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目的:检测肥胖儿童和正常对照儿童血清瘦素水平,探讨瘦素与非酒精性脂肪性肝病的相关性。方法:对100例肥胖儿童及100例正常对照儿童测量身高、体重,计算体重指数(BMI);检测空腹血糖(FPG)、胰岛素(FINS)、谷丙氨酸氨基转移酶(ALT)总胆固醇(Tc)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB);胰岛素抵抗采用稳态模式评估法的胰岛素抵抗指数(HOMA-IR)指标;血清瘦素采用酶联免疫吸附试验检测。对肥胖儿童进行肝脏B超检查,并对非酒精性脂肪性肝病病变程度分为轻、中、重度,分别积分1、2、3分。结果:肥胖组瘦素、BMI、ALT、TG、LDL-C、TC、APB、FINS、HOMA-IR较对照组高(P<0.05),而HDL-C较对照组低P<0.05。100例肥胖儿童组中根据B超发现非酒精脂肪性肝病(NAFLD)55例,与其余45例单纯肥胖儿童结果比较显示:NAFLD组瘦素、BMI、TG、ALT、FINS、HOMA-IR水平较高P<0.05,而HDL-C水平较低P<0.05;多元Logistic回归分析显示BMI、瘦素和TG水平是脂肪肝形成的主要危险因素;多元线性回归分析显示瘦素和BMI与NAFLD评分独立相关(P值<0.05)。结论:高瘦素水平是肥胖儿童非酒精性脂肪性肝病的危险因素之一,监测血清瘦素水平有助于判断非酒精性脂肪性肝病的病变程度。
Objective: To detect serum leptin levels in obese children and normal children and to explore the correlation between leptin and nonalcoholic fatty liver disease. Methods: The body weight and weight were measured in 100 obese children and 100 normal children. Body mass index (BMI), fasting plasma glucose (FPG), insulin (FINS), total alanine aminotransferase (ALT) Tc, TG, HDL-C, LDL-C, ApoA, ApoB, insulin resistance Insulin resistance index (HOMA-IR) was measured by steady-state model. Serum leptin was detected by enzyme-linked immunosorbent assay. B-ultrasound liver biopsy in obese children, and the severity of non-alcoholic fatty liver disease is divided into mild, moderate and severe, respectively, points 1, 2, 3 points. Results: The levels of leptin, BMI, ALT, TG, LDL-C, TC, APB, FINS and HOMA-IR in obesity group were significantly higher than those in control group In the obese children group, 55 cases of non-alcoholic fatty liver disease (NAFLD) were found according to the B-mode ultrasound, compared with the other 45 cases of simple obesity children. The levels of leptin, BMI, TG, ALT, FINS and HOMA- <0.05, while the level of HDL-C was lower than P <0.05. Multivariate logistic regression analysis showed that BMI, leptin and TG levels were the major risk factors for fatty liver formation. Multivariate linear regression analysis showed that leptin and BMI were independently associated with NAFLD score P value <0.05). CONCLUSION: High leptin level is one of the risk factors for nonalcoholic fatty liver disease in obese children. Monitoring serum leptin level may be helpful in judging the severity of nonalcoholic fatty liver disease.