肥胖儿童瘦素水平的变化及其与骨密度的关系

Serum leptin level and its association with bone mineral density in obese children

摘要:

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。［中国当代儿科杂志，2009，11（9）：745-748］

Abstract:

OBJECTIVE: To investigate serum leptin level and its relationship with bone mineral density in obese children from Changsha City. METHODS: One hundred and nineteen obese children and 103 normal children aged 7 to 12 years from five primary schools of Changsha City were enrolled. Obesity was assessed based on the body mass index (BMI). Dual energy X-ray absorptiometry (DEXA) was used to determine bone mineral density (BMD) and body composition. Serum leptin level was measured using enzyme-linked immunosorbentassay (ELISA). RESULTS: The obesity group had higher height, weight, BMI, waist circumference and waist to hip ratio (WHR) compared with the normal group (P<0.01). BMD, bone mineral content (BMC), lean mass (LM), fat mass (FM), percentage of body fat (%BF) and leptin concentration in the obesity group were significantly higher than those in the normal group (P<0.01). Serum leptin level was positively correlated with BMD, BMC, LM and FM (r=0.528-0.903, P<0.01). Multiple stepwise regression analysis indicated that BMI and %BF were independent influencing factors for serum leptin level. CONCLUSIONS: Obese children have higher serum leptin level. Serum leptin concentration is significantly correlated with BMD and body composition. BMI and %BF are independent influencing factors for serum leptin level in children.［Chin J Contemp Pediatr, 2009, 11 (9):745-748］