| Objective: To investigate the changes of C1q/tumor necrosis factor-related protein 6(CTRP6) levels in obese children, and to analyze the relationship between serum CTRP6 and some anti-inflammatory cytokines and inflammatory factors. And to further understand impact on physical indicators and lipid metabolism.Methods: To collect the clinical research objects of obese children, who attended the pediatric endocrinology outpatient of Tianjin Medical University General Hospital from August 2014 to May 2015.All obese children were identified by physical examination, medical history, and comprehensive evaluation, excluding genetic factors, endocrine, trauma, or other diseases caused by secondary obesity. According to the diagnostic criteria of simple obesity and metabolic syndrome,the obese children were divided into simple obesity group and metabolic syndrome group.Among them,the metabolic syndrome group has 62 cases, which 38 cases were male, 24 female cases, aged at(11.80±2.16); the simple obesity group has 77 cases, which 42 males and 35 females, aged at(11.25±2.19). At the same time, 62 cases of normal children, which 33 males and 29 females, aged at(11.49±2.19). The height(H), body weight(W), waist circumference(WC), systolic blood pressure(SBP) and diastolic blood pressure(DBP) of children in three groups were measured. We test the white blood cells(WBC), hypersensitive C-reactive protein(hs CRP), triglyceride(TG), cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), fasting plasma glucose(FPG), fasting insulin(FINS) and CTRP6, interleukin(IL)-10, IL-6 and monocyte trend of protein factor 1(MCP-1). According to the formula,using the body mass index(BMI)(kg/m2)=W(kg)/H(m2); Waist circumference(WHt R)=WC(cm)/H(cm),and homeostasis model assessment of insulin to hold(HOMAIR)=FPG(mmol/L)x FINS(m IU/L)/22.5 to calculate BMI, WHt R and HOMAIR.In addition, the metabolic syndrome group of children and the simple obesity group of children were measured Hemoglobin A1c(Hb A1c), 2 hours postprandial glucose(2h PG) and 2 hours postprandial insulin(2h INS). All data wereprocessed by SPSS19.0 statistical software, and were analyzed statistically.Results: 1. Metabolic syndrome group and simple obesity group of BMI, WC, WHt R, SBP and DBP were higher than the control group, and the metabolic syndrome group was higher than the simple obesity group, the difference had statistical significance(P<0.05). 2. Metabolic syndrome group and simple obesity group of WBC was higher than the control group, the difference had statistical significance(P<0.05);metabolic syndrome group and simple obesity group of WBC had no statistical significance(P=0.316>0.05). Metabolic syndrome group and simple obesity group of hs CRP was higher than the control group, and the metabolic syndrome group was higher than the simple obesity group, the difference had statistical significance(P<0.05). 3. Metabolic syndrome group of FPG was higher than simple obesity group and the control group, the difference had statistical significance(P<0.05); simple obesity group and the control group of FPG has no statistical significance(P=0.564>0.05). Metabolic syndrome group and simple obesity group of FINS and HOMAIR were higher than the control group, the difference had statistical significance(P<0.05). 4. Metabolic syndrome group of 2h PG?2h INS and Hb A1 c were higher than simple obesity group, the difference had statistical significance(P<0.05). 5. Metabolic syndrome group of TG was higher than simple obesity group and the control group, the difference had statistical significance(P<0.05); simple obesity group and the control group of TG had no statistical significance(P=0.213>0.05). Metabolic syndrome group and simple obesity group of TC were higher than the control group, the difference had statistical significance(P=0.003, P=0.011);metabolic syndrome group and simple obesity group of TC had no statistical significance(P=0.587>0.05). Metabolic syndrome group and simple obesity group of HDL-C was lower than the control group, and the metabolic syndrome group was lower than the simple obesity group, the difference had statistical significance(P<0.05). Metabolic syndrome group and simple obesity group of LDL-C was higher than the control group, and the metabolic syndrome group was higher than the simple obesity group, the difference had statistical significance(P<0.05).6. Metabolic syndrome group and simple obesity group of CTRP6 and IL-10 were lower than the control group, and the metabolic syndrome group were lower than the simple obesity group, the difference had statistical significance(P<0.05). Metabolic syndrome group and simple obesity group of IL-6 and MCP-1 were higher than the control group, and the metabolic syndrome group were higher than the simple obesity group, the difference had statistical significance(P<0.05). 7. CTRP6 was positively correlated with HDL-C and IL-10; and negatively correlated with BMI, WC, WHt R, SBP, DBP, hs CRP, FPG, FINS, HOMAIR, 2h PG, 2h INS, Hb A1 c, TG, TC, LDL-C, IL-6 and MCP-1. 8. CTRP6 as dependent variable, BMI, WC, WHt R, SBP, DBP, hs CRP, FPG, FINS, HOMAIR, TG, TC, HDL-C, LDL-C, IL-10, IL-6 and MCP-1 as independent variables, multiple stepwise regression analysis showed that hs CRP, HOMAIR and IL-10 were independent factors for CTRP6 levels.Conclusion: 1. Two groups of obese children have already shown a variety of risk factors for cardiovascular disease, with the development of metabolic disorder, CTRP6 levels decreased further, the risk factors for cardiovascular disease are more serious. Therefore, reducing the obesity children's weight and increasing the expression of CTRP6, may reduce the risk of obesity and its associated cardiovascular disease. 2. Obese children are at low-grade inflammatory state, which is characterized by lower CTRP6 and anti-inflammatory factor IL-10 levels,elevated levels of pro-inflammatory factor, and the inflammatory response in children with metabolic syndrome was more obvious. Thus speculate that CTRP6 is associated with obesity and low-grade inflammatory state. CTRP6 increases the expression of anti-inflammatory cytokine IL-10 in human monocyte-derived macrophages by activating ERK1/2,improve the status of inflammation in the body, it may also be one of the important mechanisms for the anti-inflammatory response of CTRP6. 3. Detection results of glucose and lipid metabolism in simple obese children were all in the normal range. But compared with the control group, the risk of glucose and lipid metabolism disorder was higher. The detection results of the metabolic syndrome group have shown high blood sugar, high blood pressure and blood lipid abnormalities. And it is related to the change of CTRP6 what we researched. Therefore, to change the expression of CTRP6 in obese children in early intervention can reduce the incidence of obesity and complications. |
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