Department of Experimental Medicine, Sapienza University of Rome, Italy.
Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L'Aquila, Italy; Department of Experimental Medicine, Sapienza University of Rome, Italy.
Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):902-910. doi: 10.1016/j.numecd.2020.11.025. Epub 2020 Dec 5.
Neurotensin (NT) is an intestinal peptide released after fat ingestion, which regulates appetite and facilitates lipid absorption. Elevated plasma levels of its stable precursor pro-neurotensin (pro-NT) are associated with type 2 diabetes, obesity and cardiovascular mortality in adult populations; no data on pro-NT and metabolic disease are available in children. Aim of the study was to evaluate plasma pro-NT in relation to the presence of obesity in children, and to test if high pro-NT associates with the development of metabolic impairment later in life.
For this longitudinal retrospective study, we studied 151 overweight/obese children undergoing metabolic evaluations at University of Cagliari, Italy. Pro-NT was also assessed in 46 normal-weight, age-, sex-comparable normal-weight children, selected as a reference group. At the baseline, pro-NT was comparable between overweight/obese and normal-weight children and correlated positively with age (p < 0.001), triglycerides (p < 0.001) and inversely with HDL levels (p = 0.008). Plasma pro-NT associated with high triglycerides with OR = 5.9 (95%CI: 1.24-28.1; p = 0.026) after adjustment for multiple confounders. At the 6.5-year follow-up, high basal pro-NT associated with impaired β-cell function to compensate for insulin-resistance (disposition index: r = -0.19, p = 0.035) and predicted bodyweight increase, as indicated by percentage change of standard deviation score BMI (median(95%CI) = +20.8(+4.9-+27.5)% in the highest tertile), independently from age, sex, triglycerides and insulin-resistance (standardized β = 0.24; p = 0.036).
Elevated pro-NT levels in children are significantly associated with weight gain later in life and may represent a marker of susceptibility to metabolic impairment in presence of obesity.
神经降压素（NT）是一种在脂肪摄入后释放的肠道肽，它可以调节食欲并促进脂质吸收。其稳定前体神经降压素原（pro-NT）的血浆水平升高与成年人群中的 2 型糖尿病、肥胖和心血管死亡率有关；但在儿童中尚无关于 pro-NT 与代谢疾病的相关数据。本研究旨在评估儿童肥胖与 pro-NT 之间的关系，并检验 pro-NT 是否与成年后代谢损害的发生有关。
本研究为一项在意大利卡利亚里大学进行的回顾性纵向研究，共纳入 151 名超重/肥胖的儿童进行代谢评估。同时，我们还评估了 46 名年龄、性别相匹配的正常体重儿童的 pro-NT 水平，将其作为参考组。在基线时，超重/肥胖儿童与正常体重儿童的 pro-NT 水平相当，且与年龄呈正相关（p<0.001），与甘油三酯呈正相关（p<0.001），与高密度脂蛋白水平呈负相关（p=0.008）。在校正了多种混杂因素后，血浆 pro-NT 与高甘油三酯呈正相关（OR=5.9（95%CI：1.24-28.1；p=0.026））。在 6.5 年的随访中，基础 pro-NT 水平较高与β细胞功能受损相关，提示存在胰岛素抵抗（处置指数：r=-0.19，p=0.035），并预测体重增加，以体重指数标准偏差评分的百分比变化（最高 tertile 中位数（95%CI）=+20.8（+4.9-+27.5）%）表示，这与年龄、性别、甘油三酯和胰岛素抵抗无关（标准化β=0.24；p=0.036）。
儿童中 pro-NT 水平升高与成年后体重增加显著相关，可能是肥胖患者发生代谢损害的易感性标志物。
