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目的了解单纯性肥胖儿童外周血单核/巨噬细胞趋化因子与胰岛素抵抗相关参数的关系。方法2006年5月至2008年5月广西医科大学第一附属医院儿科70例确诊为单纯性肥胖儿童作为研究对象,30名健康体检儿童作为健康对照组。流式细胞仪测定外周血单核细胞CD68阳性率;酶联免疫吸附(ELISA)法测定血浆巨噬细胞炎性蛋白-1α(MIP-1α)、单核细胞趋化蛋白-1(MCP-1)水平;放射免疫分析(RIA)法测定血浆脂联素(ADPN)、血浆胰岛素(Ins)浓度,计算体质指数(BMI),按HOMA模型计算胰岛素抵抗指数(InRI),并与相关变量进行Pearson相关分析或偏相关分析。结果单纯性肥胖组血浆MIP-1α、MCP-1水平高于健康对照组,两组比较差异有统计学意义(P<0.05)。两组外周血CD68阳性率比较差异无统计学意义(P>0.05)。两组InRI比较差异有统计学意义(P<0.05)。单纯性肥胖组血浆MIP-1α、MCP-1水平分别与BMI、腰围(WC)和InRI呈正相关(P<0.05)。血ADPN分别与BMI、WC和InRI呈负相关(P<0.05)。外周血单个核细胞CD68阳性率与BMI、WC和InRI无相关性(P>0.05)。结论单纯性肥胖患儿体内存在低程度炎症反应,肥胖儿童外周血单核/巨噬细胞趋化因子与胰岛素抵抗及中心性肥胖相关,可以作为肥胖相关疾病的早期预测指标之一。
Objective To investigate the relationship between peripheral blood monocyte / macrophage chemokine and insulin resistance in simple obesity children. Methods From May 2006 to May 2008, 70 children diagnosed as simple obesity in the First Affiliated Hospital of Guangxi Medical University were selected as research subjects and 30 healthy children as healthy control group. The positive rate of CD68 in peripheral blood mononuclear cells was determined by flow cytometry. The expression of MIP-1α, MCP-1 (MIP-1α) was measured by enzyme linked immunosorbent assay (ELISA) ) Were measured by radioimmunoassay (RIA) method. Plasma adiponectin (ADPN) and plasma insulin concentrations were measured by radioimmunoassay (RIA), body mass index (BMI) was calculated and insulin resistance index (InRI) was calculated by HOMA model. Correlation analysis or partial correlation analysis. Results The levels of plasma MIP-1α and MCP-1 in simple obesity group were significantly higher than those in healthy control group (P <0.05). There was no significant difference in the positive rate of CD68 between the two groups (P> 0.05). There was significant difference in InRI between the two groups (P <0.05). Plasma levels of MIP-1α and MCP-1 in simple obesity group were positively correlated with BMI, WC and InRI respectively (P <0.05). Blood ADPN was negatively correlated with BMI, WC and InRI (P <0.05). Peripheral blood mononuclear cells CD68 positive rate and BMI, WC and InRI no correlation (P> 0.05). Conclusion There is a low degree of inflammatory reaction in simple obese children. The correlation between peripheral blood monocyte / macrophage chemokines and insulin resistance and central obesity in obese children may be one of the early predictors of obesity-related diseases.