| Objective To analyze the differences and correlation of gut microbiota,serum inflammatory factors and adipocytokines levels between simple obese and normal-weight children,and to explore the pathogenesis of obese children so as to provide new ideas for the prevention and treatment of them.Methods 1)We recruited obese and normal-weight children aged 5 to 15 years old who visited to Fuzhou Children's Hospital of Fujian from January 2017 to January 2018.All subjects underwent measurements of height,weight,waist circumference,hip circumference,and blood pressure.Then we collected fasting blood samples in the morning to measure alanine aminotransferase(ALT),aspartate transaminase(AST),triglyceride(TG),total cholesterol(TC),and high density lipoprotein cholesterol(HDL),low-density lipoprotein cholesterol(LDL),fasting blood glucose(FBG),insulin(INS)and oral glucose tolerance test 2 hour blood glucose(OGTT 2h BG),and calculated waist to hip ratio(WHR),body mass index(BMI),body mass index Z,(BMI Z)score and homeostasis model insulin resistance index(HOMA-IR).Serum interleukin-6(IL-6),tumor necrosis factor alpha(TNF?),lipopolysaccharide binding protein(LBP)and glucagon-like peptide 2(GLP-2)levels were detected by enzyme-linked immunosorbent assay(ELISA).2)16S r DNA sequencing was used to analyze the composition and diversity of gut microbiota.3)R software and SPSS 22 software were used for statistics.Measurement data with normal distribution were expressed as mean±standard deviation(` x±s),and independent t test of two samples was used to compare the differences between the two groups;non-normal distribution data were measured with median(M)and interquartile range and the differences between groups were compared using two-sample independent test in the non-parametric test.The enumeration data were expressed as a rate,and they were compared using the chi-square test between the two groups;Pearson correlation analysis were used for the normal distribution data,and Spearman correlation analysis were used foe non-normal distribution data.p<0.05 was considered statistically significant.Results The part one:1)A total of 35 obese children(18 males and 17 females,mean age 9.08±1.86 years)and 24 normal weight children(11 males and 13 females,mean age 9.08±2.07years)were enrolled in this study.There was no significant difference in gender and age between the two groups(p>0.05).2)The detection rate of dyslipidemia,abnormal glycometabolism,transaminase elevation and hypertension in obese children were 20%(7/35),14.3%(5/35),5.7%(2/35)and 8.8%(3/34),respectively.The proportion of fatty liver was 33.3%(11/33);the detection rate of dyslipidemia and hypertension in the control group were 8.3%(2/24)and 4.2%(1/24),respectively.Abnormal glycometabolism and abnormal liver function were not detected out in the control group.And there was no significant difference in the detection rate of hypertension between the two groups(p>0.05).3)The serum ALT,TG,LDL,INS and HOMA-IR levels were significantly higher in obese children and the HDL levels were significantly lower when compared with the control group(p<0.05).There were no significant differences in serum TC,AST and FPG levels between the two groups(p>0.05).4)The IL-6,TNF?,LBP,leptin,and GLP-2 levels in the obese children were significantly higher than those in the control group(p<0.05).5)The BMI and BMI Z score of all the children was positively correlated with TG,INS and HOMA-IR,and negatively correlated with HDL(p<0.05),in addition,The BMI was positively correlated with LDL(p<0.05);While there was no correlation between WHR and glucose and lipid metabolism index(p>0.05).6)The IL-6 level was positively correlated with WHR(p<0.05),and negatively correlated with HDL(p<0.05);the TNF? level was positively correlated with WHR,BMI,BMI Z score,TG,FBG and HOMA-IR(p<0.05),and negatively correlated with HDL(p<0.05);the LBP level was positively correlated with WHR,BMI,BMI Z score,INS and HOMA-IR(p<0.05).7)The GLP2 level was positively correlated with WHR,BMI,BMI Z score(p<0.05),but had no significant correlation with glucose and lipid metabolism index(p>0.05);Leptin was positively correlated with BMI,BMI Z score,TG,LDL,INS and HOMA-IR,and negatively correlated with HDL(p<0.05).8)The LBP level was positively correlated with IL-6,TNF?,leptin and GLP-2(p<0.05);the leptin was positively correlated with TNF?(p<0.05);GLP-2 was positively correlated with leptin(p<0.05).The part two:9)Alhough there was no significant difference in the sobs index,chao index,and ace index between the two groups(p>0.05),the shannon index of intestinal microflora in obese children was lower,and the simpson index was higher than that in the control group(p<0.05).10)At the phylum level,the predominant bacterial taxa in feces of both obese and normal-weight children were Firmicutes(50.7% vs 49.7%)and Bacteroidetes(40.0% vs 45.1%),followed by Proteobacteria(7.6% vs 4.0%),Fusobacteria(1.4%vs 0.2%)and Actinobacteria(0.2% vs 0.8%).11)At the phylum level,the relative abundance of Firmicutes,Bacteroidetes,Proteobacteria,Fusobacteria,Actinobacteria and Firmicutes/Bacteroidetes ratio were no significant difference(p>0.05),while at the genus level,the relative abundance of Bifidobacterium and Bacteroides were lower in the obese children,and the Dialister was higher(p<0.05).12)The Dialister was positively correlated with TG,LDL and leptin;the Bacteroides was negatively correlated with WHR,BMI,BMI,IL-6 and leptin;the Bifidobacterium was negatively correlated with BMI,leptin,and GLP-2.Conclusion The part one:1)Obese children are susceptible to metabolic disorders such as hyperlipidemia,impaired glucose tolerance,elevated transaminases,and fatty liver.2)The serum inflammatory cytokines IL-6,TNF?,and LBP level are elevated in children with simple obesity,which means that the obese children are in a state of chronic low-grade inflammation.3)The LBP is positively correlated with INS and HOMA-IR,suggesting that LBP may be involved in the occurrence of insulin resistance.4)The serum leptin level is significantly increased in obese children,and be positively correlated with BMI,BMI Z score,TG,LDL,INS and HOMA-IR,while be negatively correlated with HDL,indicating that leptin is involved in the development of obesity,and is closely related to glucose and lipid metabolism.5)The serum GLP-2 level is significantly increased in obesity,and GLP-2 is positively correlated with WHR,BMI and BMI Z score,suggesting that GLP-2 is involved in the development and progression of obesity.The part two:6)The obese children are in a state of intestinal dysbacteriosis.7)The Dialister is positively correlated with TG and LDL,suggesting that Dialister may participate in lipid metabolic disorders;Both the Bacteroides and Bifidobacterium are negatively correlated with BMI,suggesting that Bacteroides and Bifidobacterium may participate in weight control.8)The intestinal microbiota may participate in the development of inflammation in obese children through LBP9)The Dialister is positively correlated with leptin,while the Bacteroides and Bifidobacterium are negatively correlated with leptin,suggesting that they may participate in energy metabolism by regulating leptin levels in obese children. |
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