关键词: 肥胖, 血压, 细胞因子, 体重指数, 中介效应分析

Abstract: Objective To examine the mediating effects of changes in adipocytokine levels on the association between body mass index (BMI) and blood pressure (BP) among obese children with hypertension. Methods A total of 120 obese children treated in the Second Affiliated Hospital of Xi′an Jiaotong University from June 2012 to August 2014 were enrolled in this study.And children with high blood pressure were intervened for six months on life style.Anthropometric data(including height, weight, waistline, BMI and BP), adiponectin,chemerin,leptin,Sfrp5,Wnt5a,hsCRP and TNF-α were assessed at baseline and after 6-month lifestyle intervention.Mediation analysis was conducted to examine whether the association between BP reduction and weight loss was mediated by changes in adipocytokines (ΔSfrp5, Δadiponectin, Δchemerin or ΔhsCRP) on the independent variable (ΔSBP or ΔDBP). Results Serum levels of Sfrp5 and adiponectin were significantly lower in obese children with hypertension, but serum levels of Wnt5a, hsCRP and chemerin were higher in obese children with hypertension(P＜0.05).There was no significant difference on the levels of TNF-α between obese children with hypertension and without hypertension(P＞0.05).The levels of adiponectin and Sfrp5 increased after intervention, while the levels of chemerin, leptin, Wnt5a,hsCRP decreased after intervention(P＜0.05).The changes in Sfrp5 and adiponectin showed a partial mediating effect on the relationship between weight loss and BP reduction after controlling for covariates, while the changes in chemerin and hsCRP had no mediating effect. Conclusion Sfrp5 and adiponectin have a certain mediating effect on the increase of blood pressure in obese children.

Key words: obesity, blood pressure, cytokines, body mass index, mediating effect analysis