代谢综合征组分聚集对儿童青少年动脉顺应性的影响

Association of metabolic syndrome and arterial compliance in children and adolescents

目的探讨儿童青少年代谢综合征(MS)与动脉顺应性(AC)的改变是否有联系。方法对2004年北京市儿童青少年MS研究中筛查出的部分高危儿童进行MS诊断和病例分组(197例),并选择非高危儿童140人为对照组。对上述337人[男188人,女149人,平均(10．95±3．01)岁]进行如下指标检测:体重指数、腰围、血压、血糖、血脂和胰岛素,并计算胰岛素抵抗简易估测指数(HOMA-IR);采用PulseTrace指端血流脉搏波检测仪测定动脉硬化指数(SI),以此判断被测者AC的情况。结果 MS患儿的SI平均为(7．69±1．63)m·s-1,高于对照组[(6．25±0．86)m·s-1](P<0．01)。随着 MS组分聚集的增多,SI逐渐上升,HOMA-IR也逐渐增加;除了MS单一组分的SI与对照组差异无统计学意义外(P> 0．05),其他各组间的差异均有统计学意义(P<0．01)。控制性别、年龄和青春期发育的影响后,SI与MS组分的聚集度及 HOMA-IR的偏相关系数分别为0．309 2和0．215 5(P均<0．001)。结论 MS患儿的AC显著下降,且随着MS组分聚集, AC下降趋势显著。进行儿童AC的筛查将对心血管疾病的早期预防工作有重要意义。

Objective To explore the association between metabolic syndrome （MS） and arterial compliance （AC） in children and adolescents. Methods Three hundred and thirty-seven subjeets （ male 188, female 149 ） aged 6 - 18 （ 10.95 ±3.01 ） year were divided into three subgroups （ including one component,two components,three ＆ more components respectively） and one control group based on the Cook＇s definition. Measurements including anthropometry, blood pressure,fasting plasma glucose and insulin,serum lipid profile were collected. HOMA-IR index was calculated for estimating individual insulin resistance. AC was measured using digital pulse wave analyzing method from the pulse trace machine （Micro Medical, London）, and then the stiffness index （ SI ） was determined. Results The mean value of SI in MS group was significantly higher than that in control group [ （7.69± 1.63 ） m·s^-1 vs （6.25 ±0. 86） m· s^-1, p 〈 0. 01 ） ]. With the increasing of the clustering of MS components, SI and HOMA-IR were gradually increased. After taking account of gender, age and pubertal development, the partial correlation analysis showed that the amount of components of MS and HOMA-IR were positively correlated with SI （ both P values were less than 0. 001）. Conclusions The AC was significantly lowered in children and adolescents with MS, and with the increasing of the clustering of MS components, AC was gradually decreased. AC assessment in children and adolescents is important in implementing the early prevention for cardiovascular disease.