Nursing Department, University of Alicante, Alicante, Spain.
Department of Nutrition and Metabolism (DMN), Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain.
J Intellect Disabil Res. 2020 Feb;64(2):170-179. doi: 10.1111/jir.12697. Epub 2019 Dec 20.
The main objective of this study was to describe the inflammatory status of adolescents with Down syndrome (DS) and their relationship with adiposity.
Ninety-five adolescents with DS (44.2% girls) and a control group of 113 adolescents (47.8% girls), aged between 11 and 18 years old, from the UP & DOWN study were included in this substudy. Serum C-reactive protein, C3 and C4 complement factors, total proteins, interleukin-6, tumour necrosis factor-α, insulin, cortisol, leptin, adiponectin, galactin-3 and visfatin were analysed; homeostatic model assessment index was calculated. In order to evaluate adiposity, we measured the following body fat variables: weight, height, waist circumference and skinfold thicknesses. Birth weight was obtained by questionnaire. In addition, body mass index, waist-to-height ratio (WHtR) and body fat percentage (BF%) were calculated.
Down syndrome group showed higher levels of body mass index, WHtR, waist circumference, BF% and lower birth weight than controls (P < 0.001). In the general linear model in the total sample, WHtR was positively associated with C3 and C4 (P < 0.001) as well as with leptin levels (P = 0.015). BF% was positively associated with total proteins (P = 0.093) and leptin levels (P < 0.001). DS was positively associated with total proteins (P < 0.001), C3 (P = 0.047) and C4 (P = 0.019). Despite the higher levels of adiposity found in DS group, no direct association was found between BF% and leptin levels, comparing with the control group.
These findings suggest that abdominal obesity should be controlled in adolescents because of its relationship with acute phase-inflammatory biomarkers but especially in DS adolescents who may show a peculiar metabolic status according to their relationship between adiposity and inflammatory biomarkers.
本研究的主要目的是描述唐氏综合征(Down syndrome,DS)青少年的炎症状态及其与肥胖的关系。
本研究纳入了 UP & DOWN 研究中的 95 名 DS 青少年(44.2%为女孩)和 113 名对照组青少年(47.8%为女孩),年龄在 11 至 18 岁之间。分析了血清 C 反应蛋白、C3 和 C4 补体因子、总蛋白、白细胞介素 6、肿瘤坏死因子-α、胰岛素、皮质醇、瘦素、脂联素、半乳糖凝集素 3 和内脂素;计算了稳态模型评估指数。为了评估体脂,我们测量了以下体脂变量:体重、身高、腰围和皮褶厚度。通过问卷获得出生体重。此外,还计算了体重指数、腰高比(waist-to-height ratio,WHtR)和体脂百分比(body fat percentage,BF%)。
DS 组的体重指数、WHtR、腰围、BF%均高于对照组,出生体重低于对照组(P<0.001)。在总样本的一般线性模型中,WHtR 与 C3 和 C4 呈正相关(P<0.001),与瘦素水平呈正相关(P=0.015)。BF%与总蛋白呈正相关(P=0.093),与瘦素水平呈正相关(P<0.001)。DS 与总蛋白(P<0.001)、C3(P=0.047)和 C4(P=0.019)呈正相关。尽管 DS 组的体脂水平较高,但与对照组相比,BF%与瘦素水平之间并未发现直接关联。
这些发现表明,应控制青少年的腹型肥胖,因为它与急性期炎症生物标志物有关,但特别是在 DS 青少年中,他们的肥胖与炎症生物标志物之间的关系可能显示出一种特殊的代谢状态。