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目的研究对肥胖儿童人群中代谢综合征(MS)与血清高敏C-反应蛋白(hs-CRP)之间的关系,探讨hs-CRP在MS发病机制中的作用及在MS诊断、评价中的可能。方法选取2006年6月至2008年3月在天津医科大学总医院儿科门诊确诊的肥胖儿童109例,根据腰围、血压、血脂及糖耐量指标将患儿分为MS组非MS组,进行人体参数测量并收集临床基本资料,测定hs-CRP、血脂,进行口服糖耐量试验和胰岛素释放试验。对上述资料进行统计学分析。结果血清hs-CRP水平MS组高于非MS组(P<0.05);Sperman相关分析提示hs-CRP水平与体重指数(BMI)、腰围、腰围/身高比值(WHtR)、非酒精性脂肪肝情况、胰岛素抵抗指数(HOMA-IR)及MS组分数呈正相关(P<0.05),与血浆HDL-C水平呈负相关(P<0.05)。回归分析表明WHtR(OR=2.708,P<0.05)、BMI(OR=1.169,P<0.05)及腰围(OR=1.145,P<0.05)为hs-CRP水平的显著影响因素。结论提示慢性炎症反应和胰岛素抵抗可能共同参与MS的发病及进展过程,血清hs-CRP水平可作为预计和评价儿童MS的有效指标之一。
Objective To investigate the relationship between metabolic syndrome (MS) and serum high-sensitivity C-reactive protein (hs-CRP) in obese children and to explore the role of hs-CRP in the pathogenesis of MS and its potential in the diagnosis and evaluation of MS . Methods From June 2006 to March 2008, 109 obese children diagnosed in pediatric outpatient department of Tianjin Medical University General Hospital were divided into MS group, non-MS group according to waist circumference, blood pressure, blood lipid and glucose tolerance index, Measurement and collection of basic clinical data, determination of hs-CRP, lipids, oral glucose tolerance test and insulin release test. The above data for statistical analysis. Results Serum hs-CRP levels in MS group were significantly higher than those in non-MS group (P <0.05). Sperman correlation analysis suggested that the correlation between hs-CRP level and BMI, WHR, WHR, , Insulin resistance index (HOMA-IR) and MS group (P <0.05), but negatively correlated with plasma HDL-C level (P <0.05). Regression analysis showed that the hs-CRP levels were significantly affected by WHtR (OR = 2.708, P <0.05), BMI (OR = 1.169, P <0.05) and waist circumference (OR = 1.145, P <0.05). Conclusions Chronic inflammation and insulin resistance may be involved in the pathogenesis and progression of MS. Serum hs-CRP levels may be used as one of the effective indicators for predicting and evaluating MS in children.