摘要
目的 研究肥胖伴黑棘皮病儿童胰岛素分泌功能的改变 ,探讨其临床意义。方法 对35例肥胖伴黑色棘皮病患儿、38例单纯肥胖患儿及 39例正常儿童进行胰岛 β细胞功能指标的测定。结果 肥胖伴黑色棘皮病组空腹胰岛素、C肽、胰岛素原、真胰岛素、胰岛素原与胰岛素、C肽比值、胰岛素抵抗指数和胰岛 β细胞分泌指数 (中位数及范围 )分别为 18 5 (5 0～ 6 0 5 )pmol/L、3 9(1 3～14 0 ) μg/L、2 8 84 (9 9～ 6 4 2 )pmol/L、32 96 (6 2～ 6 6 0 )pmol/L、1 2 (0 4～ 8 9)、6 9(2 5～ 36 6 )、5 0(0 8～ 14 1)和 30 3 3(5 2 2～ 116 3 8) ,均显著高于单纯肥胖组和正常组 (P <0 0 0 1)。结论 肥胖伴黑色棘皮病已经存在严重的胰岛 β细胞分泌亢进和胰岛素抵抗 ,是儿童患 2型糖尿病的高危
Objective The strong relation between type 2 diabetes mellitus and obesity with acanthosis nigricans is widely concerned. This study investigated the pancreatic β cell function in obese children with acanthosis nigricans, so as to find out the role of insulin secretion and insulin resistance in obese children with acanthosis nigricans. Methods Thirty five obese children with acanthosis nigricans (19 males and 16 femals with mean age 12 8±1 5 years) were enrolled in this study. Thirty eight obese children (21 boys and 17 girls with mean age 11 9±2 6 years) and 39 normal children (20 boys and 19 girls with mean age 11 2±2 2 years) were recruited as obese and normal control groups. The levels of serum fasting insulin, C peptide, proinsulin and true insulin were measured in all the subjects. The ratios of proinsulin/insulin and proinsulin/C peptide were calculated. Homeostasis model assessment was applied to assess the status of insulin resistance and basic function of pancreatic β cell. Results The levels of fasting insulin, C peptide proinsulin, true insulin, the ratios of proinsulin/insulin and proinsulin/C peptide, insulin resistance index and insulin secretion index of obese children with acanthosis nigricans, obese control children and normal control children were:18 5(5 0～60 5)pmol/L, 12 4(6 1～35 8)pmol/L and 5 1(2 0～32 8)pmol/L; 3 9(1 3～14 0)μg/ L, 2 4(1 1～4 0)μg/ L and 1 1(1 0～4 2)μg/ L; 28 8(9 9～64 2)pmol/L, 9 5(2 2～34 5)pmol/L and 4 2(2 0～16 0)pmol/L; 33 0(6 2～66 0)pmol/L, 10 6(4 8～29 4)pmol/L and 4 5(1 3～30 1)pmol/L; 1 2(0 4～8 9), 0 9(0 2～1 9)and 0 8(0 4～2 0); 6 9(2 5～36 6), 4 7(1 2～12 3)and 3 6(1 2～9 6); 5 0(0 8～14 1), 2 6(1 3～8 1)and 1 2(0 4～6 9); 303 3(52 2～1 163 8), 213 6(84 6～572 0) and 51 1(19 1～561 4). The levels of fasting insulin, C peptide, proinsulin, true insulin, the ratios of proinsulin/insulin and proinsulin/C peptide, insulin resistance index and insulin secretion index in obese children with acanthosis nigricans were significantly higher than those in obese children( P <0 001) and normal children( P <0 001). Conclusion Obese children with acanthosis nigricans had higher insulin resistance and pancreatic β cell dysfunction; acanthosis nigricans may be a skin sign of high risk of type 2 diabetes mellitus.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2004年第6期405-407,共3页
Chinese Journal of Pediatrics
