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目的调查延边地区朝鲜族和汉族学生肥胖和胰岛素抵抗(IR)及其相关脂肪细胞因子,分析肥胖和IR与不同脂肪细胞因子的关联程度。方法在吉林省延边朝鲜族自治州选择4所小学校,采用整群抽样的方法,抽取3879例小学生(朝鲜族2011例和汉族1868例)作为研究对象,通过问卷调查和体格检查的方式,调查研究对象的一般情况,测定体质指数(BMI)、腰围(WC)和空腹血糖(FBG)、胰岛素、脂联素、瘦素及肿瘤坏死因子-α(TNF-α)水平。采用稳态模式评估法(HOMA)估测人体IR(HOMA-IR)。结果 (1)朝鲜族学生的脂联素水平显著低于汉族学生,朝鲜族学生的瘦素、HOMA-IR、WC和BMI的水平显著高于汉族学生,不同民族学生上述指标平均水平比较差异均有统计学意义(P<0.01)。(2)BMI、WC和HOMA-IR与脂联素呈负相关(r=-0.178、-0.172和-0.137),其与瘦素(r=0.572、0.535和0.265)和TNF-α(r=0.110、0.119和0.691)呈正相关,其相关性均有统计学意义(P<0.001),而且朝鲜族和汉族学生肥胖和HOMA-IR与不同脂肪细胞因子的相关性程度有所不同。(3)多元线性回归分析结果显示,BMI、WC和HOMA-IR与不同脂肪细胞因子间均有显著的线性依存关系,且与脂联素(Beta=-0.022、-0.019和-0.042)、瘦素(Beta=0.154、0.069和0.039)和TNF-α(Beta=-0.082、0.018和0.654)的关联程度有所不同。结论延边地区小学生不同肥胖指标、HOMA-IR和脂肪细胞因子的分布特征出现明显的民族差异;BMI、WC和HOMA-IR与不同脂肪细胞因子的关联程度有所不同,BMI和WC与瘦素的关联程度大于HOMA-IR,HOMA-IR与脂联素和TNF-α的关联程度大于BMI和WC。
Objective To investigate the obesity and insulin resistance (IR) and its related adipocytokines in Korean and Han students in Yanbian and to analyze the association between obesity and IR and different adipokines. Methods Four primary schools were selected in Yanbian Korean Autonomous Prefecture of Jilin Province. By cluster sampling method, 3879 primary school students (2011 Korean and Han Chinese 1868) were selected as research subjects. Through questionnaire and physical examination, Body mass index (BMI), waist circumference (WC), fasting blood glucose (FBG), insulin, adiponectin, leptin and tumor necrosis factor-α (TNF-α) were measured. Human homeostasis (HOMA-IR) was estimated using the homeostasis model assessment (HOMA). Results (1) The levels of adiponectin in Korean students were significantly lower than those in Han students. The levels of leptin, HOMA-IR, WC and BMI in Korean students were significantly higher than those in Han students. The average levels of these indicators among ethnic students were significantly different There was statistical significance (P <0.01). (2) There was a negative correlation between BMI, WC and HOMA-IR with adiponectin (r = -0.178, -0.172 and -0.137), which was positively correlated with leptin (r = 0.572,0.535 and 0.265) and TNF- 0.110, 0.191 and 0.691), and the correlation was statistically significant (P <0.001). And the correlation between obesity and HOMA-IR of Korean and Han students was different from that of different adipocytokines. (3) Multiple linear regression analysis showed that there was a significant linear relationship between BMI, WC and HOMA-IR and different adipocytokines, and with adiponectin (Beta = -0.022, -0.019 and -0.042) (Beta = 0.154, 0.069 and 0.039) and TNF-α (Beta = -0.082, 0.018 and 0.654). Conclusion There are obvious ethnic differences in the distribution characteristics of different obesity indicators, HOMA-IR and adipocytokines in primary school students in Yanbian. The correlations between BMI, WC and HOMA-IR with different adipocytokines are different. The degree of association was greater than that of HOMA-IR. HOMA-IR was associated with adiponectin and TNF-α more than BMI and WC.