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目的:探讨肥胖儿童血清内脂素和丝氨酸蛋白酶抑制剂与糖脂代谢的关系。方法:选取2010年7月至2015年12月在威海市中医院内分泌科就诊及住院的126例单纯性肥胖患儿(肥胖组)及112例超重患儿(超重组),另选择120例正常儿童(正常对照组)。测量3组儿童身高、体质量、腰围及臀围,计算体质量指数(BMI)。测定各组儿童的空腹血糖(FPG)、空腹胰岛素(FINS)和血脂指标,采用酶联免疫吸附法测定3组儿童血清中丝氨酸蛋白酶抑制剂和内脂素水平。分析3组儿童血清丝氨酸蛋白酶抑制剂、内脂素水与糖脂代谢指标的相关性。结果:肥胖组和超重组的内脂素(t=1.35,P=0.007)、丝氨酸蛋白酶抑制剂(t=1.48,P=0.04)水平均高于正常对照组,肥胖儿童的FPG(t=0.624,P=0.01)、FINS(t=1.488,P=0.02)、TC(t=1.184,P=0.013)、TG(t=0.211,P=0.009)和LDL-C(0.278,P=0.032)水平均高于超重组和正常组。肥胖组的内脂素与HDL-C呈显著正相关(r=0.49 P=0.82),与FPG(r=-0.84,P=-0.47),FINS(r=-0.21,P=-0.11)呈显著负相关。肥胖组的丝氨酸蛋白酶抑制剂与FINS(r=0.58,P=0.011),TC(r=0.31,P=0.032),TG(r=0.4,P=0.002),AI(r=0.042,P=0.047)呈显著正相关,与ISI呈负相关(r=-0.23,P=0.041)。结论:肥胖儿童中内脂素与糖代谢关系密切,与脂质的代谢关系尚须进一步研究。特异性丝氨酸蛋白酶抑制剂与脂代谢及动脉粥样硬化指数密切相关,且参与了糖代谢。
Objective: To investigate the relationship between serum visfatin and serine protease inhibitors and glucose and lipid metabolism in obese children. Methods: Totally 126 simple obese children (obesity group) and 112 overweight children (overweight group) were enrolled in the Department of Endocrinology, Weihai Hospital of Traditional Chinese Medicine from July 2010 to December 2015. Another 120 normal Children (normal control group). Body height, body mass, waist circumference and hip circumference were measured in 3 groups of children, body mass index (BMI) was calculated. The levels of fasting blood glucose (FPG), fasting insulin (FINS) and serum lipids were measured in all groups. Serum levels of serine protease inhibitors and visfatin were measured by enzyme-linked immunosorbent assay. The correlation between Serum serine protease inhibitor, visfatin water and glucose and lipid metabolism was analyzed in 3 groups of children. Results: The levels of visfatin (t = 1.35, P = 0.007) and serine protease inhibitors (t = 1.48, P = 0.04) in obese and overweight groups were significantly higher than those in normal controls (P = 0.009) and LDL-C (0.278, P = 0.032), FINS (t = 1.488, P = 0.02) All higher than the overweight group and the normal group. There was a significant positive correlation between visfatin and HDL-C in obesity group (r = 0.49 P = 0.82), which was significantly correlated with FPG (r = -0.84, P = -0.47) and FINS (r = -0.21, P = -0.11) Significant negative correlation. Serum protease inhibitors in obesity group were significantly lower than those in FINS group (r = 0.58, P = 0.011), TC (r = 0.31, P = 0.032), TG ) Was negatively correlated with ISI (r = -0.23, P = 0.041). Conclusion: The visfatin is closely related to glucose metabolism in obese children and the relationship with lipid metabolism needs further study. Specific serine protease inhibitors are closely related to lipid metabolism and atherosclerosis index and are involved in glucose metabolism.