ADA2013：黑棘皮病青少年脂肪因子增加有保護作用

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脂肪因子在肥胖相關疾病中發揮重要作用。為了探討在黑棘皮病（AN）的肥胖青少年中脂肪因子的作用，來自同濟大學醫學院的曲伸教授及其團隊進行了一項研究，該研究發現在黑棘皮病青少年中，脂肪因子增加有潛在的保護作用。

該研究中，從2010年7月至2012年2月期間來上海同濟大學醫學院內分泌科就診的36例肥胖患者（14例有黑棘皮病，22例沒有黑棘皮病）參與了這項研究，并且，在這項研究中包括了20例年齡匹配的健康志愿者。在所有受試者中，進行體格檢查，測量血脂譜，通過DEXA測量脂肪分布。在所有的受試者中，進行葡萄糖耐量試驗，測量每個點的胰島素和C肽分泌。通過ELASA測量脂肪因子（血清瘦素、脂聯素和趨化素）水平。同時測量TNF-α、FFA和sCRP等炎癥因子。

該研究結果表明，三組之間的血清瘦素水平有顯著差異，AN組最高，對照組最低。AN組和OB組血清趨化素水平高于對照組（p＜0.05），但在AN組和OB組之間沒有統計學差異。血清瘦素和趨化素水平與BMI、FMI、腰臀比、LDL、體脂百分比、軀干脂肪和HOMA-IR呈正相關。在校正性別、年齡和BMI后，在研究人群中，僅有腰臀比和HOMA-IR與血清瘦素水平呈負相關。有趣的是，與肥胖糖尿病患者不同，在AN組，血清脂聯素是高的，并與肥胖糖尿病患者相比具有顯著差異。在黑棘皮病的肥胖青少年中，血清瘦素和趨化素增加，與肥胖組相比，AN組瘦素水平顯著增加，這可能與肥胖和瘦素抵抗的嚴重程度有關。

該研究發現，在黑棘皮病青少年中，脂肪因子增加有潛在的保護作用，但不同于糖尿病患者。

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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.

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編輯： 葛根    來源：丁香園