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目的观察单纯性肥胖儿童和健康正常体重儿童血清脑源性神经营养因子(BDNF)质量浓度的差异,探讨BDNF与儿童肥胖及瘦素抵抗、胰岛素抵抗的关系。方法南京军区福州总医院儿科等于2004年5月至2005年5月应用酶联免疫法检测单纯性肥胖儿童(37例)和健康儿童(31例)血清BDNF质量浓度与胰岛素(INS)浓度,应用放射免疫法检测血清瘦素(LEP)质量浓度。比较两组儿童血清BDNF、INS、LEP的差异,分析血清BDNF质量浓度与血清LEP质量浓度和INS浓度的关系。结果(1)两组儿童的体重指数(BMI)、BDNF、INS及LEP均差异显著(BMI:F=175·05,P<0·01;BDNF:F=12·35,P<0·01;INS:F=21·71,P<0·01;LEP:F=48·89,P<0·01),肥胖组BMI、INS及LEP均明显高于健康组,而肥胖组BDNF明显低于健康组。(2)影响LEP的因素依次为BMI、丙氨酸转氨酶(ALT)、BDNF(R2=0·5946,F=0·31,P<0·01);影响INS的因素依次为BMI、BDNF(R2=0·2647,F=11·34,P<0·01)。去除BMI、ALT影响后,BDNF与LEP、INS负相关(BDNF与LEP:r=-0·2455,P<0·05;BDNF与INS:r=-0·2878,P<0·05)。结论(1)肥胖儿童血清BDNF缺乏,未发现“BDNF抵抗”的特点。(2)学龄前儿童血清LEP、INS受BMI影响最大,还受血清BDNF影响。BDNF是二者独立的负相关因素。
Objective To observe the difference of serum brain-derived neurotrophic factor (BDNF) in children with simple obesity and healthy children with normal weight to explore the relationship between BDNF and childhood obesity, leptin resistance and insulin resistance. Methods The pediatric department of Fuzhou General Hospital of Nanjing Military Command was used to detect the concentration of serum BDNF and insulin (INS) in simple obese children (37 cases) and healthy children (31 cases) by enzyme-linked immunosorbent assay from May 2004 to May 2005. Radioimmunoassay was used to detect serum leptin (LEP) concentration. The differences of serum BDNF, INS and LEP between the two groups were compared. The relationship between serum BDNF concentration and serum LEP concentration and INS concentration was analyzed. Results (1) There was significant difference in body mass index (BMI), BDNF, INS and LEP among the two groups (BMI: F = 175.05, P <0.01; BDNF: F = 12.35, P <0.01 ; INS: F = 21.71, P <0.01; LEP: F = 48.89, P <0.01). The levels of BMI, INS and LEP in obese group were significantly higher than those in healthy group, while the obese group had significantly lower BDNF In the health group. (2) The influencing factors of LEP were BMI, ALT and BDNF (R2 = 0.5946, F = 0.31, P <0.01). The influencing factors of INS were BMI, BDNF R2 = 0.2647, F = 11.34, P <0.01). After removing BMI and ALT, BDNF was negatively correlated with LEP and INS (BDNF and LEP: r = -0.2455, P <0.05; BDNF and INS: r = -0.2878, P <0.05). Conclusions (1) Serum BDNF is deficient in obese children and no characteristic of “BDNF resistance” is found. (2) Serum LEP and INS in preschool children are the most affected by BMI, and are also affected by serum BDNF. BDNF is an independent negative correlation between the two factors.