Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Dr. F. Steiner Str. 5, D-45711, Datteln, Germany.
Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 Ninth Avenue, Seattle, WA, 98101, USA.
Curr Diab Rep. 2018 Oct 18;18(12):131. doi: 10.1007/s11892-018-1110-5.
Chronic inflammation, adipokines, and hepatokines have been identified as basis of insulin resistance and β cell failure in animal models. We present our current knowledge concerning the potential relationship between these cytokines, inflammation, metabolic syndrome (MetS), and type 2 diabetes mellitus (T2DM) in the pediatric population.
Pro-inflammatory cytokines related to insulin resistance and MetS in children are tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-1β, interferon gamma, pigment epithelium-derived factor, chemerin, vaspin, and fetuin A. Anti-inflammatory cytokines associated with insulin resistance and MetS in children are leptin, adiponectin, omentin, fibroblast growth factor (FGF)-21, osteocalcin, and irisin. These anti-inflammatory cytokines are decreased (adiponectin, omentin, and osteocalcin) or increased (leptin, FGF-21, and irisin) in obesity suggesting a resistance state. TNF-α, fetuin A, and FGF-21 are altered in obese children with T2DM suggesting an involvement in β cell failure. These cytokines, adipokines, and hepatokines may be able to predict development of MetS and T2DM and have a potential therapeutic target ameliorating insulin resistance.
慢性炎症、脂肪因子和肝因子已被确定为动物模型中胰岛素抵抗和β细胞衰竭的基础。我们目前对这些细胞因子、炎症、代谢综合征（MetS）和 2 型糖尿病（T2DM）之间潜在关系的认识在儿科人群中进行了介绍。
与儿童胰岛素抵抗和 MetS 相关的促炎细胞因子有肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、IL-1β、干扰素γ、色素上皮衍生因子、趋化素、内脂素、胎球蛋白 A。与儿童胰岛素抵抗和 MetS 相关的抗炎细胞因子有瘦素、脂联素、网膜素、成纤维细胞生长因子（FGF）-21、骨钙素和鸢尾素。这些抗炎细胞因子在肥胖儿童中减少（脂联素、网膜素和骨钙素）或增加（瘦素、FGF-21 和鸢尾素），表明存在抵抗状态。TNF-α、胎球蛋白 A 和 FGF-21 在患有 T2DM 的肥胖儿童中发生改变，提示其参与β细胞衰竭。这些细胞因子、脂肪因子和肝因子可能能够预测 MetS 和 T2DM 的发生，并具有改善胰岛素抵抗的潜在治疗靶点。
