儿童肥胖与代谢综合征及胰岛素抵抗的关系

摘要/Abstract

摘要： 目的研究儿童肥胖与代谢综合征(metabolic syndrome,MS)组分及胰岛素抵抗的关系。方法选择本院儿科门诊筛选的46例肥胖儿童患者[年龄(12.6±2.1)岁]为研究对象,51例正常体重儿童[年龄(12.5±1.9)岁]作为对照组,比较两组的临床特征及MS组分的差异,并分析胰岛素抵抗的影响因素。结果 1)肥胖组儿童的体质指数(body mass index,BMI)、腰围(waist circumference,WC)、血糖、血压、血脂水平(包括总胆固醇、甘油三酯、低密度脂蛋白、非高密度脂蛋白)及胰岛素抵抗程度均明显高于对照组,而高密度脂蛋白(high-density lipoprotein cholesterol,HDL-c)明显低于对照组(均P<0.05);2)肥胖组中高血压儿童7例(15.2%),高甘油三酯(TG)血症14例(30.4%),低HDL-c或高非HDL-c血症2例(4.3%),血糖异常3例(6.5%),可诊断为MS的儿童有8例(17.4%),而正常对照组仅2例TG增高(3.9%);3)多元逐步回归显示WC(标准化β=0.432,P<0.01)及TG(标准化β=0.207,P<0.05)为胰岛素抵抗的独立影响因素。结论肥胖儿童易存在不同程度的代谢异常,更易患代谢综合征。腰围及甘油三酯为胰岛素抵抗的独立影响因素。

关键词: 肥胖, 代谢综合征, 胰岛素抵抗, 儿童

Abstract: Objective To investigate the relationship between obesity,the components of metabolic syndrome(MS),and insulin resistance in children. Methods Forty-six obese children aged 12.6±2.1 years were selected from pediatrics outpatient clinic as subjects,and another 51 children with normal weight aged 12.5±1.9 years were enrolled as controls.Clinical characteristics and the components of MS were compared between the two groups,and the influencing factors of insulin resistance were evaluated. Results 1) Compared with normal weight children,obese children had significantly higher body mass index(BMI),waist circumference(WC),glucose levels,blood pressure,lipid profile including total cholesterol,triglyceride,low-density lipoprotein cholesterol,and non-high-density lipoprotein cholesterol,as well as insulin resistance(HOMA-IR),but lower high-density lipoprotein cholesterol(HDL-c)(all P<0.05).2) In obese group,7 children(15.2%) had hypertension,14(30.4%) had hypertriglyceridemia,2(4.3%) had low HDL-c or high non-HDL-c,3(6.5%) had hyperglycemia,and 8(17.4%) was diagnosed as MS;while only 2 children with normal weight(3.9%) had hypertriglyceridemia.3) Multiple regression analysis showed that WC(standardized β=0.432,P<0.05) and TG(standardized β=0.207,P<0.05) were independently correlated with HOMA-IR. Conclusions Obese children are prone to suffer more different metabolic disorders and MS.WC and TG are independently correlated with insulin resistance.

Key words: obesity, metabolic syndrome, insulin resistance, children

中图分类号:

R723.14

王红丽,金薇,高毅. 儿童肥胖与代谢综合征及胰岛素抵抗的关系[J]. 中国儿童保健杂志, 2013, 21(5): 512-514.

WANG Hong-li,JIN Wei,GAO Yi.. Relationship between obesity,metabolic syndrome and insulin resistance in children.[J]. journal1, 2013, 21(5): 512-514.

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