Characters Of Glucose And Lipid Metabolic And It's Relationship With Serum Levels Of Visfatin,vaspin,adiponectin In Different Types Of Children Obesity

Objective: To investigate the characters of metabolic disorders and the level of serm cytokines:visfatin,Vaspin,adiponectin in different types of children obesity. To find the relationship between glycometabolism,lipid metabolism and visfatin,Vaspin,adiponectin, in order to know the possible pathophysiological mechanisms in childhood obesity and metabolic disorders.Methods:(1)From Jul. 2006 to Jul. 2009, one hundred and forty five obese children(n=145) and 80 healthy children (n=80) were recruited in Children's Hospital of Chongqing Medical University. Height, body weight, waist circumference (WC), hip circumference and blood pressure were measured, body mass index (BMI) were calculated and blood fat, fasting glucose and fasting serum insulin were measured, or oral glucose tolerance test(OGTT) was done, then 2h postprandia glucose,2h postprandia insulin were measured, and insulin resistance index (HOMA-IR) were calculated.(2)The children were divided into obese group and noamal group according to BMI, and then obese group were divided into abdominal group and non-abdominal obesity group according WC. Blood pressure, blood lipids, fasting glucose and fasting insulin were compared between the two obese groups and normal group. 2h postprandia glucose and 2h postprandia insulin were compared between both obesity group.(3) Serum visfatin,Vaspin,adiponectin were measured with enzyme-linked immunosorbent assay (ELISA) in 96 cases of obesity children and 75 cases of normal children. Compare the differences of serm level of the three cytokines in three groups. Analysis the correlation between the visfatin,Vaspin,adiponectin levels and anthropometric parameters,biochemical markers.Results:(1)Abdominal obesity have an incidence of 87.59% (127 cases) among 145 obese children, while non-abdominal obesity accounting for 12.41% (18 cases).(2)Fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and blood pressure in abdominal obesity children were higher than non-abdominal obesity and normal children (P<0.05). There were no significant differences (P<0.05) in FPG, TC, LDL, high-density lipoproteins (HDL) and blood pressure between non-abdominal obesity and normal group but TG of non-abdominal obesity group were higher than normal group. There were 77 cases of insulin resistance(60.6%), 14 cases of impaired fasting glucose(11.02%), 7 cases of damage carbohydrate tolerance(5.51%), 24 cases of high TG Hyperlipemia(18.9%), 13 cases of hypercholesterinemia(10.02%), 10 cases of high LDL hyperlipidemia(7.8%) and 15 cases of hypertension(11.81%), among 127 abdominal obesity children. Only two cases of insulin resistance were detected in non-abdominal obesity.(3)Correlation analysis showed that both WC,BMI had a positive relationship with blood pressure,TG,TC and HOMA-IR , showed negative relationship with HDL-C, WC also showed a relationship with FPG. WC had a stronger relationship with systolic blood pressure(SBP),TC,HOMA-IR,FPG than BMI.(4)Serm visfatin in abdominal group,non- abdominal group,normal group is 68.91±21.85ng/ml,51.18±20.06ng/ml,34.83±14.09ng/ml in respective, serm vaspin is 1869±56pg/ml,1543±42pg/ml,1581±45pg/ml in three group respectively, and Serm adiponectin is respectively 7.54±2.12μg/ml,9.12±2.53μg/ml,10.21±3.34μg/ml of three group. Serm visfatin in obesity children were higher than normal children, but there was no significant difference between abdominal group and non- abdominal group. There showed no significant difference in three groups of serm vaspin. Serm adiponectin level was lower in abdominal group than non-abdominal obesity and normal children, there was no disparity between non-abdominal group and normal group.(5) Serm visfatin had a positive relationship with WC,SBP,DBP,FPG,2hPG,2hINS; vaspin had a positive relationship with FPG,2hPG,2hINS; there was no significant relationship between visfatin,vaspin and TC,TG,HDL-C,LDL-C, adiponectin level showed a negative relationship with BMI,WC,FPG,2hPG,FINS, a positive relationship with HDL-C.Conclusion:(1)Abdominal obesity is the leading type of children obesity and in the metabolic changes, Abdominal obesity is more susceptible to abnormality of metabolism than non-abdominal obesity.(2)The impact of increasing with obdominal fat on metabolic disorder is stronger than total body fat mass.(3)The serm level of visfatin and adiponectin are closely related to obesity and abdominal fat accumulation in children; visfatin and vaspin have closely relationship with sugar metabolism; adiponectin plays a important role in both glycometabolism and lipid metabolism.