肥胖儿童糖脂代谢与膳食摄入

Carbohydrate and lipid metabolism and dietary intake in obese children

目的分析肥胖儿童糖脂代谢异常情况及其膳食结构。方法入选门诊肥胖患儿57例,男41例、女16例,年龄7～16岁。测定其人体成分、血压、血脂、血糖和胰岛素,其中21例进行连续3d的膳食调查。结果 57例患儿中共有34例(59.6%)血糖和(或)血脂代谢异常。体质指数(BMI)与空腹胰岛素(FINS)、餐后2h胰岛素(2hINS)、胰岛素抵抗指数(IRI)、腰臀比、收缩压(SBP)和舒张压(DBP)呈正相关。糖脂代谢异常组患儿的SBP、血三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)明显高于糖脂代谢正常组(P<0.05);糖脂代谢异常的患儿膳食中饱和脂肪酸(SFA)和单不饱和脂肪酸(MUFA)摄入明显高于代谢正常的患儿(P均<0.05),而多不饱和脂肪酸(PUFA)的摄入则低于代谢正常的患儿(P<0.05)。结论肥胖儿童普遍存在糖脂代谢紊乱、脂肪酸摄入不合理。

Objective To investigate the abnormal carbohydrate and lipid metabolism and the dietary pattern in obese children.Methods The body composition,blood pressure,lipidemia,glycemia and insulin were measured in 57 obese children（41 boys and 16 girls） aged 7-16 years old in the obese out-patient service.Twenty-one of them accepted the investigation of dietary intake for three consecutive days.Results The dysglucosemia and/or dyslipidemia were found in 34 cases（59.6%） of 57 obese children.The body mass index（BMI） was positively correlated with fasting insulin,2 hour insulin,insulin resistance index,waist hip ratio,systolic blood pressure（SBP） and diastolic blood pressure（DBP）.The SBP,total triglyceride（TG）,and low-density lipoprotein cholesterol（LDL-C） in children with dysglucosemia and/or dyslipidemia were significantly higher than those in children without metabolic disturbance（P〈0.05）.Furthermore,there were a higher intake of the saturated fatty acid（SFA） and the monounsaturated fatty acid（MUFA）（P = 0.028,P = 0.038） and a lower intake of the polyunsaturated fatty acid（P = 0.010） in children with dysglucosemia and/or dyslipidemia compared to those in children without metabolic disturbance.Conclusions The metabolic disturbance of carbohydrate and lipid and unreasonable intake of fatty acid are commonly seen in obese children.