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肥胖儿童的血清淀粉酶原水平与葡萄糖稳态。

Asprosin serum levels and glucose homeostasis in children with obesity.

机构信息

Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Italy.

Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Italy.

出版信息

Cytokine. 2021 Jun;142:155477. doi: 10.1016/j.cyto.2021.155477. Epub 2021 Mar 1.

Abstract

PURPOSE

Asprosin is a novel adipokine involved in glucose homeostasis, food intake regulation and energy homeostasis. However, the role of asprosin in glucose homeostasis regulation remains still controversial, especially in pediatrics. Aims of the study were to compare fasting serum asprosin levels between obese children and controls and to investigate the relationships of asprosin with body mass index (BMI) and biochemical markers of insulin resistance, insulin sensitivity, β-cell function and cardio-metabolic risk in obese non-diabetic children.

METHODS

This cross-sectional, case-controlled, study included 43 obese children and 24 lean matched controls consecutively recruited. Children underwent clinical and biochemical assessments, including oral glucose tolerance test. Fasting asprosin serum levels were measured using an enzyme-linked immunosorbentassay (ELISA). Homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-B), Matsuda-index, Insulinogenic-index, Areas Under the Curves for glucose and insulin were calculated. Successively, asprosin variable was dichotomized according to mean value in order to create two ordered classes of values.

RESULTS

Fasting asprosin concentration was significantly lower in obese children compared to controls (331.9 ± 120.5 vs 358.1 ± 74.1 pg/ml; p = 0.013). Asprosin was lower in boys than in girls (313.7 ± 59.5 vs 361.1 ± 127.2 pg/ml; p = 0.044), while BMI standard deviation score (SDS) was higher in boys compared to girls (p = 0.024). Asprosin was negatively correlated with BMI (p = 0.024), BMI SDS (p = 0.044) and male sex (p = 0.043) in the entire cohort. No significant differences in asprosin levels were demonstrated between insulin resistant and non-insulin resistant obese children. Logistic regression models documented a significant negative association between BMI SDS and dichotomized asprosin. In particular, higher BMI SDS values were associated to lower asprosin serum levels class. A receiver operating characteristic (ROC) analysis showed existence of the best cut-off for BMI SDS (+2.7 SDS) variable into discriminating patients belonging to two asprosin classes in our cohort.

CONCLUSIONS

In conclusion, asprosin serum levels were significantly lower in obese children compared to control. Fasting asprosin decreased with increasing BMI, but it was not significantly affected by IR.

摘要

目的

内脂素是一种参与葡萄糖稳态、摄食调节和能量稳态的新型脂肪因子。然而,内脂素在葡萄糖稳态调节中的作用仍存在争议,尤其是在儿科领域。本研究旨在比较肥胖儿童和对照组之间空腹血清内脂素水平,并探讨内脂素与肥胖非糖尿病儿童的体重指数(BMI)和胰岛素抵抗、胰岛素敏感性、β细胞功能及心血管代谢风险的生化标志物之间的关系。

方法

本研究为一项横断面、病例对照研究,连续纳入了 43 名肥胖儿童和 24 名匹配的瘦对照组。儿童进行了临床和生化评估,包括口服葡萄糖耐量试验。使用酶联免疫吸附测定(ELISA)法测定空腹血清内脂素水平。计算稳态模型评估的胰岛素抵抗指数(HOMA-IR)、稳态模型评估的β细胞功能指数(HOMA-B)、Matsuda 指数、胰岛素生成指数、血糖和胰岛素的曲线下面积。然后,根据平均值将内脂素变量分为两个有序值类,以便创建两个有序类的值。

结果

与对照组相比,肥胖儿童的空腹内脂素浓度显著降低(331.9±120.5 与 358.1±74.1 pg/ml;p=0.013)。男孩的内脂素水平低于女孩(313.7±59.5 与 361.1±127.2 pg/ml;p=0.044),而男孩的 BMI 标准差评分(SDS)高于女孩(p=0.024)。在整个队列中,内脂素与 BMI(p=0.024)、BMI SDS(p=0.044)和男性性别(p=0.043)呈负相关。在胰岛素抵抗和非胰岛素抵抗的肥胖儿童中,内脂素水平无显著差异。Logistic 回归模型表明,BMI SDS 与二分法内脂素之间存在显著的负相关。具体而言,BMI SDS 值越高,血清内脂素水平越低。ROC 分析显示,在我们的队列中,BMI SDS 变量的最佳截断值为+2.7 SDS,可用于区分属于两种内脂素类别的患者。

结论

总之,与对照组相比,肥胖儿童的血清内脂素水平显著降低。空腹内脂素随 BMI 的增加而降低,但不受 IR 的显著影响。

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