dxy

原文载于：J Clin Endocrinol Metab. 2005 Aug 30; [Epub ahead of print]

背景：低脂联素血症是成年人发生的一种慢性亚临床感染，它的发生与糖尿病和心血管疾病(CVD)的发生有关。儿童肥胖人群中脂联素、感染、以及生活方式干预对低脂联素血症的调节作用之间的关系还没有阐明。

目的：研究青少年中脂脂联素与肥胖相关炎性因子、C反应蛋白和白细胞介素-6之间的关系；(ii)生活方式干预对脂联素的影响，以及该影响作用是否与炎性因子的变化有关。

研究方法和操作程序：对21个肥胖青少年，在较瘦的青少年中按年龄进行配对(年龄在 14到18岁，Tanner分期大于等于 IV)。评价基础状态下和干预后脂联素、脂肪量、胰岛素抵抗和炎性因子之间的关联。结果：与对照组相比，肥胖组血浆脂联素含量较低(P < 0.001)。脂联素、炎性因子、胰岛素血症、胰岛素抵抗和脂肪量之间呈明显负相关。干预后脂联素浓度降低34%(P = 0.0004)，虽然体重降低可以忽略，但脂肪量、高胰岛素血症、胰岛素抵抗和炎性因子降低明显(所有指标均 P < 0.01)。结论：数据表明青少年肥胖相关性的低脂联素血症与亚临床炎症有关，短期生活方式干预增加脂联素浓度。这些结果似乎与脂肪量和炎性因子降低有关。就我们对脂联素生理学的现有理解，肥胖青少年低脂联素血症的逆转可以降低CVD和糖尿病的发病危险。

Reversal of Obesity-related Hypoadiponectinemia by Lifestyle Intervention - A Controlled Randomized Study in Obese Adolescents.
Context: Hypoadiponectinemia and chronic sub-clinical inflammation in adults are associated with the development of diabetes and cardiovascular disease. The potential relationship between adiponectin and inflammation and its modulation by lifestyle intervention in the pediatric obese population remain unclear.Objectives: To investigate in adolescents  the relationship between adiponectin and obesity-related inflammatory factors, C-reactive protein and interleukin-6; (ii) the effect of a lifestyle intervention on adiponectin and whether these effects are related to changes in inflammatory factors. Research Methods and Procedures: Twenty-one obese and age-matched lean adolescents (Age 14 to 18 yr.; Tanner stage >/= IV) were studied cross-sectionally. Fifteen obese adolescents also underwent a randomized controlled physical activity-behavior-diet based lifestyle intervention for three months.Associations among adiponectin, fat mass, insulin resistance and inflammatory factors at baseline as well as after the intervention were assessed.Results: Plasma adiponectin concentration was lower (P < 0.001) in the obese vs. age-matched lean adolescents. Significant inverse relationships were observed between adiponectin and inflammatory factors, insulinemia, insulin resistance and fat mass.Intervention produced a 34% increase in adiponectin concentration (P = 0.0004) despite negligible weight loss but with reductions in fat mass, hyperinsulinemia, insulin resistance and inflammatory factors (all P < 0.01).Conclusions: The data suggest that in adolescents obesity-related hypoadiponectenemia is associated with sub-clinical inflammation and a short-term lifestyle intervention augments adiponectin concentrations.These effects appear to be related to reductions in fat mass and inflammatory factors. Based on our current understanding of adiponectin physiology, reversal of hypoadiponectinemia in obese adolescents may protect against risks for CVD and diabetes.