学龄期肥胖儿童肠道菌群失调与机体炎症因子、胰岛素抵抗的相关性分析

Correlation of intestinal flora imbalance with inflammatory factors and insulin resistance in school-age children with obesity

摘要

目的 探究学龄期肥胖儿童肠道菌群失调与机体炎症因子、胰岛素抵抗的相关性。方法 选择2023年6月到2024年9月在温州市中心医院就诊的86例学龄期儿童作为研究对象,根据儿童肥胖相关诊断标准,将肥胖儿童纳入肥胖组(n=32),非肥胖儿童纳入非肥胖组(n=54)。对比两组基线资料、肠道菌群拷贝数及拟杆菌/硬壁菌比值(B/F)值、炎症因子[肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]、胰岛素抵抗[空腹胰岛素(FINS)与空腹血糖(FPG)及胰岛素抵抗指数(HOMA-IR)],采用Pearson相关系数分析学龄期肥胖儿童肠道菌群失调与机体炎症因子、胰岛素抵抗的相关性。结果 肥胖组儿童男性占比、年龄、体质指数(BMI)、腰围、腰臀比、体脂率显著高于非肥胖组(χ²/t=6.309、8.180、35.788、9.755、5.156、14.954,P＜0.05);肥胖组硬壁菌拷贝数显著高于非肥胖组(t=16.707,P＜0.001),而拟杆菌拷贝数及B/F显著低于非肥胖组(t=18.689、12.989,P＜0.001);肥胖组TNF-α、IL-6、IL-10水平显著高于非肥胖组(t=25.218、25.446、29.218,P＜0.001),两组hs-CRP、WBC、IL-2差异无统计学意义(P＞0.05);肥胖组FINS、HOMA-IR显著高于非肥胖组(t=17.709、10.633,P＜0.001),两组FPG差异无统计学意义(P＞0.05);肥胖儿童硬壁菌拷贝数与TNF-α、IL-6、IL-10及FINS、HOMA-IR均呈正相关(r介于0.538~0.631之间,P＜0.05),拟杆菌拷贝数、B/F与TNF-α、IL-6、IL-10及FINS、HOMA-IR均呈负相关(r分别介于-0.694~-0.542及-0.753~-0.627之间,P＜0.05)。结论 学龄期肥胖儿童具有肠道菌群失调、炎症因子与胰岛素抵抗高水平的特征,其肠道菌群失调与机体炎症因子、胰岛素抵抗具有相关性。

Abstract

Objective To explore correlations of intestinal flora imbalance with inflammatory factors and insulin resistance (IR) in school-age obese children. Methods 86 school-age children who visited Wenzhou Central Hospital from June 2023 to September 2024 were selected as study subjects. According to obesity-related diagnostic criteria, the children with obese were included in obese group (n=32) and those children without obese were enrolled in non-obese group (n=54). Baseline data, intestinal flora copy number and bacteroides/firmicutes ratio (B/F), inflammatory factors [tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBC), interleukin-2 (IL-2), interleukin-6 (IL-6) and interleukin-10 (IL-10)] and IR [fasting insulin (FINS), fasting plasma glucose (FPG) and homeostatic model assessment of insulin resistance (HOMA-IR)] were compared between the two groups. Pearson correlation coefficient analysis was used to analyze correlations of intestinal flora imbalance with inflammatory factors and IR in school-age obese children. Results The proportion of male children, age, body mass index (BMI), waist circumference, waist-to-hip ratio and body fat rate of the children in the obese group were significantly higher than those in the non-obese group (t=6.309, 8.180, 35.788, 9.755, 5.156 and 14.954 respectively, all P＜0.05). The copy number of Fermicutes (F) of the children in the obese group was significantly higher than that in the non-obese group (t=16.707, P＜0.001), while the copy number of Bacteroides and B/F ratio were significantly lower than those in the non-obese group (t=18.689 and 12.989 respectively, both P＜0.001). The serum levels of TNF-α, IL-6 and IL-10 of the children in the obese group were significantly higher than those in the non-obese group (t=25.218, 25.446 and 29.218 respectively, all P＜0.001), and there were no statistically significant differences in hs-CRP, WBC and IL-2 between the two groups (t=1.336, 0.578 and 0.709 respectively, all P＞0.05). FINS and HOMA-IR of the children in the obese group were significantly higher than those in the non-obese group (t=17.709 and 10.633 respectively, both P＜0.001), while there was no statistically significant significance in FPG between the two groups (t=1.207, P＞0.05). Pearson correlation analysis showed that the copy number of Fermicutes was positively correlated with TNF-α, IL-6, IL-10, FINS and HOMA-IR (r=0.538-0.631, all P＜0.05), while the copy number of Bacteroides and B/F ratio were negatively correlated with TNF-α, IL-6, IL-10, FINS and HOMA-IR (r=-0.694--0.542; r=-0.753--0.627, all P＜0.05). Conclusion The school-age obese children have such characteristics as severe intestinal flora imbalance and high levels of inflammatory factors and IR, and this intestinal flora imbalance is correlated with body's inflammatory factors and IR.

关键词

肥胖 / 学龄期儿童 / 肠道菌群 / 炎症因子 / 胰岛素抵抗 / 相关性分析

Key words

obesity / school-age children / intestinal flora / inflammatory factor / insulin resistance / correlation analysis

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基金资助

温州市科研项目(Y2023322)