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肥胖和超重儿童的脂联素作为预测代谢综合征及其各组分的生物标志物。

Adiponectin in eutrophic and obese children as a biomarker to predict metabolic syndrome and each of its components.

机构信息

Community Health Research Department, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico.

出版信息

BMC Public Health. 2013 Jan 30;13:88. doi: 10.1186/1471-2458-13-88.

Abstract

BACKGROUND

Obesity is associated with the rise of noncommunicable diseases worldwide. The pathophysiology behind this disease involves the increase of adipose tissue, being inversely related to adiponectin, but directly related to insulin resistance and metabolic syndrome (MetS). Therefore, this study aimed to determine the relationship between adiponectin levels with each component of MetS in eutrophic and obese Mexican children.

METHODS

A cross sectional study was conducted in 190 school-age children classified as obese and 196 classified as eutrophic. Adiponectin, glucose, insulin, high density lipoprotein cholesterol (HDL-C) and triglycerides were determined from a fasting blood sample. Height, weight, waist circumference, systolic and diastolic blood pressures (BP) were measured; MetS was evaluated with the IDF definition. The study groups were divided according to tertiles of adiponectin, using the higher concentration as a reference. Linear regression analysis was used to assess the association between adiponectin and components of the MetS. Finally, stepwise forward multiple logistic regression analysis controlling for age, gender, basal HOMA-IR values and BMI was performed to determine the odds ratio of developing MetS according to adiponectin tertiles.

RESULTS

Anthropometric and metabolic measurements were statistically different between eutrophic and obese children with and without MetS (P <0.001). The prevalence of MetS in obese populations was 13%. Adiponectin concentrations were 15.5 ± 6.1, 12.0 ± 4.8, 12.4 ± 4.9 and 9.4 ± 2.8 μg/mL for eutrophic and obese subjects, obese without MetS, and obese with MetS, respectively (P <0.001). Obese children with low values of adiponectin exhibited a higher frequency of MetS components: abdominal obesity, 49%; high systolic BP, 3%; high diastolic BP, 2%; impaired fasting glucose, 17%; hypertriglyceridemia, 31%; and low HDL-C values, 42%. Adjusted odds ratio of presenting MetS according to adiponectin categories was 10.9 (95% CI 2.05; 48.16) when the first tertile was compared with the third.

CONCLUSION

In this sample of eutrophic and obese Mexican children we found that adiponectin concentrations and MetS components have an inversely proportional relationship, which supports the idea that this hormone could be a biomarker for identifying individuals with risk of developing MetS.

摘要

背景

肥胖与全球范围内非传染性疾病的上升有关。这种疾病的病理生理学涉及脂肪组织的增加,与脂联素呈负相关,但与胰岛素抵抗和代谢综合征(MetS)直接相关。因此,本研究旨在确定脂联素水平与墨西哥肥胖和正常体重儿童代谢综合征各组成部分之间的关系。

方法

对 190 名肥胖和 196 名正常体重的学龄儿童进行横断面研究。从空腹血样中测定脂联素、葡萄糖、胰岛素、高密度脂蛋白胆固醇(HDL-C)和甘油三酯。测量身高、体重、腰围、收缩压和舒张压(BP);采用 IDF 定义评估 MetS。根据脂联素的三分位值将研究组分为三组,以较高浓度作为参考。采用线性回归分析评估脂联素与 MetS 各组成部分之间的关系。最后,进行逐步向前多元逻辑回归分析,控制年龄、性别、基础 HOMA-IR 值和 BMI,以确定根据脂联素三分位值发生 MetS 的比值比。

结果

肥胖和正常体重儿童的代谢和肥胖指标存在差异,无论是否患有 MetS(P <0.001)。肥胖人群 MetS 的患病率为 13%。脂联素浓度分别为 15.5±6.1、12.0±4.8、12.4±4.9 和 9.4±2.8μg/mL,用于肥胖和正常体重的儿童,肥胖但没有 MetS 的儿童,以及肥胖但患有 MetS 的儿童(P<0.001)。脂联素水平低的肥胖儿童患有更多的 MetS 成分:腹部肥胖 49%;高收缩压 3%;高舒张压 2%;空腹血糖受损 17%;高三酰甘油血症 31%;和低 HDL-C 值 42%。与第三组相比,当第一组与第三组比较时,根据脂联素类别出现 MetS 的调整比值比为 10.9(95%CI 2.05;48.16)。

结论

在本研究中,我们发现墨西哥肥胖和正常体重儿童的脂联素浓度和 MetS 成分呈反比关系,这支持了这种激素可以作为识别有 MetS 风险个体的生物标志物的观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5e4/3570482/d0b65f777152/1471-2458-13-88-1.jpg

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