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肥胖儿童的氯唑沙宗清除率高于非肥胖同龄人。

Higher chlorzoxazone clearance in obese children compared with nonobese peers.

机构信息

Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.

Children's Obesity Clinic, European Center of Management (EASO). Department of Pediatrics, Zealand University Hospital, Holbaek, Denmark.

出版信息

Br J Clin Pharmacol. 2018 Aug;84(8):1738-1747. doi: 10.1111/bcp.13602. Epub 2018 Jun 3.

Abstract

AIMS

To test the in vivo activity of Cytochrome P450 (CYP) 2E1 in obese children vs. nonobese children, aged 11-18 years. Secondly, whether the activity of CYP2E1 in these patients is associated with NALFD, diabetes or hyperlipidaemia.

METHODS

Seventy children were divided into groups by body mass index (BMI) standard deviation score (SDS). All children received 250 mg oral chlorzoxazone (CLZ) as probe for CYP2E1 activity. Thirteen blood samples and 20-h urine samples were collected per participant.

RESULTS

Obese children had an increased oral clearance and distribution of CLZ, indicating increased CYP2E1 activity, similar to obese adults. The mean AUC value of CLZ was decreased by 46% in obese children compared to nonobese children. The F was was increased twofold in obese children compared to nonobese children, P < 0.0001. Diabetic biomarkers were significantly increased in obese children, while fasting blood glucose and Hba1c levels were nonsignificant between groups. Liver fat content was not associated with CLZ Cl.

CONCLUSION

Oral clearance of CLZ was increased two-fold in obese children vs. nonobese children aged 11-18 years. This indicates an increased CYP2E1 activity of clinical importance, and dose adjustment should be considered for CLZ.

摘要

目的

检测 CYP2E1 在肥胖儿童(11-18 岁)与非肥胖儿童体内的活性。其次,探究 CYP2E1 活性与 NALFD、糖尿病或高脂血症是否相关。

方法

70 名儿童按照体重指数(BMI)标准差评分(SDS)进行分组。所有儿童均接受 250mg 氯唑沙宗(CLZ)口服,作为 CYP2E1 活性的探针。每位参与者采集 13 份血样和 20 小时尿液样本。

结果

与非肥胖儿童相比,肥胖儿童的 CLZ 口服清除率和分布增加,表明 CYP2E1 活性增加,这与肥胖成年人相似。与非肥胖儿童相比,肥胖儿童的 CLZ 平均 AUC 值降低了 46%。与非肥胖儿童相比,肥胖儿童的 F 值增加了两倍,P<0.0001。肥胖儿童的糖尿病生物标志物显著增加,而空腹血糖和 Hba1c 水平在两组间无显著差异。肝内脂肪含量与 CLZ Cl 无相关性。

结论

与 11-18 岁的非肥胖儿童相比,肥胖儿童的 CLZ 口服清除率增加了两倍。这表明 CYP2E1 活性增加,具有重要的临床意义,对于 CLZ 应考虑调整剂量。

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