超敏C反应蛋白与儿童青少年代谢综合征的相关性

doi:10.11852/zgetbjzz2022-0469

中国儿童保健杂志 ›› 2023, Vol. 31 ›› Issue (4): 427-432.DOI: 10.11852/zgetbjzz2022-0469

超敏C反应蛋白与儿童青少年代谢综合征的相关性

吴巧玲¹, 徐健¹, 赵正言², 彭咏梅^3,4, 龚春丹³

1.上海交通大学医学院附属国际和平妇幼保健院,上海 200030;
2.浙江大学医学院附属儿童医院;
3.上海市妇幼保健中心;
4.复旦大学附属儿科医院

收稿日期:2022-04-18 修回日期:2022-05-10 发布日期:2023-04-18 出版日期:2023-04-10
通讯作者: 彭咏梅,E-mail:ympeng@fudan.edu.cn
作者简介:吴巧玲(1985-),女,四川人,主治医师,博士学位,主要研究方向为儿童营养与生长发育。
基金资助:
国家科技部十一五支撑计划项目(2009BAI80B03);国际和平妇幼保健院临床研究基金(YN201908)

Correlation of hypersensitive C-reactive protein and metabolic syndrome in children and adolescents

WU Qiaoling¹, XU Jian¹, ZHAO Zhengyan², PENG Yongmei^3,4, GONG Chundan³

1. International Peace Maternity and Child Health Hospital,School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China;
2. Children's Hospital of Medical College,Zhejiang University;
3. Shanghai Maternal and Child Health Centre;4.Pediatric Hospital of Fudan University

Received:2022-04-18 Revised:2022-05-10 Online:2023-04-10 Published:2023-04-18
Contact: PENG Yongmei, E-mail:ympeng@fudan.edu.cn

摘要/Abstract

摘要： 目的探讨血清超敏C反应蛋白(hs-CRP)水平与儿童青少年代谢综合征(MetS)患者体格指标及血清实验室代谢指标的相关关系。方法对来自国家“十一五”科技支撑计划项目“代谢综合征的早期识别和干预技术研究”中符合条件的543名10~15岁儿童青少年体格检查及代谢指标检测结果进行分析,并对不同hs-CRP水平儿童的体格及代谢指标进行比较,分析hs-CRP与MetS及其相关指标的关系。结果高hs-CRP儿童甘油三酯(TG)、C肽、颈动脉内膜中层厚度(IMT)、舒张压水平及非酒精性脂肪肝(NAFLD)患病率显著增高(t=-3.150、-3.537、-3.662、-2.439,χ²=7.521,P<0.05),空腹血糖(FBG)、糖化血红蛋白比值(HbA1C%)水平及高血糖患病率显著降低(t=3.859、4.060,χ²=8.268,P<0.05)。Hs-CRP水平与TG、C肽、IMT及舒张压呈显著正相关(r=0.112、0.223、0.174、0.140,P<0.05),与高密度脂蛋白胆固醇(HDL-C)、FBG呈显著负相关(r=-0.098、-0.234,P<0.001)。校正性别及年龄因素后,腹型肥胖(OR=1.215, 95%CI:1.002~1.472)及NAFLD儿童的hs-CRP显著增高(OR=1.741,95%CI:1.332~2.275),高血糖者hs-CRP显著降低(OR=0.187,95%CI:0.038~0.929)。进一步校正腹型肥胖及NAFLD患病情况后,高血糖者hs-CRP仍然显著降低(OR=0.178, 95%CI:0.034~0.924)。结论 hs-CRP水平增高是儿童青少年MetS的重要早期监测因子,与腹型肥胖、糖脂代谢紊乱、舒张压升高、IMT增加及NAFLD的发生均显著相关。hs-CRP与腹型肥胖的关联性强于体重指数,C肽比FBG对于MetS早期更具有糖代谢异常的预警意义。

关键词: 超敏C反应蛋白, 代谢综合征, 儿童青少年, 非酒精性脂肪肝

Abstract: Objective To investigate the relationship between serum hypersensitive C-reactive protein (hs-CRP) level andphysical and serum laboratory metabolic indicators in children and adolescents with metabolic syndrome (MetS). Methods The physical examination and metabolic indicators of 543 children and adolescents aged 10 - 15 years were retrieved from the national"11th Five-Year" Science and Technology Support Plan project Research on early identification and intervention technology of metabolic syndrome. The physical and metabolic indexes of children with different levels of hs-CRP were compared, and the association between hs-CRP and MetS related indexes was analyzed. Results Subjects with higher hs-CRP had significantly higher levels of triglyceride (TG), C-peptide, carotid intima media thickness (IMT), diastolic blood pressure and the prevalence of non-alcoholic fatty liver disease (NAFLD) (t=-3.150,-3.537,-3.662,-2.439,χ²=7.521,P<0.05), while significantly lower levels of fasting blood-glucose (FBG), glycosylated hemoglobin A1C ratio (HbA1C%) and the prevalence of hyperglycemia (t=3.859,4.060,χ²=8.268,P<0.05). hs-CRP level was positively correlated with TG, C-peptide, IMT and diastolic blood pressure (r=0.112, 0.223, 0.174, 0.140, P<0.05), and was negatively correlated with high density lipoprotein cholesterol (HDL-C) and FBG (r=-0.098, -0.234, P<0.001). After adjusting for gender and age, children with abdominal obesity (OR=1.215, 95%CI:1.002 - 1.472) and NAFLD (OR=1.741, 95%CI:1.332 - 2.275) had significantly higher hs-CRP levels, whereas children with hyperglycemia had significantly lower hs-CRP levels (OR=0.187, 95%CI:0.038 - 0.929). hs-CRP was still significantly lower in children with hyperglycemia after adjusting for gender, age, abdominal obesity and NAFLD (OR=0.178, 95%CI:0.034 - 0.924). Conclusions hs-CRP is an important early monitoring indicator for MetS in children and adolescents, and it is significantly correlated with abdominal obesity, glycolipid metabolism disorder, increased diastolic blood pressure and NAFLD. The association between hs-CRP and abdominal obesity is stronger than that of body mass index and C peptide is more important in predicting abnormal glucose metabolism than FBG in the early stage of MetS.

Key words: hypersensitive C-reactive protein, metabolic syndrome, children and adolescents, non-alcoholic fatty liver disease

中图分类号:

R725.8

吴巧玲, 徐健, 赵正言, 彭咏梅, 龚春丹. 超敏C反应蛋白与儿童青少年代谢综合征的相关性[J]. 中国儿童保健杂志, 2023, 31(4): 427-432.

WU Qiaoling, XU Jian, ZHAO Zhengyan, PENG Yongmei, GONG Chundan. Correlation of hypersensitive C-reactive protein and metabolic syndrome in children and adolescents[J]. Chinese Journal of Child Health Care, 2023, 31(4): 427-432.

参考文献

[1] Zimmet P, Alberti KG, Kaufman F, et al. The metabolic syndrome in children and adolescents-an IDF consensus report[J]. Pediatr Diabetes, 2007, 8(5):299-306.
[2] Grandl G, Wolfrum C. Hemostasis, endothelial stress, inflammation, and the metabolic syndrome[J]. Semin Immunopathol, 2018,40(2):215-224.
[3] Hsieh CJ, Wang PW, Chen TY. The relationship between regional abdominal fat distribution and both insulin resistance and subclinical chronic inflammation in non-diabetic adults[J]. Diabetol Metab Syndr, 2014,6(1):49.
[4] Yoshinaga R, Doi Y, Ayukawa K, et al. High-sensitivity C reactive protein as a predictor of inhospital mortality in patients with cardiovascular disease at an emergency department:A retrospective cohort study[J]. BMJ Open, 2017,7(10):e15112.
[5] Shannon A, Alkhouri N, Carter-Kent C, et al. Ultrasonographic quantitative estimation of hepatic steatosis in children with NAFLD[J]. J Pediatr Gastro enterol Nutr,2011, 53(2):190-195.
[6] Koo DJ, Lee MY, Jung I, et al. Baseline homeostasis model assessment of insulin resistance associated with fibrosis progression in patients with nonalcoholic fatty liver disease without diabetes:A cohort study[J]. PLoS One, 2021,16(8):e255535.
[7] Li H, Ji CY, Zong XN, et al. Body mass index growth curves for Chinese children and adolescents aged 0-18 years[J]. Chin J Pediatr, 2009, 47:493-498.
[8] Ji CY, Sung Rita YT, Ma GS, et al. Waist Circumference Distribution of Chinese School-age Children and Adolescents[J]. Biomed Environ Sci, 2010, 23:12-20.
[9] 中国肥胖问题工作组.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志, 2004, 25(2):97-101.
Group of China Obesity Task Force:Body mass index reference norm for screening overweight and obesity in Chinese children and adolescents [J].Chin J Epidemiol,2004, 25(2):97-102.
[10] Daniels SR, Greer FR. Lipid screening and cardiovascular health in childhood[J]. Pediatrics, 2008, 122:198-208.
[11] 胡亚美, 江载芳. 诸福棠实用儿科学[M]. 7版. 北京:人民卫生出版社, 2002.
Hu YM, Jiang ZF. Zhu Futang textbook of pediatrics [M]. 7th Ed. Beijing:People's Medical Publishing House, 2002.
[12] Andrade R, Gigante DP, de Oliveira IO, et al. C-peptide and cardiovascular risk factors among young adults in a southern Brazilian cohort[J]. BMC Endocr Disord, 2018,18(1):80.
[13] Koziarska-Ros'ciszewska M, Gluba-Brzózka A, Franczyk B, et al. High-sensitivity C-reactive protein relationship with metabolic disorders and cardiovascular diseases risk factors[J]. Life (Basel), 2021,11(8).
[14] Wang Z, Wang X, Chen Z, et al. Distribution of high-sensitivity C-reactive protein and its relationship with other cardiovascular risk factors in the middle-aged chinese population[J]. Int J Environ Res Public Health, 2016,13(9):872.
[15] Smitka K, Marešová D. Adipose tissue as an endocrine organ:An update on pro-inflammatory and anti-inflammatory microenvironment[J]. Prague Med Rep, 2015, 116:87-111.
[16] Oruc N, Ozutemiz O, Yuce G, et al. Serum procalcitonin and CRP levels in non-alcoholic fatty liver disease:A case control study[J]. BMC Gastroenterol, 2009, 9:16-916.
[17] Liu W, Baker RD, Bhatia T, et al. Pathogenesis of nonalcoholic steatohepatitis[J]. Cell Mol Life Sci, 2016, 73(10):1969-1987.
[18] Huang G, Xu J, Zhang T, et al. Hyperuricemia is associated with metabolic syndrome in the community very elderly in Chengdu[J]. Scientific reports, 2020,10(1):8678.
[19] 李自云,刘波,季业,等. 2型糖尿病患者血尿酸水平与超敏C反应蛋白的关系[J]. 中华医学杂志,2017,97(28):2181-2185.
Li ZY, Liu B, Ji Y, et al.Association between serum uric acid levels and high sensitive C-reactive protein in patients with type 2 diabetes[J].Chinese Medical Journal,2017,97(28):2181-2185.
[20] Kasliwal RR, Bansal M, Desai D, et al. Carotid intima-media thickness:Current evidence, practices, and Indian experience[J]. Indian J Endocrinol Metab, 2014,18(1):13-22.
[21] Juonala M, Singh GR, Davison B, et al. Childhood metabolic syndrome, inflammation and carotid intima-media thickness. The aboriginal birth cohort study[J]. Int J Cardiol, 2016,203:32-36.

超敏C反应蛋白与儿童青少年代谢综合征的相关性

Correlation of hypersensitive C-reactive protein and metabolic syndrome in children and adolescents

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