儿童肥胖与代谢综合征的相关性研究

Study on relativity of children obesity and metabolism syndrome

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 investigate the relativity of children obesity and some indexes of metabolism syndrome. [Methods] 69 volunteers with obesity were randomly selected as obesity group, 30 normal volunteers matching in sex and age as control group, out of 13,702 children and adolescents （2-18 years old） in Xiangtan city. Their index of body weight （IBM）, blood pressure （BP）, blood lipid （BL）, hypersensitive C-reactive protein （hsCRP）, leppin （LP）, fasting blood glucose （FBG）, fasting pure insulin （INS）, blood uric acid （UA）, and liver B-ultrasound were examined, and their mean artery pressure （MAP） and insulin sensitive index （ISI） were calculated on the basis of blood pressure and fasting pure insulin respectively, and then the differences of the indexes between two groups were compared and the relativity of the indexes was analyzed. [Results] The incidence of fatty liver, the values of MAP, triglyceride （TG）, Apolipoprotein-B （APO-B）, hsCRP, INS, LP and UA were significantly higher in obesity group than in control group （P 〈0.01）, while the values of Apolipoprotein-A （Apo-A） and ISI were significantly lower in obesity group than in control group （P 〈0.01）. The value of hsCRP was significantly positively correlative to those of FBG and INS （P 〈0.05 or P 〈0.01）, while it was significantly riegatively correlative to that of ISI; the value of LP was significantly positively correlative to those of BMI and INS （P 〈0.01）, while it was significantly negatively correlative to that of ISI; the value of INS was significantly positively correlative to that of BMI （P 〈0.01）, while it was significantly negatively correlative to that of ISI; the value of UA was significantly positively correlative to those of BMI and INS （P 〈0.01）, while it was significantly negatively correlative to that of ISI. [Conclusions] Insulin resistance （IR）, LP resistance （LR）, compensatory hyperinsulinemia, liver injury, hyperlipidemia, hypertension, hyperuricacidemia may exist in the children with obesity, and some inflammatory factors such as hsCRP may play an important role in pathogenesis of children obesity.