The Relationship Between Insulin Resistance And IL-6,TNF-? And Hs-CRP In Simple Obese Children

Background As a multi-cause disease,obesity are related to metabolic,genetic traits,personal factors and etc.As a global problem,obesity has shown a stable increasing trend in younger age group.Meanwhile simple childhood obesity has aroused widespread concern around the world,the growth rate of proportion of simple obese children in China's is even higher than average number of the world.Many studies have confirmed that the higher the level of obesity,the more likely insulin resistance(IR)is going to occur,and IR is a link between obesity and glucose and lipid metabolism disorders,and also the pathophysiology of metabolic disorders.More and more studies have confirmed that the nature of obesity is a systemic chronic low inflammation,which is induced by a variety of inflammatory factors.For the current,such idea is accepted by more and more scholars.IR and inflammatory factors are related.It is convinced that interleukin-6(IL-6),tumor necrosis factor(TNF-?),hypersensitive C-reactive protein(hs-CRP)are the most important three inflammatory factors that have caused insulin resistance and metabolic syndrome.Previous studies have demonstrated that IR and inflammatory factors have significant differences in simple obese children and normal weight infants,but there is a relative lack of research on the specific relationship between IR levels and related factors.Study Object Studying the relationship between insulin resistance and TNF-?,IL-6 and CRP in simple obese children to provide new ideas for early screening and prevention of obesity and related complications.Materials and Methods In this study,the samples were collected from the Second Affiliated Hospital of Dalian Medical Universitywith a total of 30 obese children.The treatment period was from March 2015 to December 2016,with 21 boys and 9 girls;the gender ratio is 2.33 : 1(M/F);aged from 6 years to 14 years old with an average of 10.31 ± 2.24.Criteria for reference to China 2-18 year-old children overweight,obesity screening Body mass index(Body Mass index,BMI)threshold data.After the physical examination,ultrasound,biochemical examination to assess liver and kidney function and endocrine and other related checks,except for genetic metabolic diseases,congenital genetic disease,central nervous system diseases and other endocrine diseases caused by secondary pathological obesity.For the contrast group,matchde by age and sex,26 healthy children with normal weight were selected.Among them,there were 14 boys and 12 girls,with a gender ratio of 1.17: 1(M/F)and age between 6 and 14 years.The average age was 9.37 ± 2.17 years.The all children were selected except when they were collected,except for acute and chronic infectious diseases.All subjects were informed by family members(guardians).Same measuring tools were used to measure height and weight.The fasting glucose(FPG),triglyceride(TG),Total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST)data in this study were collected by a fully automated biochemical analyzer.The levels of TNF-? and IL-6 were measured by enzyme-linked immunosorbent assay(ELISA).The data of the expression of hs-CRP was collected by immunoturbidimetry.The data of the expression of TNF-? and IL-6 was collected by radioimmunoassay.Insulin resistance index(HOMA-IR)was used to assess insulin sensitivity,and HOMA-IR=FPG(mmo/L)×FINS(m U/L)/22.5.For the above research indicators,using independent t test to compare the measurement data.The chi-square test(2?)was used to compare the collected data.For the non-normal distribution of measurement data after the conversion and testing,it was a normal distribution of measurement data for the t test.The correlation analysis was performed with Pearson and the multivariate stepwise linear regression analysis.SPSS 17.0 was the main data processing software for the study.And also part of the data was preprocessed with Excel 2010.Results(1)In the obese group and the control group,the differences in gender,age,were not found in the obese group and the control group(P<0.05),but there was no significant difference between the two groups statistically significant(P> 0.05).(2)The levels of FPG and FINS in the obese group were significantly higher than those in the control group(P<0.05),but there was no significant difference(P>0.05)between the two groups.The HOMA-IR in obese group was significantly higher than that in control group(P<0.05).The levels of TC,TG and ALT in obese children were significantly higher than those in control group(P<0.05).Compared with LDL-C,AST and albumin there was no significant difference between the two groups(P>0.05).(3)The levels of IL-6,TNF-? and hs-CRP in obese children were significantly higher than those in control group(P<0.05).HOMA-IR was positively correlated with BMI,IL-6,TNF-?,TG and TC(r = 0.59;r = 0.76;r = 0.70;r = 0.61;r = 0.55,P<0.05),and IL-6 is an independent influencing factor of IR(regression coefficient r2 = 0.57,P<0.001).But there was no significant correlation with ALT,HDL-C and hs-CRP(P>0.05).Conclusions(1)Simple obese children are often accompanied by varying degrees of hyperinsulinemia and insulin resistance,and there will be dyslipidemia and liver dysfunction.(2)The levels of IL-6,TNF-? and hs-CRP were significantly increased in simple obese children.(3)IR in simple obese children may be related to IL-6,TNF-?,BMI,TG and TC,and IL-6 is an independent factor of IR.