目的 观察脂联素(ADP)基因+45多态性在肥胖儿童及青少年非酒精性脂肪性肝病(NAFLD)中的分布，探讨其基因多 态性与血清ADP、胰岛素抵抗(IR)、体脂、血脂的关系。方法 选取100例单纯性肥胖NAFLD儿童及青少年，年龄 6.5-18.3岁，另选70例年龄、性别相匹配的健康儿童及青少年。清晨空腹测量其体质量、身高、腰围(WC)和臀 围，计算体块指数(BMI)和腰臀比(WHR)、腰围身高比(WHtR)，静脉采血检测血清胰岛素(FINS)、糖(FBG)、胆固 醇 (TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、ALT、AST等，计算稳态模 型胰岛素抵抗指数(HOMA-IR=FINS×FBG/22.5)，行肝胆等部位超声检查。采用ELISA法测定ADP浓度，酚氯仿法提 取DNA，经PCR扩增后用双脱氧链终止法进行基因测序。结果 NAFLD组血ADP为(2.79±2.19)mg/L，明显低于健康对 照组的(3.90±2.13)mg/L，与BMI、WHtR、TG、FINS、HOMA-IR值呈负相关，其中HOMA-IR为影响ADP最为显著的因 素；NAFLD组ADP基因+45位点T/G的基因型分布和等位基因频率与对照组的差异无显著性意义(P>0.05)，血ADP、血 脂、血糖、胰岛素和IR、BMI、WC、WHR、WHtR等在NAFLD组ADP基因+45位点各基因型间的差异也无统计学意义(P均 >0.05)。结论 脂联素基因+45T/G多态性可能与深圳市汉族单纯性肥胖儿童及青少年NAFLD及其代谢指标无显著关联 性。

Objective To study the relationship between adiponectin gene +45 polymorphism and serum adiponectin(ADP), insulin resistance(IR), body fat and serum lipids in the obese children and adolescents with nonalcoholic fatty liver disease (NAFLD). Methods One hundred simple obese children and adolescents with NAFLD aged 6.5 years to18.3 years and 70 healthy children and adolescents of similar age and sex (healthy control group) were randomly enrolled in the study. Early in the morning, fasting body weights, heighs, waist circumferences and hip circumferences were measured for calculation of BMI ,WHR and WHtR, and venous blood samples were collected for test of serum insulin(FINS), glucose(FBG), total cholesterol(TC), triglycerides(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase(ALT) and aspartate aminotransferase (AST), which contributed to the calculation of homeostasis model assessment-Insulin resistance (IR=FINS×FBG/22.5). Ultrasonographic examinations were given to the liver and related organs. Serum ADP levels were measured by ELISA, and DNA sequencing after PCR amplification were performed with dideoxy chain termination method. Results Serun ADP level in NAFLD group was 2.79±2.19 mg/L, significantly lower than the healthy control (3.90±2.13 mg/L), it was negatively correlated with BMI, WHtR, TG, FINS and IR values, and IR was the most significant factor that affected serum ADP level. NO significant differences in genotype or allele frequency of ADP gene SNP+45 between NAFLD group and healthy controls(P>0.05). There was no difference of serum ADP, lipid, FBG, FINS and IR, BMI, WC, WHR, WHtR among different genotype of +45 site in children and adolescents with NAFLD(all P >0.05). Conclusions ADP gene SNP+45 may be not associated with occurrence of NAFLD and the metabolic parameters in Chinese simple obesity children and adolescents of Shenzhen.