Young adult obese subjects with and without insulin resistance: what is the role of chronic inflammation and how to weigh it non-invasively?
Young adult obese subjects with and without insulin resistance: what is the role of chronic inflammation and how to weigh it non-invasively?
复制标题
DOI：
10.1186/1476-9255-6-6
复制
发表时间：
2009-03-16
影响因子：
5.1
通讯作者：
Pasanisi, Fabrizio
中科院分区：
文献类型：
--
作者：
Tarantino, Giovanni;Colicchio, Patrizia;Pasanisi, Fabrizio
背景：肥胖是代谢综合征的主要危险因素，代谢综合征的进一步表现是非酒精性脂肪肝。代谢综合征与促炎状态有关，促炎状态导致胰岛素抵抗。最后，一个“代谢良性肥胖”，不伴有胰岛素抵抗最近被假定存在。目的：要找到是否有任何炎症标志物与胰岛素抵抗的存在独立相关，评估特定的人体测量，超声和实验室参数在人口中的年轻成年obesity.Methods：42个年轻人，分为两组（有或无胰岛素抵抗），研究了血清C-反应蛋白和纤维蛋白原的慢性炎症状态的指标。作为代谢评估的一部分，对体重指数、腰围和代谢综合征的存在进行了评估。超声检查加权内脏和皮下腹部脂肪厚度，脾脏的大小作为纵向直径和肝脏hyperechogenicity.Results和讨论：血清C-反应蛋白和纤维蛋白原以及脾脏的纵向直径显着增加，在肥胖青年胰岛素抵抗组相比，非胰岛素抵抗组。胰岛素抵抗与超声检查的肝脂肪变性评分显著相关（r = 0.33，P = 0.03），脾纵径（r = 0.35，P = 0.02）与C反应蛋白（r = 0.38，P = 0.01），但与体重指数、腹部内脏或皮下脂肪组织、腰围、纤维蛋白原无相关性（P分别为0.18、0.46、0.33、0.37和0.4）。超声脂肪变性评分与脾脏体积（rho = 0.40，P = 0.01）和C反应蛋白水平（rho = 0.49，P = 0.002）密切相关。代谢综合征在肥胖伴胰岛素抵抗患者中更常见。这些研究结果表明，在年轻的成年人，只有腹部肥胖没有胰岛素抵抗，起着稀缺的作用，在确定肝脂肪变性以及代谢syndrome.Conclusion：增加脾脏大小和CRP水平是一个可靠的工具，在诊断胰岛素抵抗。
Background: Obesity is a leading risk factor for metabolic syndrome whose further expression is non-alcoholic fatty liver disease. Metabolic syndrome is associated with a proinflammatory state that contributes to insulin resistance. Finally, a "metabolically benign obesity" that is not accompanied by insulin resistance has recently been postulated to exist. Aim: To find whether any inflammation markers were independently associated with the presence of insulin resistance, evaluating specific anthropometric, ultrasonographic and laboratory parameters in a population of young adult obese subjects.Methods: Of forty two young individuals, divided into two groups ( with or without insulin resistance), were studied serum C-reactive protein and fibrinogen as indexes of chronic pro-inflammatory status. Body mass index, waist circumference and metabolic syndrome presence were assessed as part of the metabolic evaluation. Ultrasonography weighted visceral and subcutaneous abdominal fat thickness, spleen size as longitudinal diameter and liver hyperechogenicity.Results and Discussion: Serum C-reactive protein and fibrinogen as well as spleen longitudinal diameter were significantly increased in the obese young with insulin resistance compared to non-insulin resistance group. Insulin resistance was significantly associated with hepatic steatosis score at sonography (r = 0.33, P = 0.03), spleen longitudinal diameter ( r = 0.35, P = 0.02) and C-reactive protein ( r = 0.38, P = 0.01), but not with body mass index, visceral or subcutaneous abdominal adipose tissue, waist circumference and fibrinogen ( P = 0.18, 0.46, 0.33, 0.37 and 0.4, respectively). Steatosis score at sonography was well associated with spleen volume ( rho = 0.40, P = 0.01) and C-reactive protein levels ( rho = 0.49, P = 0.002). Metabolic syndrome was much more frequent in obese patients with insulin resistance. These findings show that in young adults the only abdominal adiposity without insulin resistance, plays a scarce role in determining hepatic steatosis as well as metabolic syndrome.Conclusion: Increases in spleen size and CRP levels represent a reliable tool in diagnosing insulin resistance.