目的 探讨单纯性肥胖症儿童血清同型半胱氨酸水平与糖尿病、心血管疾病发生的相关性,为临床防治儿童单纯性肥胖提供参考依据。 方法 选择2016年8月-2017年12月来深圳市儿童医院儿童保健门诊就诊的53例单纯性肥胖儿童纳入肥胖组,以及同期在本院进行体格检查的82例健康儿童为正常组。采用化学发光法测定血清同型半胱氨酸(Hcy),分别检测两组儿童身高、体重、臀围、腰围,计算体重指数(BMI)、腰臀比(WHR)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、空腹血糖(FBG)、空腹胰岛素(FINS)、计算胰岛素分泌功能指数(HOMA-β)、稳态模型胰岛素抵抗指数(HOMA-IR);并对Hcy与各指标进行相关性分析。 结果 肥胖组儿童的血清Hcy水平明显高于正常组儿童的水平,差异有统计学意义(t=3.136,P＜0.05)。两组儿童身高比较差异无统计学意义(P＞0.05)。肥胖组体重、臀围、腰围、BMI、WHR均高于正常组,差异有统计学意义(P＜0.05)。肥胖组儿童的FBG、FINS、HOMA-IR高于对照组,HOMA-β低于对照组,差异均有统计学意义(P<0.05)。血清Hcy与BMI、WHR、FBG、FINS、HOMA-IR、TG、TC、LDL-C水平呈正相关(r=0.473~0.732,P＜0.05),与HOMA-β、HDL-C呈负相关(r=-0.774,-0.725,P＜0.05) 。 结论 单纯性肥胖儿童血清同型半胱氨酸升高,与糖尿病及心血管疾病密切相关,单纯性肥胖儿童应定期监测血清同型半胱氨酸水平。
Abstract
Objectives To investigate the relationship between serum Hcy and the risk of diabetes mellitus and cardiovascular disease in simple obese children,in order to provide reference for clinical diagnosis and treatment of simple obesity in chidren. Methods Totally 53 simple obese children who visited in Shenzhen children′s Hospital were enrolled in obesity group from August 2016 to December 2017,and 82 healthy children who underwent physical examination in this hospital during the same period were selected as normal group. Serum homocysteine(Hcy) level was determined by chemiluminescence. Height,weight,hip circumference,waist circumference,body mass index(BMI),waist-hip ratio(WHR),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),fasting blood glucose(FBG) and fasting insulin(FINS) were measured,and insulin secretion function index(HOMA-β),homeostasis model insulin resistance index(HOMA-IR) were calculated. Also,the correlation between Hcy and other indicators was analyzed. Results The level of serum Hcy in obesity group was significantly higher than that in normal group(t=3.136,P<0.05). There was no significant difference in height between the two groups(P>0.05),while the body weight,hip circumference,waist circumference,BMI and WHR in obesity group were higher than those of the normal group(P<0.05). Moreover,the levles of FBG,FINS and HOMA-IR in simple obese children were significantly higher than those of normal group,while the level of HOMA-β was significantly lower in simple obese children(P<0.05). Serum Hcy level was positively correlated with BMI,WHR,FBG,FINS,HOMA-IR,TG,TC and LDL-C levels(r=0.473—0.732,P< 0.05),and negatively related to HOMA-beta and HDL-C levels(r=-0.774,-0.725,P<0.05). Conclusion Serum homocysteine level is increasing in simple obese children,which is closely correlated with diabetes mellitus and cardiovascular disease.So it is suggested that serum homocysteine level should be monitored regularly in simple obese children.
关键词
同型半胱氨酸 /
单纯肥胖症儿童 /
心血管疾病 /
糖尿病
Key words
homocysteicacid /
simpleobesechildren /
cardiovasculardisease /
diabetesmellitus
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Chung ST,Onuzuruike AU,Magge SN. Cardiometabolic risk in obese children [J]. Ann N Y Acad Sci,2018,1411(1):166-183.
[2] Noguchi H,Tazawa Y,Nishinomiya F,et al. The relationship between serum transaminase activities and fatty liver in children with simple obesity [J]. Acta Paediatr Jpn,2015,37(5):621-625.
[3] Heshmat R,Kelishadi R,Motamed-Gorji N,et al. Association between body mass index and perceived weight status with self-rated health and life satisfaction in Iranian children and adolescents:the CASPIAN-III study[J]. Qual Life Res,2015,24(1):263-272.
[4] Baskaran C,Kandemir N. Update on endocrine aspects of childhood obesity[J]. Curr Opin Endocrinol Diabetes Obes,2018,25(1):55-60.
[5] Krishnappa SK,Yashoda HT,Boraiah G,et al. Sagittal abdominal diameter to measure visceral adipose tissue in overweight or obese adolescent children and its role as a marker of insulin resistance [J]. J Clin Diagn Res,2015,9(11):SC09-SC12.
[6] 陈光泽. 单纯性肥胖成人血浆纤维蛋白原、血脂水平与胰岛素抵抗的关系[J]. 牡丹江医学院学报,2016,37(6):58-60.
[7] 贲秀鸾,季凤华. 儿童单纯性肥胖症与非酒精性脂肪性肝病的相关性研究[J]. 肝脏,2016,21(8):705-707.
[8] Lee SY,Chang HJ,Sung J,et al. The impact of obesity on subclinical coronary atherosclerosis according to the risk of cardiovascular disease [J]. Obes,2014,22(7):1762-1768.
[9] 吴莹,孙金海,岳庆芳,等. 个体化健康管理对单纯性肥胖儿童身体形态、糖脂代谢及C-反应蛋白的影响[J]. 中国儿童保健杂志,2018,26(1):27-31.
[10] Dregan A,Charlton J,Chowienczyk P,et al. Chronic inflammatory disorders and risk of type 2 diabetes mellitus,coronary heart disease,and stroke:a population-based cohort study [J]. Circulation,2014,130(10):837-844.
[11] Park MH,Falconer C,Viner RM,et al. The impact of childhood obesity on morbidity and mortality in adulthood:a systematic review [J]. Obes Rev,2012,13(11):985-1000.
[12] Ravanbakht SN,Skinner AC,Perrin EM. Early prevention and treatment interventions for childhood obesity[J]. Curr Pediat Rep,2017,5(4):199-203.
[13] 滕胜男,杨军. 高密度脂蛋白促胆固醇逆转运作用与冠心病发病的关系[J]. 中西医结合心血管病电子杂志,2017,5(23):20-22.
[14] 陆元方. 脑梗死、颈动脉斑块及高同型半胱氨酸的关系[J]. 卒中与神经疾病,2016,23(2):134-135.
[15] 吴旭龙,赵雯,李晶晶,等. 北京市学龄前儿童单纯性肥胖影响因素研究[J]. 中国儿童保健杂志,2015,23(4):340-343.
[16] 杜梦琳. 不同剂量叶酸片降同型半胱氨酸疗效观察[J]. 中西医结合心脑血管病杂志,2016,14(6):664-665.
基金
深圳市科技基金资助项目(201003138)
PDF(524 KB)
