标题：单纯肥胖儿童血脂、脂联素水平与胰岛素抵抗和脂肪肝发病率的相关性分析

      作者：刘亚军
    （广元市中心医院儿二科，四川 广元 628000）

      卷次： 2014年25卷14期

      【摘要】 目的 探讨单纯性肥胖症儿童的血脂、血浆脂联素(Adiponectin)水平与胰岛素抵抗和脂肪肝发生
率的相关性。方法 选取56例在我科诊治的单纯性肥胖患儿为肥胖组，并选取60例同期体检的体重正常儿童
为对照组。记录身高、腰围、臀围、体重，采用ELISA法、免疫比浊法分别测定两组儿童的脂联素、血脂、胰岛素、
肝功能等指标，超声检查脂肪肝、非酒精性脂肪肝发病率，分析血脂、脂联素水平与胰岛素抵抗、脂肪肝发病率的
关系。结果 肥胖组与对照组儿童体质指数(BMI)、腰围(WC)、腰臀比(WHR)差异明显，肥胖组43例儿童血脂异
常。肥胖组与对照组儿童血清空腹胰岛素(FINS)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、脂联素、胰岛素
抵抗指数(HOMA-IR)等比较差异有统计学意义(P<0.05)。Pearson相关性分析，肥胖组儿童脂联素与BMI、TG、
FINS、HOMA-IR值呈负相关。肥胖组中 13例诊断为脂肪肝，6例为非酒精性脂肪性肝病(NAFLD)，20例肝脏
增大，对照组中仅 6例儿童有肝脏增大，两组儿童脂肪肝、非酒精性脂肪性肝病差异有统计学意义(P<0.05)。
结论 肥胖儿童脂联素水平低于正常儿童，其水平与TG、胰岛素抵抗指数呈负相关。肥胖儿童脂肪肝、肝功能
异常和NAFLD发生率高于正常儿童。

      【关键词】 脂联素；儿童；肥胖；胰岛素抵抗；脂肪肝；

      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2014）14—2030—03


Relationship of plasma lipid and adiponectin levels and the incidence of insulin resistance and fatty liver in
simple obese children.
LIU Ya-jun. the Second Department of Pediatrics, the Central Hospital of Guangyuan City,
Guangyuan 628000, Sichuan, CHINA

【Abstract】 Objective To analyze the relationship of plasma lipid and adiponectin levels and the incidence of
insulin resistance and fatty liver in simple obese children. Methods Fifty-six simple obese children were selected as
fatty group, while 60 normal children were selected as control group. The height, waistline, hipline, and body weight
were record, and levels of plasma lipid, adiponectin and insulin as well as liver function were detected by ELISA and
immunoturbidimetry. Ultrasonography was used to exam the incidence of fatty liver and nonalcoholic fatty liver dis-
ease. Results There were obvious differences in body mass index (BMI), waist circumference (WC) and waist-hip
(WHR) between the two groups. In fatty group, 43 children were revealed dyslipidmias. There were significant differ-
ences in serum FINS, TG, LDL-C, adiponectin and HOMA-IR between the two groups (P<0.05). By Pearson correla-
tion analysis, negative correlation was found between adiponectin level and body mass index, TG, LDL-C, FINS,
HOMA-IR. In fatty group, there were 13 children with fatty liver, 6 children with nonalcoholic fatty liver disease
·论 著·doi:10.3969/j.issn.1003-6350.2014.14.0800 (NAFLD), and 20 children with liver enlargement. However, in control group, there were only 6 children with liver en-
largement. There were significant differences in incidence of fatty liver and NAFLD between the two groups (P<0.05).
Conclusion The plasma adiponectin levels in simple obese children were lower than those in normal children, which
showed negative relationship with TG and HOMA-IR. The incidences of fatty liver, abnormal liver function and
NAFLD in simple obese children were higher than those in normal children.

      【Key words】 Adiponectin; Children; Fatty; Insulin resistance; Fatty liver