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【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。
【Objective】 To study the relationship between childhood obesity and metabolic syndrome (MS) components and insulin resistance. 【Methods】 Forty-six obese children [12.6 ± 2.1 years old] selected from pediatric outpatients in our hospital were selected as study subjects and 51 normal weight children (12.5 ± 1.9 years old) as control group. Clinical characteristics and MS components of the differences, and analyze the factors that affect insulin resistance. 【Results】 1) Body mass index (BMI), waist circumference (WC), blood glucose, blood pressure, blood lipid level (including total cholesterol, triglyceride, low density lipoprotein, (P <0.05); 2) The level of HDL-c and HDL-c in obesity group was significantly higher than that in control group 14 cases (30.4%) had high triglyceride (TG), 2 cases (4.3%) had low HDL-c or high non-HDL-c and 3 cases (6.5% 8 (17.4%) in children diagnosed with MS, compared to 2 in normal control subjects (3.9%); 3) Multiple stepwise regression showed that WC (normalized β = 0.432, P <0.01) and TG = 0.207, P <0.05) is an independent factor of insulin resistance. 【Conclusion】 Obese children are prone to different degrees of metabolic abnormalities and are more susceptible to metabolic syndrome. Waist circumference and triglycerides are independent influencing factors of insulin resistance.