肥胖儿童脂肪餐后血脂动态变化与体质量指数相关性研究

Dynamic Changes of Serum Lipids and Relationship with Body Mass Index after Fat Diets in Obese Children and Adolescents

目的探讨肥胖儿童脂肪餐后血脂的动态变化及其与体质最指数的相关性。方法根据体质量指数(BMI),选择肥胖儿童31例和对照组30例进行脂肪餐耐量试验,测定空腹及餐后2、4、6、8h血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白AI、B(apoAI、apoB)和磷脂(PL)。结果肥胖组空腹和餐后TG均显著高于对照组(P<0.001),其餐后TG平均达高峰时间(3.87h)显著长于对照组(3.07h)(P=0.003)。对照组46.7%在餐后2h、53.3%在4h达高峰;而肥胖组12.9%在2h、83.9%在4h、3.2%在8h达高峰。肥胖组平均TG峰值、TG曲线下面积(TG—AUC)和TG峰反应(TGPR)分别为3.08mmol/L、10.90mmol/L、1.75mmol/L,均显著高于对照组(P<0.001)。TG与BMI呈显著正相关。肥胖组45.2%餐后8h仍偏高。肥胖组和对照组脂肪餐后PL表现出与TG类似的反应曲线,肥胖组餐后TC、HDL-C、LDL-C、apoB也有不同程度改变。结论肥胖儿童TG廓清速率减慢,脂肪清除能力降低,可能足儿童代谢综合征的重要原因。

Objective To explore dynamic response of serum lipids and relationship with body mass index（BMI）after fat meal in obese children and adolescents. Methods The subjects were 31 obese children and adolescents （BMI ≥25 kg/m^2） and 30 controls （BMI 〈 23 kg/m^2）. Morning fasting venous blood specimens were collected from each child. After fat meal, blood specimens were taken at 2,4,6 and 8 hours, respectively. The serum triglyceride （TG）, total cholesterol （TC）, high density lipoprotein cholesterol （HDL- C）, low density lipoprotein cholesterol （LDL - C）, apolipoprotein AI and B （apoAI, apoB） and phospholipids （PL） contents were analyzed for each specimen. Results Fasting and postprandial TG value in obese group was significantly higher than those in control group （ P〈0. 001 ）. The average peak time of postprandial TG response corves in obese group （3.87 h） was significantly slower than in control group （3.07 h） （P = 0. 003）. Forty - six point seven percent controls reached its peak at 2 hours and 53.3% at 4 hours. Tweleve point nine percent obeses reached its peak at 2 hours, eighty - three point nine percent at 4 hours and 3.2 % at 8 hours. The average TG peak value,area under triglyceride curve （TG - AUC）and triglyceride peak response （TGPR） for obese group were 3.08 mmol/L, 10.90 mmol/L and 1.75 mmol/L, respectively. These results in obese group were significantly higher than those in control group （ P〈0. 001 ）. The values of TG was significantly positively correlated with the values of BMI. The TG value of 45.2% obeses was still higher at 8 hours. Postprandial PL response curves for obese and control groups were similar to TG. Some changes were revealed for the postprandial TC, HDL - C, LDL - C and apoB in obese group. Conclusions The clearance of triglycerides is delayed in obese children and adolescents, which means that the capacity for fat removal is decreased. It might be an important cause of metaholic syndrome