中文摘要：

目的：探讨青少年及年轻成人肥胖患者糖脂代谢的特点及与前蛋白转化酶枯草溶菌素9（PCSK9）的关系。方法：收集就诊患者54例（其中男22例,女32例）,排除既往有糖尿病史者,对其进行问卷调查、体格检查以及相关代谢指标的测定,同时行口服葡萄糖耐量试验（OGTT）。用ELISA方法检测血清样本中PCSK9的水平。结果：体质指数（BMI）与空腹血糖（FBG）、空腹胰岛素（FINS）、空腹C肽（FCP）、胰岛素抵抗指数（HOMA-IR）呈正相关（r值分别为0.386、0.488、0.363、0.546,P均〈0.05）,与甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）呈正相关（r值分别为0.365、0.274、0.305,P均〈0.05）,与高密度脂蛋白胆固醇（HDL-C）呈负相关（r=-0.270,P〈0.05）,BMI与C反应蛋白（CRP）、γ谷氨酰胺转肽酶（γGGT）呈正相关（r值分别为0.577、0.417,P均〈0.05）,与总胆红素（TBIL）呈负相关（r=-0.322,P〈0.05）。PCSK9水平与BMI、FINS、HOMA-IR呈正相关（r值分别为0.406、0.535、0.496,P均〈0.05）,但与TG、TC、LDL-C、HDL-C相关性不明显（r值分别为0.089、0.237、0.269、-0.002,P均〉0.05）。CRP与FINS、FCP、HOMA-IR、TG呈正相关（r值分别为0.331、0.464、0.494、0.530,P均〈0.05）。γGGT与FBG、TG呈正相关（r值分别为0.284、0.501,P均〈0.05）,与HDL-C呈负相关（r=-0.289,P〈0.05）。TBIL与FINS、FCP、LDL-C呈负相关（r值分别为-0.324、-0.290、-0.315,P均〈0.05）。结论：肥胖青少年及年轻成人机体存在多种糖脂代谢指标的异常,其中PCSK9与FINS和HOMA-IR密切相关。对青少年及年轻成人肥胖的预防有助于预防未来心血管疾病和2型糖尿病的发生。

英文摘要：

Objective：To discuss the characteristics of glucose and lipid metabolism and the relationship between plasma PCSK9 and relative metabolic factors in adolescents and young adults. Methods： Blood samples were obtained from 54 （22 males and 32 females） subjects who were diagnosed as obese. Questionnaires,physical examinations,oral glucose tolerance test （OGTT）,lipid profile,and other metabolic factors were performed on these objects. Serum PCSK9 was measured with Sandwich ELISA. Results： Data showed that the bone mass index （BMI） was positively correlated with fasting blood glucose （FBG）,fasting insulin （FINS）, fasting C peptide （FCP）, HOMA insulin resistance index （HOMA-IR） （r = 0.386,0.488,0.363,0.546, P 〈 0.05）. BMI was positively correlated with total triglyceride （TG）, total cholesterol （TC）,low density cholesterol （LDL-C） （r = 0.365,0.274,0.305,P 〈 0.05）, and it was negatively correlate with high density cholesterol （HDL-C）（r = -0.270,P 〈 0.05）. BMI was positively correlate with C- reactive protein （CRP）and gamma-glutamyl transferase （γ-GGT） （r = 0.577,0.417,P 〈 0.05 ）. It was negatively with total bilirubin （TBIL） （r = -0.322,P 〈 0.05）. PCSK9 was positively correlated with BMI,FINS,HOMA-IR （r = 0.406,0.535,0.496,P 〈 0.05）. There was no significant correlation with BMI and blood lipid levels such as TG, TC, LDL-C, HDL-C （r = 0.089,0.237,0.269,-0.002, P 〉 0.05）. CRP was positively correlated with FINS,FCP,HOMA-IR,TG （r = 0.331,0.464,0.494,0.530,P 〈 0.05）. 7GGT was positively correlated with FBG,TG （r = 0.284,0.501,P 〈 0.05）. 7GGT was negatively correlated with HDL-C（r = -0.289,P 〈 0.05）. TBILI was negatively correlated with FINS, FCP,LDL-C （r = -0.324,-0.290,-0.315,P 〈 0.05）. Conclusion： There were multiple abnormalities of glucose and lipid metabolism in obese adolescents and young adults in this study. PCSK9 was closely related to FINS and HOMA-IR. The prevention of obesity might