【目的】 研究单纯性肥胖患儿血清17种氨基酸水平的分布情况,探讨血清氨基酸水平与胰岛素抵抗之间的关系,为临床制定综合治疗干预方案提供科学依据。 【方法】 用高效液相色谱法对78例单纯性肥胖儿童和40例正常儿童的血清17种氨基酸水平进行检测;用化学发光法检测空腹胰岛素(FINS)、全自动生化仪检测空腹血糖(FPG),计算稳态模型的胰岛素抵抗指数(HOMA-IR),并对氨基酸与FINS、FPG 和HOMA-IR之间的相关性进行分析。 【结果】 实验组患儿的血清氨基酸水平严重失衡,其蛋氨酸Met,半胱氨酸Cys和甘氨酸Gly显著的低于对照组(P<0.05),其余14种氨基酸[苏氨酸(Thr)、缬氨酸(Val)、异亮氨酸(Ile)、亮氨酸(Leu)、苯丙氨酸(Phe)、赖氨酸(Lys)、组氨酸(His)、精氨酸(Arg)、天冬氨酸(Asp)、谷氨酸(Glu)、丙氨酸(Ala)、脯氨酸(Pro)、丝氨酸(Ser)、酪氨酸(Tyr)]显著高于对照组(P<0.05);患儿存在着血清Thr、His、Arg、Gly和Ala水平分布高、低极不均的情况;实验组患儿虽空腹血糖正常,但普遍存在胰岛素抵抗;其FINS 及HOMA-IR与 Lys、Ile、Leu、Val呈正比。 【结论】 在对单纯性肥胖患儿治疗干预的过程中,动态监测血清氨基酸水平,可以帮助临床医生了解肥胖儿童体内氨基酸水平失衡的情况,为制定针对性的综合治疗方案,提供科学依据。

【Objective】 To provide scientific evidence for clinic to treating the children with simple obesity by studying the distributions of 17 amino acids in the serum and researching the relation between the levels of amino acids and simple obesity. 【Methods】 The levels of 17 amino acids of 78 patients and 40 healthy children were detected by high performance liquid chromatography(HPLC). 17 amino acids included Thr, Val, Ile, Leu, Phe, Lys, His, Arg, Asp, Glu, Ala, Pro, Ser, Tyr, Met, Cys, Gly. Fasting plasma glucoses(FPG) and Fasting insulins(FINS) were detected by chemiluminescent immunoassay. HOMA-IR were calculated. The relations between 17 amino acids and FINS, FPG, HOMA-I were analyzed. 【Results】 There were serious unbalance of the distributions of 17 amino acids in the serum of patients. The levels of Met, Cys, Gly were obviously lower than those of control group(P<0.05). The levels of 14 amino acids(Thr, Val, Ile, Leu, Phe, Lys, His, Arg, Asp, Glu, Ala, Pro, Ser, Tyr) were obviously higher than those of control group(P<0.05). The distributions of Thr, His, Arg, Gly, Ala were seriously unbalanced. Although the levels of FPG of patients were normal, there were insulin resistance among the children troubled with simple obesity. There were positive correlations between FINS, HOMA-IR and Lys, Ile, Leu, Val. 【Conclusion】 In the treatment of children with simple obesity, the dynamic monitoring of serum amino acid level can help clinicians to understand the situation of imbalance in the amino acid level of the patients and to make a individual and integrative treatment plan for patients.