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目的探讨长沙市肥胖儿童血清瘦素水平的变化及与骨密度(BMD)、身体成分的关系,为预防和治疗儿童肥胖及骨质疏松提供科学依据。方法从长沙市5所小学随机抽取119例肥胖儿童和103例正常儿童,采用双能X线骨密度仪(DEXA)进行全身扫描,测定骨密度及身体成分;采用酶联免疫吸附试验(ELISA)测定血清瘦素水平。结果①肥胖儿童的身高、体重、体重指数(BMI)、腰围和腰臀比均显著高于正常儿童(P<0.01)。②肥胖儿童的全身骨密度、骨矿物质含量、瘦组织含量、脂肪组织含量、体脂百分比(%BF)及血清瘦素水平均显著高于正常儿童(P<0.01)。③血清瘦素水平与儿童全身骨密度、骨矿物质含量、瘦组织含量、脂肪组织含量均呈显著正相关(r=0.528~0.903),其中瘦素水平与脂肪组织含量呈高度正相关(男:r=0.883,女:r=0.903)。多元逐步回归分析显示,BMI及%BF是儿童血清瘦素水平的独立影响因素。结论肥胖儿童血清瘦素水平升高,血清瘦素水平与骨密度及身体成分显著相关,BMI、%BF是儿童血清瘦素水平的独立影响因素。
Objective To investigate the changes of serum leptin levels and their relationship with bone mineral density (BMD) and body composition in obese children in Changsha City, and provide a scientific basis for the prevention and treatment of childhood obesity and osteoporosis. Methods A total of 119 obese children and 103 normal children were randomly selected from 5 primary schools in Changsha City. Whole body scanning was performed by dual energy X-ray absorptiometry (DEXA) to measure the bone mineral density (BMD) and body composition. Enzyme-linked immunosorbent assay (ELISA) Serum leptin levels were measured. Results ① The height, weight, body mass index (BMI), waist circumference and waist-hip ratio of obese children were significantly higher than those of normal children (P <0.01). ② The body BMD, bone mineral content, lean tissue content, adipose tissue content, body fat percentage (% BF) and serum leptin level in obese children were significantly higher than those in normal children (P <0.01). (3) There was a significant positive correlation between serum leptin level and total body mineral density (BMD), bone mineral content, lean tissue content and adipose tissue content (r = 0.528-0.903), and leptin level was positively correlated with adipose tissue content : r = 0.883, female: r = 0.903). Multiple stepwise regression analysis showed that BMI and% BF were independent influencing factors of serum leptin level in children. Conclusions Serum leptin level is elevated in obese children. Serum leptin level is significantly correlated with bone mineral density and body composition. BMI and% BF are independent influencing factors of serum leptin level in children.