儿童代谢综合征尿酸变化及其与心血管危险因素的关系

Serum uric acid and its correlation with cardiovascular risk factors in children with metabolic syndrome

目的探讨肥胖代谢综合征儿童血清尿酸(SUA)水平与心血管疾病危险因素之间的相关性。方法肥胖儿童157例,代谢综合征(MS)77例,非代谢综合征(非MS)80例。分析两组患儿人体测量参数、血尿酸、血脂、血糖及胰岛素等指标间差异,观察SUA与人体测量参数、血压、糖脂代谢紊乱的相关性,并对影响SUA水平的指标进行多元逐步回归分析。结果MS组血尿酸、腰围、血压、三酰甘油(TG)均高于非MS组,高密度脂蛋白胆固醇(HDL-C)低于非MS组(P<0.05)。Spearman相关分析提示SUA水平与体质指数、腰围、腰围身高比、舒张压、收缩压、空腹胰岛素水平、胰岛素抵抗指数(HOMA-IR)、TG及患儿已表现出的MS组分个数呈正相关(P<0.05);与HOMA-IS及HDL-C呈负相关(P<0.05)。结论MS儿童除血压、血脂、血糖异常,也伴有嘌呤代谢紊乱。腰围、TG、舒张压、HDL-C为SUA水平的重要影响指标。高尿酸血症与中心性肥胖、高血压、高血脂关系密切。SUA水平增高可能成为心血管疾病的一个重要的危险因素,参与心血管相关疾病的发生、发展过程。

Objective To study the relationship between serum uric acid （SUA） and cardiovascular risk factors in children with obese metabolic syndrome. Methods Data of 157 obese patients including 77 with metabolic syndrome （MS） and 80 withOUt MS were studied. Anthropometrics, SUA, lipid profiles, glucose an＇d insulin concentration were determined. The differences of these parameters between these two groups and the cprrelation of SUA with other parameters were analyzed. Multiple stepwise regression analysis was done to study the parameters affecting SUA Results, In comparison with children without MS, SUA, waist circumference （WC）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） anti serum triglyceride （TG） were higher, while serum high density lipoprotein cholesterol （HDL-C） was lower in children with MS （P 〈 0.05）. The SUA concentration was positively correlated with body mass index, WC waist and height ratio, SBP, DBP, homeostasis model of insulin resistance （HOMA-IR） , fasting insulin level and TG （P 〈 0.05）, and negatively correlated with HOMA-IS and HDL-C （P 〈 0.05）. Conclusions Except for changes of blood pressure, serum lipids and glucose, purine metabolic disorders were also found in children with MS. WC, TG, diastolic pressure, HDL-C was significantly correlated with central obesity, hypertension, and hyperglycemia. SUA concentration, suggesting hyperuricemia was associated with SUA could be one of the risk factors in the development of cardiovascular diseases.