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1型糖尿病儿童、青少年和年轻成人血清脂联素水平升高及其年龄、性别、体重指数和代谢控制的影响:一项纵向研究

Elevated serum levels of adiponectin in children, adolescents and young adults with type 1 diabetes and the impact of age, gender, body mass index and metabolic control: a longitudinal study.

作者信息

Galler Angela, Gelbrich Götz, Kratzsch Jürgen, Noack Nicole, Kapellen Thomas, Kiess Wieland

机构信息

University Hospital for Children and Adolescents, University of Leipzig, Oststr. 21-25, D-04317 Leipzig, Germany.

出版信息

Eur J Endocrinol. 2007 Oct;157(4):481-9. doi: 10.1530/EJE-07-0250.

Abstract

OBJECTIVE

Adiponectin plays an important role in pathophysiology of obesity, type 2 diabetes and cardiovascular disease. The aim of this study was to determine adiponectin concentrations in children and adolescents with type 1 diabetes in a longitudinal manner and to study the impact of age, gender, body mass index (BMI) and metabolic control.

RESEARCH DESIGN AND METHODS

In this study, 88 children and adolescents with type 1 diabetes were followed longitudinally. At baseline and during follow-up, serum levels of adiponectin were measured by enzyme-linked immunoassay and correlated with clinical data, HbA1c and lipids. Healthy children (n = 259) were chosen as a control group.

RESULTS

Serum adiponectin levels were significantly higher in children with type 1 diabetes compared with healthy children (13.1 vs 9.1 microg/ml at baseline, P < 0.001). Adiponectin concentrations inversely correlated with BMI s.d.s (P < 0.001). No significant difference of adiponectin levels regarding gender, diabetes duration or HbA1c was seen. Adiponectin concentrations decreased in males with type 1 diabetes during puberty (P = 0.03) while there was no significant change in females. In a subgroup of patients with new onset type 1 diabetes, adiponectin concentrations were not different from adiponectin levels in control subjects but increased during follow-up (P = 0.007). Stepwise multiple regression analysis showed that most important predictors of adiponectin levels in type 1 diabetes at the end of the study were adiponectin concentration at baseline (beta = 0.574, P < 0.001) and BMI s.d.s (beta = -0.302, P = 0.001, r2 = 0.56).

CONCLUSIONS

Children and adolescents with type 1 diabetes have BMI-dependent elevated serum concentrations of adiponectin compared with healthy children.

摘要

目的

脂联素在肥胖、2型糖尿病和心血管疾病的病理生理学中发挥重要作用。本研究的目的是以纵向方式测定1型糖尿病儿童和青少年的脂联素浓度,并研究年龄、性别、体重指数(BMI)和代谢控制的影响。

研究设计与方法

在本研究中,对88名1型糖尿病儿童和青少年进行了纵向随访。在基线和随访期间,通过酶联免疫吸附测定法测量血清脂联素水平,并将其与临床数据、糖化血红蛋白(HbA1c)和血脂相关联。选择健康儿童(n = 259)作为对照组。

结果

与健康儿童相比,1型糖尿病儿童的血清脂联素水平显著更高(基线时为13.1 vs 9.1 μg/ml,P < 0.001)。脂联素浓度与BMI标准差呈负相关(P < 0.001)。在性别、糖尿病病程或HbA1c方面,脂联素水平无显著差异。1型糖尿病男性在青春期脂联素浓度下降(P = 0.03),而女性无显著变化。在新诊断的1型糖尿病患者亚组中,脂联素浓度与对照组无差异,但在随访期间升高(P = 0.007)。逐步多元回归分析表明,研究结束时1型糖尿病患者脂联素水平的最重要预测因素是基线时的脂联素浓度(β = 0.574,P < 0.001)和BMI标准差(β = -0.302,P = 0.001,r2 = 0.56)。

结论

与健康儿童相比,1型糖尿病儿童和青少年的血清脂联素浓度因BMI升高而升高。

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