单纯儿童肥胖胰岛素抵抗与血流动力学变化

Insulin Resistance and Hemodynamic Changes in Simple Childhood Obesity

目的探讨单纯儿童肥胖胰岛素抵抗与血流动力学变化的状况,找到预防与治疗儿童肥胖症的方法。方法选择100例采用身高标准体重法评价的肥胖儿童,按评定标准分成轻度肥胖24例,中度肥胖20例,重度肥胖14例,30例正常儿童作为对照组。肥胖组与对照组儿童均测定身高体重、血压、血糖及胰岛素,血液流变学的指标。结果肥胖组和对照组收缩压、舒张压之间有非常显著差异(P<0.001),肥胖组与对照组FIS、1hIS、2hIS、MIS值比较,除轻度肥胖FIS、1hIS值外,其他两组均有显著差异(P<0.05,P<0.01,P<0.001)。AUC值及FIS/FGS值比较,两组全部有显著差异(P<0.05,P<0.001)。两组全血粘度(高切)、全血粘度(中切)、全血粘度(低切)、血浆粘度、红细胞聚集指数、红细胞刚性指数、红细胞电泳指数均有显著差异(P<0.05,P<0.01,P<0.001)。结论单纯肥胖儿童有血压升高、胰岛素抵抗、血液流变学指标异常的临床表现,对肥胖儿童应引起重视,防治动脉硬化、高血压、糖尿病应从儿童时期做起。

Objeetive To investigate insulin resistance and hemodynamic changes for simple childhood obesity to find the prevention and treatment approach of childhood obesity. Methods 100 children with simple obesity were evaluated according to assessment criteria of the standard weight, they were divided into 24 cases of obesity mild, 20 cases of moderate obesity, 14 cases of severe obesity. 30 cases of normal children were as a control group. Height and weight, blood pressure, blood glucose and insulin （FIS, 1hIS, 2hIS, MIS, AUC, FIS/FGS）, hemorheology indicators were measured in ehildren of obesity group and control group. Results Systolic blood pressure and diastolic blood pressure were a very significant difference between obesity and control groups（P〈 0.001 ）. FIS, 1hIS, 2HIS, MIS, 1hIS value in obesity group and control group,exception of mild obesity FIS,the other values in two group are significant differences（P〈 0.05,P〈 0.01 ,P〈 0.001 ）. AUC values and FIS/FGS all have significant differences between two groups（P 〈 0.05, P 〈 0.001 ）. Whole blood viscosity（high-cut）, whole blood viscosity （cut）, whole blood viscosity （low-cut）, plasma v/scosity, red blood cells rigid index, index of rigid red blood cells, red blood cell electrophoresis index were significantly different in two groups（P〈 0.05,P〈 0.01 ,P〈 0.001 ）. Conclusion Our study shows that obese children are simply high blood pressure, insulin resistance, abnormal blood rheology indicators of performance, the obese children should pay attention, prevention and treatment of arteriosclerosis, high blood pressure, diabetes should start with children period.