高敏C反应蛋白与儿童肥胖及代谢综合征相关代谢异常的关系

摘要

Objective To explore the relationship between high-sensitivity C-reactive protein (hsCRP)and obesity/metabolic syndrome(MetS)related factors in children. Methods 403 children aged 10-14 and born in Beijing were involved in this study. Height,weight,waist circumference,fat mass percentage(Fat%),blood pressure(BP),hsCRP,triglyceride(TG),total cholesterol(TC), fasting plasma glucose(FPG),high and low density lipoprotein cholesterol(HDL-C,LDL-C)were observed among these children. hsCRP was transformed with base 10 logarithm(lgCRP). MetS was defined according to the International Diabetes Federation 2007 definition. Associations between MetS related components and hsCRP were tested using partial correlation analysis,analysis of covariance and linear regression models. Results 1) lgCRP was positively correlated with BMI,waist circumference,Fat%,BP,FPG,LDL-C and TC while negatively correlated with HDL-C. With BMI under control,the relationships disappeared,but LDL-C(r=0.102). 2)The distributions of lgCRP showed obvious differences in all the metabolic indices,in most groups,respectively. With BMI under control,close relationships between lgCRP and high blood pressure/high TG disappeared and the relationship with MetS weakened. 3) Through linear regression models, factors as waist circumference,BMI,Fat% were the strongest factors related to hsCRP,followed by systolic BP, HDL-C,diastolic BP,TG and LDL-C. With BMI under control,the relationships disappeared,but LDL-C (β=0.045). Conclusion hsCRP was correlated with child obesity,lipid metabolism and MetS. Waist circumference was the strongest factors related with hsCRP. Obesity was the strongest and the independent influencing factor of hsCRP.%目的：探讨儿童时期高敏C反应蛋白（hsCRP）与肥胖及MS相关代谢异常的关系，并比较其联系强度。方法在历史队列中选取成功随访并参与hsCRP及各项指标检测的403名儿童作为研究对象。体格检查包括身高、体重、WC、血压、体脂含量百分比（Fat%）、血生化指标（hsCRP、TG、TC、LDL-C、HDL-C、FPG）等。对hsCRP和TG测定值分别取以10为底的对数（lgCRP、lgTG）转化为近似正态分布，分析lgCRP和代谢异常之间的关系。采用偏相关分析、协方差分析，并控制儿童出生体重等因素。计算各代谢指标的Z分值，与lgCRP做线性回归分析。结果（1）lgCRP与HDL-C水平呈负相关，与其他体量及代谢指标存在明显正相关；控制BMI后，除LDL-C外，其他指标和lgCRP的相关性消失。（2）lgCRP在是否高FPG组间、是否低HDL-C组间、是否高TC组间差异不明显（P＞0.05），在其他代谢异常组间的差异有统计学意义（P＜0.05）；控制BMI后，lgCRP与高血压、高TG的联系消失，与MS的联系被削弱。（3）线性回归分析比较各代谢指标与hsCRP的联系强度，可见WC、BMI、Fat%与肥胖相关的指标与hsCRP的联系最密切（β值分别为0.294、0.289和0.277），其次是SBP、HDL-C、DBP、lgTG和LDL-C。控制BMI后，只有LDL-C与hsCRP的线性关系仍存在，但已被大大削弱，其他指标与hsCRP的线性关系消失。结论hsCRP与肥胖、血脂代谢、MS均相关；WC是与hsCRP的联系最密切的指标；肥胖是hsCRP最强且独立的影响因素。