Department of Clinical Sciences and Community Health, University of Milan, Via Vanvitelli 32, 20129 Milan, Italy.
Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Via Ariosto 13, 20145 Milan, Italy.
Int J Endocrinol. 2013;2013:565967. doi: 10.1155/2013/565967. Epub 2013 Dec 21.
Obese adults frequently exhibit a low-grade inflammation and insulin resistance, which have been hypothesized to be established early in childhood. Aim of this study was to evaluate the age-dependent relationships between inflammatory state and insulin resistance in obese adolescents and adults. Clinical and metabolic parameters, circulating adipokines (TNF- α , adiponectin, and leptin), ghrelin, their leukocyte receptors (TNFR1, ADIPOR2, OBRL and GHSR1a), and acute phase reactants (CRP and white blood cells) were assessed in lean and obese adolescents compared with the adult counterparts. Only obese adults had higher HOMA-IR, insulin, and triglycerides compared to the lean group. An inflammatory state was present in obese adolescents and adults, as demonstrated by the higher values of CRP and neutrophils. There were no group differences in circulating levels of TNF- α and leukocyte expression of TNFR1. Adiponectin concentrations and leukocyte expression of ADIPOR2 were higher in the lean groups than in the corresponding obese counterparts. For leptin and leukocyte expression of OBRL, the results were opposed. Circulating levels of ghrelin were higher in lean adolescents and adults than the related lean groups, while there was a higher leukocyte expression of GHSR1a in (only) lean adults than obese adults. When the analysis was performed in (lean or obese) adults, TNF- α , neutrophils, leptin, and GHSR1a were predictors of HOMA-IR. None of the considered independent variables accounted for the degree of insulin resistance in the adolescent group. In conclusion, a dissociation between the low-grade inflammation and insulin resistance is supposed to exist in the early phases of obesity.
肥胖成年人常表现出低度炎症和胰岛素抵抗，这些现象被认为在儿童早期就已确立。本研究旨在评估肥胖青少年和成年人中炎症状态与胰岛素抵抗之间的年龄相关性。与瘦对照组相比，评估了临床和代谢参数、循环脂肪因子（TNF-α、脂联素、瘦素）、ghrelin、其白细胞受体（TNFR1、ADIPOR2、OBRL 和 GHSR1a）和急性期反应物（CRP 和白细胞）在肥胖青少年和成年人中的情况。与瘦组相比，仅肥胖成年人的 HOMA-IR、胰岛素和甘油三酯更高。CRP 和中性粒细胞较高表明存在炎症状态，肥胖青少年和成年人均存在这种情况。TNF-α和白细胞表达的 TNFR1 的循环水平在各组之间无差异。瘦组的脂联素浓度和白细胞表达的 ADIPOR2 高于相应的肥胖组。而瘦素和白细胞表达的 OBRL 则相反。瘦青少年和成年人的 ghrelin 循环水平高于瘦对照组，而只有瘦成年人的 GHSR1a 白细胞表达高于肥胖成年人。当在（瘦或肥胖）成年人中进行分析时，TNF-α、中性粒细胞、瘦素和 GHSR1a 是 HOMA-IR 的预测因子。在青少年组中，没有考虑到的独立变量可以解释胰岛素抵抗的程度。总之，在肥胖的早期阶段，低度炎症和胰岛素抵抗之间可能存在分离。
