McAlister Kelsey L, Fisher Koren L, Dumont-Driscoll Marilyn C, Rubin Daniela A
California State University, Fullerton, Department of Kinesiology, Fullerton, CA, USA.
University of Florida College of Medicine, General Pediatrics, Gainesville, FL, USA.
J Pediatr Endocrinol Metab. 2018 Aug 28;31(8):837-845. doi: 10.1515/jpem-2017-0539.
The objective of this study was to examine the associations between adiposity, metabolic syndrome (MetS), cytokines and moderate-to-vigorous physical activity (MVPA) in youth with Prader-Willi syndrome (PWS) and non-syndromic obesity (OB).
Twenty-one youth with PWS and 34 with OB aged 8-15 years participated. Measurements included body composition, blood pressure, fasting blood markers for glucose control, lipids and inflammation and MVPA. Group differences for adiposity, MetS, blood parameters and MVPA were determined using independent t-tests and chi-square (χ2) analyses. Bivariate correlations and analysis of variance (ANOVA) examined the associations between adiposity, MetS severity, cytokines and MVPA.
PWS presented similar percentage of body fat (%), lower body mass index (BMI) z-scores, insulin resistance, triglycerides, MetS severity, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and MVPA and higher high-density lipoprotein (HDL) and adiponectin (ADP) than OB. Fewer PWS presented MetS based on BMI z-score (61.9% vs. 91.2%) and glucose (14.3% vs. 44.1%) compared to OB. In all youth, MetS severity was significantly associated with body fat %, ADP, interleukin-6 (IL-6) and TNF-α and also with CRP in PWS, but associations became non-significant for CRP and IL-6 when controlling for body fat %. In PWS, those with low MVPA had significantly higher TNF-α than those with high MVPA (1.80±0.45 vs. 1.39±0.26 pg/mL).
Although PWS presented better cardiometabolic profiles than OB and lower MetS risk, associations between body fat, MetS and cytokines were somewhat similar for both groups, with the exception of CRP. Results suggest a potential role for MVPA related to MetS and inflammation and extend associations shown in OB to PWS.
本研究的目的是探讨普拉德-威利综合征(PWS)患儿及非综合征性肥胖(OB)青少年的肥胖、代谢综合征(MetS)、细胞因子与中等到剧烈身体活动(MVPA)之间的关联。
21名8至15岁的PWS患儿和34名OB青少年参与了研究。测量指标包括身体成分、血压、血糖控制、血脂和炎症的空腹血液标志物以及MVPA。使用独立t检验和卡方(χ2)分析确定肥胖、MetS、血液参数和MVPA的组间差异。双变量相关性分析和方差分析(ANOVA)检验肥胖、MetS严重程度、细胞因子与MVPA之间的关联。
与OB相比,PWS的体脂百分比(%)相似,体重指数(BMI)z评分、胰岛素抵抗、甘油三酯、MetS严重程度、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和MVPA较低,而高密度脂蛋白(HDL)和脂联素(ADP)较高。基于BMI z评分(61.9%对91.2%)和血糖(14.3%对44.1%),与OB相比,PWS中符合MetS的患儿较少。在所有青少年中,MetS严重程度与体脂百分比、ADP、白细胞介素-6(IL-6)和TNF-α显著相关,在PWS中还与CRP显著相关,但在控制体脂百分比后,CRP和IL-6的相关性不再显著。在PWS中,MVPA水平低的患儿TNF-α显著高于MVPA水平高的患儿(1.80±0.45对1.39±0.26 pg/mL)。
尽管PWS的心脏代谢状况优于OB且MetS风险较低,但两组的体脂、MetS与细胞因子之间的关联在某种程度上相似,CRP除外。结果表明MVPA与MetS和炎症之间可能存在关联,并将OB中显示的关联扩展到了PWS。