目的：探讨单纯性肥胖症儿童的血脂、血浆脂联素(Adiponectin)水平与胰岛素抵抗和脂肪肝发生率的相关性。方法选取56例在我科诊治的单纯性肥胖患儿为肥胖组，并选取60例同期体检的体重正常儿童为对照组。记录身高、腰围、臀围、体重，采用ELISA法、免疫比浊法分别测定两组儿童的脂联素、血脂、胰岛素、肝功能等指标，超声检查脂肪肝、非酒精性脂肪肝发病率，分析血脂、脂联素水平与胰岛素抵抗、脂肪肝发病率的关系。结果肥胖组与对照组儿童体质指数(BMI)、腰围(WC)、腰臀比(WHR)差异明显，肥胖组43例儿童血脂异常。肥胖组与对照组儿童血清空腹胰岛素(FINS)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、脂联素、胰岛素抵抗指数(HOMA-IR)等比较差异有统计学意义(P<0.05)。Pearson相关性分析，肥胖组儿童脂联素与BMI、TG、FINS、HOMA-IR值呈负相关。肥胖组中13例诊断为脂肪肝，6例为非酒精性脂肪性肝病(NAFLD)，20例肝脏增大，对照组中仅6例儿童有肝脏增大，两组儿童脂肪肝、非酒精性脂肪性肝病差异有统计学意义(P<0.05)。结论肥胖儿童脂联素水平低于正常儿童，其水平与TG、胰岛素抵抗指数呈负相关。肥胖儿童脂肪肝、肝功能异常和NAFLD发生率高于正常儿童。%Objective To analyze the relationship of plasma lipid and adiponectin levels and the incidence of insulin resistance and fatty liver in simple obese children. Methods Fifty-six simple obese children were selected as fatty group, while 60 normal children were selected as control group. The height, waistline, hipline, and body weight were record, and levels of plasma lipid, adiponectin and insulin as well as liver function were detected by ELISA and immunoturbidimetry. Ultrasonography was used to exam the incidence of fatty liver and nonalcoholic fatty liver dis-ease. Results There were obvious differences in body mass index (BMI), waist circumference (WC) and waist-hip (WHR) between the two groups. In fatty group, 43 children were revealed dyslipidmias. There were significant differ-ences in serum FINS, TG, LDL-C, adiponectin and HOMA-IR between the two groups (P<0.05). By Pearson correla-tion analysis, negative correlation was found between adiponectin level and body mass index, TG, LDL-C, FINS, HOMA-IR. In fatty group, there were 13 children with fatty liver, 6 children with nonalcoholic fatty liver disease (NAFLD), and 20 children with liver enlargement. However, in control group, there were only 6 children with liver en-largement. There were significant differences in incidence of fatty liver and NAFLD between the two groups (P<0.05). Conclusion The plasma adiponectin levels in simple obese children were lower than those in normal children, which showed negative relationship with TG and HOMA-IR. The incidences of fatty liver, abnormal liver function and NAFLD in simple obese children were higher than those in normal children.
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