Rudzka-Kocjan Agnieszka, Szarras-Czapnik Maria, B Janusz, Ginalska-Malinowska Maria
Klinika Pediatrii, Oddział Endokrynologii Instytutu "Pomnik--Centrum Zdrowia Dziecka" w Warszawie, Warszawa.
Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw. 2006;12(3):211-5.
Insulin resistance--a key element of the metabolic syndrome--is observed in children with simple obesity. Adipose tissue is producing bioactive substances called adipocytokines. Some of them may play a role in the development of insulin resistance.
Estimation of the frequency of insulin resistance and its correlation with leptin, adiponectin and resistin levels in children with simple obesity.
The 53 children (BMI>97 centile), mean age 13.57 years. Mean BMI was +4.04 SDS. Oral glucose tolerance test (OGTT) was performed. Insulin levels at 0' < or = 15 microIU/mL and/or insulin peak during OGTT < or = 150 microIU/mL and/or peak at 120' < or =75 microIU/mL were established as normal values. Homa ratio was calculated. Patients were divided into groups depending on the presence or absence of hyperinsulinemia / insulin resistance. Concentrations of adiponectin, leptin, resistin were measured.
In 13.23 % children various types of hyperglycemia were diagnosed and hyperinsulinemia in OGTT was noted in 83.02 %. Severe insulin resistance (HOMA>3) was diagnosed in 71.82 %. In the hyperinsulinemia group higher glucose levels in OGTT were stated comparing to the non hyperinsulinemia group. In children with insulin resistance, higher BMI and SD BMI were observed. In this paper results of correlations of adipocytokines levels and anthropometric parameters or carbohydrates metabolism in children with / without insulin resistance are presented.
In children with severe insulin resistance adiponectin concentrations correlate negatively with glucose levels, there is a positive correlation of adiponectin and glucose and insulin in a group without severe insulin resistance. In patients with insulin resistance leptin concentrations correlate positively with the degree of obesity and insulin levels in OGTT.
胰岛素抵抗——代谢综合征的关键要素——在单纯性肥胖儿童中较为常见。脂肪组织会产生被称为脂肪细胞因子的生物活性物质。其中一些可能在胰岛素抵抗的发展过程中发挥作用。
评估单纯性肥胖儿童中胰岛素抵抗的发生率及其与瘦素、脂联素和抵抗素水平的相关性。
选取53名儿童(BMI>第97百分位数),平均年龄13.57岁。平均BMI为+4.04 SDS。进行口服葡萄糖耐量试验(OGTT)。将0分钟时胰岛素水平≤15微国际单位/毫升和/或OGTT期间胰岛素峰值≤150微国际单位/毫升和/或120分钟时峰值≤75微国际单位/毫升确定为正常值。计算稳态模型评估(HOMA)比值。根据是否存在高胰岛素血症/胰岛素抵抗将患者分组。测定脂联素、瘦素、抵抗素的浓度。
13.23%的儿童被诊断出患有各种类型的高血糖,83.02%的儿童在OGTT中出现高胰岛素血症。71.82%的儿童被诊断为严重胰岛素抵抗(HOMA>3)。与非高胰岛素血症组相比,高胰岛素血症组在OGTT中的血糖水平更高。在有胰岛素抵抗的儿童中,观察到更高的BMI和SD BMI。本文展示了有/无胰岛素抵抗儿童中脂肪细胞因子水平与人体测量参数或碳水化合物代谢的相关性结果。
在严重胰岛素抵抗的儿童中,脂联素浓度与血糖水平呈负相关,在无严重胰岛素抵抗的组中,脂联素与血糖和胰岛素呈正相关。在胰岛素抵抗患者中,瘦素浓度与肥胖程度和OGTT中的胰岛素水平呈正相关。