Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy.
Front Endocrinol (Lausanne). 2024 Feb 8;15:1329363. doi: 10.3389/fendo.2024.1329363. eCollection 2024.
Zonulin recently emerged as a valuable biological marker to assess the integrity of the intestinal mucosal barrier. Nevertheless, data about zonulin in pediatric age are extremely scarce. Aim of this study was to investigate the relationship between serum zonulin levels, both fasting and postprandial, with body mass index (BMI) and biochemical markers of insulin resistance (IR), insulin sensitivity, b-cell function and cardio-metabolic risk in obese non-diabetic youths.
One hundred and four children and adolescents with obesity (BMI ≥ 2.0 SDS) were enrolled (mean age 11.43 ± 2.66). All the patients underwent clinical and biochemical assessment, including oral glucose tolerance test (OGTT) and liver ultrasonography. Zonulin serum levels were measured at fasting state, at 60-minute and 120-minute OGTT timepoint.
Impaired fasting glycaemia and impaired glucose tolerance were documented in 27.9% and 11.5% of patients, respectively. IR was documented in 69.2% of cases. Liver steatosis was diagnosed in 39.4%. Zonulin serum levels significantly increased from baseline to 60-minute and 120-minute OGTT timepoint (p positive correlation between BMI SDS and serum zonulin levels at 120-minute OGTT timepoint (p highlighted a positive association of zonulin fasting levels with IR and glutamicoxalacetic transaminase levels (GOT, p zonulin levels were demonstrated for age, sex, pubertal status, glucose, lipid profile and the other obesity-related parameters.
Our results show, for the first time in a pediatric cohort, the meal-related pattern of secretion of serum zonulin, which tends to significantly increase during and at 2-hours postprandial assessment. Even if the underlying mechanisms associating intestinal permeability and obesity have not been fully elucidated yet, our data confirm a close relationship between zonulin concentration and obesity in pediatric population. IR seems to significantly influence zonulin serum levels, thus a central role of IR in this pathway is conceivable.
肠联素（zonulin）最近被认为是评估肠道黏膜屏障完整性的有价值的生物学标志物。然而，儿科人群中有关肠联素的数据极其缺乏。本研究旨在探讨肥胖非糖尿病青少年空腹和餐后血清肠联素水平与体重指数（BMI）及胰岛素抵抗（IR）、胰岛素敏感性、β细胞功能和心血管代谢风险的生化标志物之间的关系。
纳入 104 例肥胖（BMI≥2.0 SDS）患儿和青少年（平均年龄 11.43±2.66 岁）。所有患者均进行临床和生化评估，包括口服葡萄糖耐量试验（OGTT）和肝脏超声检查。空腹、OGTT 60 分钟和 120 分钟时检测血清肠联素水平。
27.9%和 11.5%的患者分别存在空腹血糖受损和糖耐量受损。69.2%的患者存在 IR。39.4%的患者存在肝脂肪变性。与基线相比，血清肠联素水平在 OGTT 60 分钟和 120 分钟时显著升高（p<0.001）。BMI SDS 与 120 分钟 OGTT 时的血清肠联素水平呈正相关（p<0.001）。空腹血清肠联素水平与 IR 和谷草转氨酶（GOT）水平呈正相关（p<0.05）。在校正了年龄、性别、青春期状态、血糖、血脂谱和其他肥胖相关参数后，仍观察到血清肠联素水平与 BMI SDS 之间存在正相关。
本研究首次在儿科人群中显示了血清肠联素的餐后分泌模式，其在餐后和 2 小时评估时呈显著升高趋势。尽管尚未完全阐明肠道通透性和肥胖之间的关联机制，但我们的数据证实了在儿科人群中，肠联素浓度与肥胖之间存在密切关系。IR 似乎显著影响血清肠联素水平，因此，IR 在该途径中的核心作用是可以想象的。
