood pressure (P=.019), whereas there were no significant changes in the children with stable weight status. The changes in hsCRP and TNF-alpha levels over the 1-year period were not significantly correlated to the changes in lipids, blood pressure, and HOMA. Obese children demonstrated significantly higher levels of hsCRP and TNF-alpha compared with nonobese children. The chronic inflammation markers TNF-alpha and hsCRP were independent of lipids, blood pressure, and insulin resistance index. Weight loss was associated with the significant decrease of hsCRP and triglyceride levels, and blood pressure.

摘要

为了证实肥胖诱导的炎症的存在,并阐明这种炎症与其他心血管危险因素之间的关联,我们在对肥胖儿童的长期随访中,研究了高敏C反应蛋白(hsCRP)、肿瘤坏死因子α(TNF-α)、肥胖、血压、血脂和胰岛素抵抗之间的关系。我们比较了14名非肥胖儿童和31名肥胖儿童的hsCRP、TNF-α、高密度脂蛋白胆固醇和甘油三酯的血清浓度,以及血压和胰岛素抵抗指数(稳态模型评估[HOMA])。此外,我们研究了16名体重减轻的肥胖儿童和15名体重在1年期间无变化的肥胖儿童这些参数的变化。与非肥胖儿童相比,肥胖儿童的血压(P = 0.003)、HOMA(P = 0.034)、甘油三酯(P = 0.011)、TNF-α(P = 0.015)和hsCRP(P < 0.001)水平显著更高,而高密度脂蛋白胆固醇浓度显著更低(P = 0.015)。体重减轻与hsCRP(P = 0.008)、甘油三酯(P = 0.048)水平、HOMA(P < 0.001)和血压(P = 0.019)的显著降低相关,而体重稳定的儿童则无显著变化。hsCRP和TNF-α水平在1年期间的变化与血脂、血压和HOMA的变化无显著相关性。与非肥胖儿童相比,肥胖儿童的hsCRP和TNF-α水平显著更高。慢性炎症标志物TNF-α和hsCRP与血脂、血压和胰岛素抵抗指数无关。体重减轻与hsCRP、甘油三酯水平和血压的显著降低相关。

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