肥胖儿童胰岛素抵抗及代谢综合征发病分析

Incidence of insulin resistance and metabolic syndrome in obese children and their correlations

目的探讨肥胖儿童胰岛素抵抗及代谢综合征的发生率,分析两者之间的关系。方法选择保定市第一医院在2015-01至2016-08收治的88例肥胖儿童作为研究对象,进行口服葡萄糖耐量(oral glucose tolerance test,OGTT)试验,并且对儿童的胰岛素水平和血清三酰甘油、高密度脂蛋白、低密度脂蛋白等指标进行测定。结果在88例肥胖儿童中,OGTT正常儿童数量为45例,比例为51.14%。在不正常的结果中,空腹血糖损害9例,占10.23%;糖耐量损伤31例,占35.23%;被诊断为2型糖尿病的3例,占3.41%;血脂指标正常41例,占46.59%。在血脂异常的情况中,高密度脂蛋白降低10例,占11.36%,总胆固醇增高同时伴有低密度脂蛋白增高7例,占7.95%;高密度脂蛋白降低同时伴有低密度脂蛋白增高8例,占9.09%;总胆固醇增高同时伴有高密度脂蛋白降低同时伴有低密度脂蛋白增高21例,占23.86%;61例被诊断成胰岛素抵抗的儿童中,出现脂类代谢异常41例,出现糖类代谢异常38例,被诊断成代谢综合征31例,在胰岛素抵抗儿童与非胰岛素抵抗儿童的比较之中,脂类代谢、糖类代谢和代谢综合征发病率之间,差异均有统计学意义(P<0.05)。结论肥胖儿童中胰岛素抵抗和代谢异常的发生率比较高,需引起高度重视,做好预防工作。

Objective To explore the incidence of insulin resistance and metabolic syndrome in obese children and the relationships between them.Methods Eighty-eight obese children admitted to our hospital between January 2015 and August 2016 were selected as the subjects of this study.OGTT test was carried out and the children’s insulin levels and serum triglycerides,high-density lipoprotein and low density lipoprotein were measured.Results In these 88 cases of obese children,the number of cases with normal indicators of OGTT was 45,accounting for 51.14%of the total.Among the cases with abnormal results,there were 9 cases of fasting blood glucose damage,accounting for 10.23%,31 cases of impaired glucose tolerance that accounted for 35.23%,3 cases diagnosed as type 2 diabetes mellitus that accounted for 3.41%,and 41 cases of normal blood lipids that accounted for 46.59%.Among cases of abnormal blood lipids,there were 10 cases of reduced high-density lipoprotein that accounted for 11.36%and 7 cases of increased triglycerides and low-density lipoprotein that accounted for 7.95%,and 8 cases of decreased high-density lipoprotein accompanied by increased low-density lipoprotein,accounting for 9.09%.There were 21 cases of increased triglycerides and decreased high-density lipoprotein coupled with increased low-density lipoprotein,accounting for 23.86%.Among the 61 cases diagnosed with insulin resistance,abnormal lipid metabolism occurred in 41 cases,carbohydrate metabolism abnormalities in 38 cases,and metabolic syndrome in 31 cases.There were significant differences(P<0.05)in the incidence of lipid metabolism,carbohydrate metabolism and metabolic syndrome between children with insulin resistance and those without.Conclusions The incidence of insulin resistance and metabolic abnormalities is relatively high among obese children,which deserves more attention.