Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Obesity (Silver Spring). 2012 Mar;20(3):512-6. doi: 10.1038/oby.2011.49. Epub 2011 Mar 24.
Overweight is related to higher levels of C-reactive protein (CRP) and leptin, which have been independently associated with increased risk for diabetes, cardiovascular disease, and the metabolic syndrome. Elevated CRP may trigger leptin resistance by inhibiting the binding of leptin to its receptors. We cross-sectionally examined the relationship between CRP, leptin, BMI z-score, percent body fat (%BF) assessed by air plethysmography (BodPod), and insulin sensitivity (SI) and acute insulin response (AIRg) measured by intravenous glucose tolerance test in 51 Latina and African-American females (77% Latina), mean age 9.2 (±0.9) years, at either Tanner Pubertal Stage (TPS) 1 (n = 25) or TPS 2 (n = 26). Females at TPS 2 had higher BMI z-scores, %BF (23% ± 10.1 vs. 30% ± 10.0, P = 0.02), AIRg (976.7 ± 735.2 vs. 1555.3 ± 1,223 µIU/ml, P = 0.05), fasting insulin (11.0 ± 10.8 vs. 17.2 ± 13.6 µlU/ml, P = 0.00) and leptin levels (11.0 ± 7.1 vs. 19.6 ± 10.9 ng/ml, P < 0.001) than those at TPS 1. There were no ethnic differences in any of the measured variables. CRP was positively correlated with BMI z-score (P = 0.001), %BF (P = 0.006), fasting insulin and AIRg (P = 0.02), and fasting leptin (P = 0.00), and negatively correlated with SI (P = 0.05). A linear regression model showed that CRP independently explained 10% (P = 0.00) of the variance in leptin after adjusting %BF, TPS, ethnicity, habitual physical activity and SI. Hence, low-grade inflammation may contribute to prolonged leptin exposure and leptin resistance, even in healthy children.
超重与 C 反应蛋白(CRP)和瘦素水平升高有关,而这些物质已被证明与糖尿病、心血管疾病和代谢综合征的风险增加独立相关。CRP 可能通过抑制瘦素与其受体的结合而引发瘦素抵抗。我们通过空气排空法(BodPod)评估的体脂百分比(%BF)和静脉葡萄糖耐量试验测量的胰岛素敏感性(SI)和急性胰岛素反应(AIRg),对 51 名拉丁裔和非裔美国女性(77%为拉丁裔)进行了横断面研究,这些女性平均年龄为 9.2(±0.9)岁,正处于青春期第 1 期(n = 25)或第 2 期(n = 26)。处于青春期第 2 期的女性 BMI z 评分更高、体脂百分比(23%±10.1%与 30%±10.0%,P=0.02)、AIRg(976.7±735.2 与 1555.3±1223µIU/ml,P=0.05)、空腹胰岛素(11.0±10.8 与 17.2±13.6µlU/ml,P=0.00)和瘦素水平(11.0±7.1 与 19.6±10.9ng/ml,P<0.001)均高于青春期第 1 期的女性。在所有测量的变量中,种族之间没有差异。CRP 与 BMI z 评分(P=0.001)、%BF(P=0.006)、空腹胰岛素和 AIRg(P=0.02)以及空腹瘦素(P=0.00)呈正相关,与 SI(P=0.05)呈负相关。线性回归模型显示,在调整了%BF、TPS、种族、习惯性体力活动和 SI 后,CRP 可独立解释 10%(P=0.00)的瘦素变异。因此,即使在健康儿童中,低度炎症也可能导致瘦素暴露和瘦素抵抗时间延长。