用血糖仪筛查不同年龄段儿童青少年代谢综合征和糖调节异常的可行性

The feasibility study of screening of metabolic syndrome and impaired glucose regulation in overweight and obese children and adolescents using blood glucose meter

目的分析用血糖仪筛查不同年龄段儿童青少年代谢综合征（MS）和糖调节异常（IGR）的可行性。方法根据志愿的原则,以符合MS条件的557例男生和541例女生为超重肥胖组（Ob）、以身体健康的469例男生和446例女生为对照组（NC）,同时进行空腹指末梢血糖（FCBG）、空腹血糖（FBG）、餐后2 h指末梢血糖（2hCBG）、餐后2h血糖（2h BG）和空腹胰岛素（FIns）的检测,然后以7~10岁、11~14岁和15~18岁3个年龄段对两组检测数据进行统计分析。结果 （1）男女生各年龄段Ob组与NC组分别比较,收缩压、舒张压、FCBG、FBG、2hCBG、2h BG、末梢血空腹血糖受损（CIFG）、静脉血空腹血糖受损（IFG）、末梢血糖耐量低减（CIGT）、静脉血糖耐量低减（IGT）、FIns、胰岛素抵抗指数（IR）和胰岛素敏感指数（IS）差异均有统计学意义（P〈0.05或P〈0.01）;末梢血IFG检出率均高于静脉血IFG的检出率,而末梢血IGT检出率均低于静脉血IGT的检出率。7~10岁年龄段Ob组男生的IFG发生率高于女生Ob组约20%;11~14岁年龄段Ob组女生的IFG发生率高于男生Ob组约12%;15~18岁年龄段Ob组男女生的IFG发生率接近。（2）IFG、IGT末梢血法与静脉血法分别相比,男生差异无统计学意义（均P〉0.05）;女生差异无统计学意义（均P〉0.05）。结论在保证血糖仪工作稳定性和准确性的情况下,用血糖仪筛查不同年龄段儿童青少年代谢综合征和糖调节异常是可行的。

Objective To evaluate the feasibility of MS and TGR screening in overweight and obese children and adolescents by measuring the FGB and 2hBG using the blood glucose meter and automatic biochemistry analyzer.Methods From May to October 2010,6096 middle school students aged 7 to 18 in city of Donguan were censured.The fingertip fasting capillary glucose was screened by blood glucose meter.Students who met any abnormal indexes were included in MS group.On the basis of voluntary principle,557 male students and 541 female students,who conformed to MS,were assigned into overweight group（Ob）;while 469 male health students and 446 female health students were assigned into normal control（NC） group.FCBG,FBG,2hCBG,2hBG and Fins were measured at the same time.Subgroup analysis was carried out according to different age groups（7-10ys,11-14ys and 14-18ys）.Results 1.Significant impairments were revealed with striating analysis according to different age groups and genders in systolic pressure,diastolic pressure,FCBG,FBG,2hCBG,2hBG,CIFG,IFG,CIGT,GT,Fins,IR and IS in Ob group,comparing with those in NC group（P0.05）.Although significantly higher detection rate of IFG was revealed in fingertip blood than that in vein blood,lower detection rate of IGT was found.IFG prevalence was higher in male than female by 20 and 12% at the age of 7-10ys and 11-14ys,respectively,in Ob group.However,no difference was revealed in IFG prevalence between male and female with age of 15-18ys in Ob group.2.No significant difference was revealed in IFG or IGT detection between fingertip blood and venous screenings in male or female groups（P0.05）.Conclusion Screening of metabolic syndrome and the impaired glucose regulation situation in overweight and obese in children and adolescents is feasible.