Abstract: Objective To study the influential factors about lipids with simple obesity children,and provide clinic accordance with high risk child of prophase lipid screening and prophase interference. Methods 100 cases of simple obesity children and 100 cases of normal children were selected by random sampling to proceed case control study.Both the two groups were had physique measurement,answer the questionnaire about relevant case history,diet condition,life style.At equal pace,total cholesterol(TC),triglyceride(TG),high-density,lipoprotein,cholesterol(HDL),low-density lipoprotein cholesterol(LDL),apolipoprotein A (apoA) and apolipoprotein B (apoB) were determined with the 12h fasting blood.What was more,using DNA sequencing method to detect the apolipoproteinE gene polymorphism of children both group,then,the effection of environment and gene on lipids was analyzed of simple obesity children. Results Compared to control group,experimental group had higher dyslipidemia rate and parent's high blood lipids,family history of cardiovascular disease,high intake of fat and exercise were influential factors of dyslipidemia in environment (P＜0.05); what was more,apoE3 allele of experimental group had higher levels of TG,TC,LDL and lower levels of HDL,apoA,while apoE4 allele had higher levels of TG,apoB and lower levels of HDL,apoA(P＜0.05).In experimental group,compared to apoE3 allele,the child who carry apoE2 allele had lower levels of TC,LDL and apoB(P＞0.05),apoE4 allele had higher levels of TG,apoB and lower HDL(P＜0.01); Conclusion Parent's high blood lipids,family history of cardiovascular disease,parent's obesity,high intake of fat,exercise and apoE gene polymorphism are influential factors with simple obesity children,apoE4 is one of the risk genes of dyslipidemia and correlated with dyslipidemia of obesity children.

Key words: obesity children, environment, apoE gene, lipids

摘要： 目的 研究肥胖儿童血脂水平的影响因素,为高危儿童早期干预提供临床依据。方法 本实验为病例对照研究,对两组分别进行体格测量、家族相关病史、饮食及生活方式情况问询,并抽取空腹静脉血作甘油三酯(triglyceride,TG)、胆固醇(total cholesterol,TC)、高密度脂蛋白(high-density lipoprotein,HDL)、低密度脂蛋白(low-density lipoprotein,LDL)、载脂蛋白A(apolipoprotein A,apoA)、载脂蛋白 B(apolipoprotein B,apoB)检测,另外对两组儿童进行载脂蛋白E(apolipoprotein E,apoE)基因多态性等位基因测定,从环境和基因两方面分析影响肥胖儿童血脂的因素。结果 与对照组比较,肥胖儿童有较高的血脂异常率;父母高血脂、心血管家族史、高脂肪饮食和运动等对血脂异常的影响差异有统计学意义(P＜0.05);不同等位基因对血脂的影响不同,apoE3型等位基因有较高的TG、TC、LDL水平和较低HDL、apoA水平,apoE4型有较高的血TG、apoB水平和较低的HDL、apoA水平(P＜0.05)。肥胖儿童组内比较,以apoE3为参照,apoE2等位基因呈现出较低水平的TC、LDL和apoB(P＞0.05),而apoE4则具有较高的TG、apoB水平和较低的HDL水平(P＜0.01); 结论 父母高脂血症、心血管家族史、父母肥胖史、高脂肪饮食、运动及aopE基因多态性是肥胖儿童血脂异常的影响因素,其中apoE4等位基因是血脂异常的风险基因之一,与肥胖儿童的血脂异常存在显著相关性。

关键词: 肥胖儿童, 环境, apoE基因, 血脂