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目的探讨单纯性肥胖(肥胖)患儿胰岛素抵抗与血脂的关系。方法选取肥胖患儿50例为肥胖组(男23例,女27例),同期健康儿童30例为健康对照组(男14例,女16例)。对每位对象采用同一磅秤标准,测量其身高、体质量,并计算其体质量指数(BMI)。采用儿童标准血压测定法测定2组儿童血压。采用发光免疫法、快速测血糖法分别对2组儿童的血糖、血胰岛素、血脂进行检测,并计算稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-ISI)、胰岛素和葡萄糖曲线下的面积比值反映组织对胰岛素的敏感性(AUC)、肝脏组织对胰岛素的敏感性(FINS/FBG),并应用SPSS12.0软件进行统计学分析。结果与健康对照组比较,肥胖组患儿HOMA-IR、AUC、FINS/FBG均显著增高(t=3.939、6.314、3.723,Pa<0.01),空腹三酰甘油(TG)亦显著增高(t=2.573,P<0.05),高密度脂蛋白(HLD)、HOMA-ISI显著低于健康对照组(t=-2.982、-4.75,P<0.05、0.01)。多因素Pear-son相关分析显示,肥胖组TG与HOMA-IR、AUC、FINS/FBG呈显著正相关(r=0.392、0.553、0.371,Pa<0.05);TG与HOMA-ISI呈负相关(r=-0.392,P<0.05)。结论肥胖患儿存在脂代谢紊乱,血清TG与肥胖患儿的胰岛素抵抗密切相关,肥胖患儿血脂增高影响了组织对胰岛素的敏感性。
Objective To investigate the relationship between insulin resistance and blood lipids in children with simple obesity (obesity). Methods Fifty obese children were selected as obese group (23 males and 27 females), and 30 healthy children in the same period were healthy controls (14 males and 16 females). The same scales were used for each subject, their height and body mass were measured, and their body mass index (BMI) was calculated. Blood pressure was measured in two groups of children using standard pediatric blood pressure test. The levels of blood glucose, blood insulin and blood lipids were detected by luminescence immunoassay and rapid blood glucose test. The homeostasis model insulin resistance index (HOMA-IR), insulin sensitivity index (HOMA-ISI), insulin and glucose The area ratio under the curve reflected the tissue sensitivity to insulin (AUC) and the sensitivity of liver tissue to insulin (FINS / FBG), and the statistical analysis was performed using SPSS12.0 software. Results Compared with healthy control group, the levels of HOMA-IR, AUC and FINS / FBG were significantly increased in obese children (t = 3.939,6.314,3.723, Pa <0.01) and fasting triglyceride (TG) 2.573, P <0.05). The levels of HLD and HOMA-ISI were significantly lower than those in healthy controls (t = -2.982, -4.75, P <0.05,0.01). Multivariate Pear-son correlation analysis showed that there was a significant positive correlation between TG and HOMA-IR, AUC and FINS / FBG (r = 0.392,0.553,0.371, Pa <0.05) in obesity group; TG was negatively correlated with HOMA- = -0.392, P <0.05). Conclusion Lipid metabolism disorder exists in obese children. Serum TG is closely related to insulin resistance in obese children. Increased blood lipids in obese children have an impact on tissue insulin sensitivity.