Abstract: 【Objective】 To observe the rates of occurrence of insulin resistance (IR) and metabolic syndrome (MS) and the association between IR and MS in a group of Chinese obese children. 【Methods】 Oral glucose tolerance test (OGTT) was done and serum insulin was measured in 76 children (49 males and 27 females) with obesity aged between 3 and 14 years old. Fasting blood sample was also obtained to measure total cholesterol, triglycerides, HDL-C, LDL-C, uric acid, liver function and androgen in serum. 【Results】 In the 76 obese children, 68.4% of them had IR, 27.6% had impaired glucose tolerance or type II diabetes, 61.8% had dyslipidemia, 14.5% had hypertension, 28.9% had hyperuricemia, 26.3% had increased ALT. Hyperandrogenism was found in 6 out of the 27 female children. 32.9% met the criteria of MS. The rates of impaired glucose tolerance, dyslipidemia and MS were 34.6%, 73.1% and 44.2%, respectively, in children with IR, which were significantly higher than those without IR(P< 0.05 or 0.01, respectively). Out of the 20 cases with delayed or absent insulin responsive peak, 13 of them had impaired glucose tolerance and one was diagnosed with Type II diabetes. 【Conclusions】 Insulin resistance and MS are very common in children with obesity. The occurrence of MS is strongly and positively related to IR.

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

摘要： 【目的】 观察肥胖儿童胰岛素抵抗及代谢综合症的发生率及其两者之间的关系。 【方法】 76例儿童因肥胖进行口服葡萄糖耐量试验,同时检测血清胰岛素水平及空腹血清胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、睾酮及谷丙转氨酶(ALT)水平。所有患儿排除了甲状腺功能低下、皮质醇增多症。 【结果】 76例肥胖儿童中,胰岛素抵抗52例,占68.4%;糖耐量损伤17例,空腹血糖损害3例,2型糖尿病1例,糖代谢异常总发生率为27.6%;血脂紊乱47例,占61.8%;高尿酸血症22例(28.9%),ALT增高20例(26.3%),女性高睾酮血症6例,血压增高11例(14.5%)。符合代谢综合症诊断标准者25例,占32.9%。胰岛素抵抗组与无胰岛素抵抗组比较,糖代谢异常(34.6% VS 12.5%,χ²=4.016,P<0.05)、血脂紊乱(73.1% VS 37.5%,χ²=8.808,P<0.01)和代谢综合症(44.2% VS 8.3%,χ²=9.586,P<0.01)的发生率均显著增高。20例胰岛素分泌峰值后移或无峰值的患儿中,糖耐量受损13例,2型糖尿病1例。 【结论】 肥胖儿童胰岛素抵抗与代谢综合症密切相关。

关键词: 胰岛素抵抗, 代谢综合症, 肥胖, 儿童