ADA2013：黑棘皮病青少年脂肪因子增加有保护作用
脂肪因子在肥胖相关疾病中发挥重要作用。为了探讨在黑棘皮病（AN）的肥胖青少年中脂肪因子的作用，来自同济大学医学院的曲伸教授及其团队进行了一项研究，该研究发现在黑棘皮病青少年中，脂肪因子增加有潜在的保护作用。
该研究中，从2010年7月至2012年2月期间来上海同济大学医学院内分泌科就诊的36例肥胖患者（14例有黑棘皮病，22例没有黑棘皮病）参与了这项研究，并且，在这项研究中包括了20例年龄匹配的健康志愿者。在所有受试者中，进行体格检查，测量血脂谱，通过DEXA测量脂肪分布。在所有的受试者中，进行葡萄糖耐量试验，测量每个点的胰岛素和C肽分泌。通过ELASA测量脂肪因子（血清瘦素、脂联素和趋化素）水平。同时测量TNF-α、FFA和sCRP等炎症因子。
该研究结果表明，三组之间的血清瘦素水平有显著差异，AN组最高，对照组最低。AN组和OB组血清趋化素水平高于对照组（p＜0.05），但在AN组和OB组之间没有统计学差异。血清瘦素和趋化素水平与BMI、FMI、腰臀比、LDL、体脂百分比、躯干脂肪和HOMA-IR呈正相关。在校正性别、年龄和BMI后，在研究人群中，仅有腰臀比和HOMA-IR与血清瘦素水平呈负相关。有趣的是，与肥胖糖尿病患者不同，在AN组，血清脂联素是高的，并与肥胖糖尿病患者相比具有显著差异。在黑棘皮病的肥胖青少年中，血清瘦素和趋化素增加，与肥胖组相比，AN组瘦素水平显著增加，这可能与肥胖和瘦素抵抗的严重程度有关。
该研究发现，在黑棘皮病青少年中，脂肪因子增加有潜在的保护作用，但不同于糖尿病患者。
Adipokines play an important role in the obesity related diseases. In this study We aim to investigate its effect in obesity adolescents with acanthosis nigricans.
36 obese patients (14 with AN and 22 without AN) visiting our department from July 2010 to February 2012 participated our trail and 20 age-matched healthy volunteers were included in this study. The physical examination lipid profile measurement of fat distribution by DEXA were measured in all the participants. Glucose tolerance test with the secretion of insulin and C peptides in each points was performed in all participants. Adipokines (Serum leptin adiponectin and chemerin) levels were measured by ELASA. Inflammation factors as TNF-a FFA and sCRP were also measured at same time .
The differences of serum leptin levels among the three groups were significant the highest in AN group and the lowest in control group. The serum chemerin levels were higher in the AN and OB group than that in the control group (p<0.05) but there was no significant difference between the two groups. The serum leptin and chemerin levels were positively correct with BMI FMI waist/hip ratio LDL percentage body fat truncal fat I0 and HOMA-IR. After adjustment for sex age and BMI only waist/hip ratio I0 and HOMA-IR had a negative correction with serum leptin level in the study population. Interestingly Serum adiponectin is high and have significantly difference in AN group which different with diabetic obesity patients.There was an increase serum leptin and chemerin in obesity adolescents with acanthosis nigricans leptin level was significantly higher in AN than obesity group. which may be related to the severity of obesity and leptin resistance.
The increasing of adiponectin play a potential protective affect which is different from diabetic patients.
ADA是美国糖尿病学会 (Americn Diabetos Association)的缩写，美国糖尿病协会县美国重要的非赢利性卫生姐织，旨在提供有关糖尿病的研究进展和信息，促进糖尿病的科研、教育、诊疗等，关注一切与糖尿病有关的事务。