Bascietto Cinzia, Giannini Cosimo, D'Adamo Ebe, de Giorgis Tommaso, Chiarelli Francesco, Mohn Angelika
Department of Pediatrics, University of Chieti, Via Dei Vestini 5, 66100 Chieti, Italy.
J Pediatr Endocrinol Metab. 2012;25(3-4):255-60. doi: 10.1515/jpem-2011-0478.
There is a worsening high prevalence of global obesity. Special attention has been paid to the gut-endocrine system, represented by the regulators of appetite. In particular, it has been suggested that ghrelin ("hunger" peptide), and obestatin and glucagon-like peptide-1 (GLP-1) ("satiety" peptides) could play important roles in the pathogenesis of obesity.
The aims of this study were to compare fasting plasma ghrelin, obestatin, and GLP-1 levels between obese and nonobese prepubertal children, and to assess their relations with fatness indexes and insulin resistance (IR).
Fifty-two prepubertal obese children and 22 controls were enrolled. Fasting levels of gastrointestinal hormones (ghrelin, obestatin, and GLP-1), glucose, and insulin were evaluated. IR was assessed using the homeostasis model assessment of IR (HOMA-IR) index. Analysis was performed by Mann-Whitney U-test, Kruskal-Wallis test, and Spearman's correlation.
Obese prepubertal children and normal-weight controls had similar age distribution. Obese children were more insulin resistant when compared to controls (HOMA-IR: p < 0.01 ). GLP-1 levels were significantly lower in obese children than in controls (p < 0.01). Obestatin was significantly higher in obese than normal-weight children (p < 0.01), while ghrelin was not different. There was a negative correlation between GLP-1 and standard deviation score-body mass index (r = -0.36, p = 0.009) and between GLP-1 and waist circumference (r = -0.45, p = 0.001), while no association was observed with HOMA-IR.
GLP-1 levels have been shown to be correlated with adiposity indexes, but not with HOMA-IR, suggesting that this hormone could play an important role in the early development of obesity.
全球肥胖症的高患病率正在恶化。以食欲调节因子为代表的肠道内分泌系统受到了特别关注。特别是，有人提出胃饥饿素（“饥饿”肽）、肥胖抑制素和胰高血糖素样肽-1（GLP-1）（“饱腹感”肽）可能在肥胖症的发病机制中发挥重要作用。
本研究的目的是比较肥胖和非肥胖青春期前儿童空腹血浆胃饥饿素、肥胖抑制素和GLP-1水平，并评估它们与肥胖指数和胰岛素抵抗（IR）的关系。
招募了52名青春期前肥胖儿童和22名对照。评估了胃肠道激素（胃饥饿素、肥胖抑制素和GLP-1）、葡萄糖和胰岛素的空腹水平。使用胰岛素抵抗的稳态模型评估（HOMA-IR）指数评估IR。采用Mann-Whitney U检验、Kruskal-Wallis检验和Spearman相关性分析。
肥胖青春期前儿童和正常体重对照的年龄分布相似。与对照组相比，肥胖儿童的胰岛素抵抗更强（HOMA-IR：p < 0.01）。肥胖儿童的GLP-1水平显著低于对照组（p < 0.01）。肥胖儿童的肥胖抑制素显著高于正常体重儿童（p < 0.01），而胃饥饿素无差异。GLP-1与标准差评分-体重指数之间呈负相关（r = -0.36，p = 0.009），与腰围之间呈负相关（r = -0.45，p = 0.001），而与HOMA-IR无关联。
已表明GLP-1水平与肥胖指数相关，但与HOMA-IR无关，这表明该激素可能在肥胖症的早期发展中起重要作用。
