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目的探讨儿童肥胖与代谢综合征(MS)各指标的相关性。方法抽样调查湘潭市13,702名2～18岁儿童及青少年,将69名肥胖自愿者及30名年龄、性别相匹配的自愿受试者分为两组,分别测体重指数(BMI)、血压、计算平均动脉压(MAP),测血脂、超敏C反应蛋白(hsCRP)、瘦素(LP)、空腹血糖(FPG)、空腹纯胰岛素(INS),计算胰岛素敏感指数(ISI)、血尿酸(UA)、肝脏B超,比较两组差异及各指标的相关性。结果肥胖组B超检查脂肪肝等肝脏异常发生率显著高于对照组(χ2=6.47,P=0.01);MAP显著高于对照组(P<0.01);甘油三酯(TG)显著高于对照组(P<0.001);载脂蛋白A(Apo-A)显著低于对照组(P<0.005);载脂蛋白B(Apo-B)显著高于对照组(P<0.005);肥胖组hsCRP、INS、LP、UA显著高于对照组(P<0.001),ISI显著低于对照组(P<0.001);hsCRP与FPG、INS呈显著正相关(P<0.05～0.001),与ISI呈显著负相关(P<0.001);LP与INS、BMI呈显著正相关(P<0.001),与ISI呈显著负相关(P<0.001),INS与BMI呈显著正相关(P<0.001),ISI与BMI呈显著负相关(P<0.001),UA与INS(P<0.001)、BMI(P<0.005)呈显著正相关,与ISI(P<0.001)呈显著负相关。结论肥胖儿童存在胰岛素抵抗(IR)、瘦素抵抗(LR)及代偿性高胰岛素血症,同时存在肝脏受损、脂代谢紊乱、血压、血UA升高。CRP等炎症因子在肥胖发病过程中可能起重要作用。
Objective To explore the correlation between childhood obesity and metabolic syndrome (MS). Methods A total of 13,702 children and adolescents aged 2-18 years in Xiangtan City were sampled and divided into two groups according to 69 obese volunteers and 30 age and sex matched volunteers. Body mass index (BMI), blood pressure Mean arterial pressure (MAP), serum lipid, hsCRP, LP, FPG, INS, ISI, UA ), Liver B ultrasound, the differences between the two groups and the correlation between the indicators. Results The incidence of liver abnormalities such as fatty liver in obese group was significantly higher than that in control group (χ2 = 6.47, P = 0.01); MAP was significantly higher than that in control group (P <0.01); triglyceride (TG) (P <0.001); Apo-A was significantly lower in the obesity group than in the control group (P <0.005); Apolipoprotein B (Apo-B) , INS, LP, UA were significantly higher than those in control group (P <0.001), ISI was significantly lower than that in control group (P <0.001); hsCRP was positively correlated with FPG and INS There was a significant positive correlation between LP and INS, BMI (P <0.001), negative correlation with ISI (P <0.001), INS and BMI (P <0.001) BMI (P <0.001). There was a significant positive correlation between UA and INS (P <0.001), BMI (P <0.005), and negative correlation with ISI (P <0.001). Conclusion There are insulin resistance (IR), leptin resistance (LR) and compensatory hyperinsulinemia in obese children, with liver damage, dyslipidemia, blood pressure and blood UA elevated. Inflammatory cytokines such as CRP may play an important role in the pathogenesis of obesity.