儿童青少年超重及肥胖与代谢综合征的相关性研究

The Relationship between Obesity and Metabolic Syndrome in Children and Adolescents

目的探讨儿童青少年超重肥胖与代谢综合征(MS)的相关性,为MS的早期干预提供参考。方法回顾性分析2007-2010年本院小儿内分泌门诊就诊的57例超重及155例肥胖儿童青少年的临床资料[血压、腰围、空腹血糖(FPG)、空腹血胰岛素(FINS)、血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)],以国际糖尿病联盟(IDF)的青少年MS定义为诊断标准计算MS检出率,并与同期常规体检的年龄性别匹配的228例非超重肥胖健康者进行比较。结果 (1)超重组、肥胖组与对照组比较,腰围、血压及FPG、TG、TC、LDL-C等多项糖脂代谢指标差别有统计学意义(P<0.05),但HDL-C各组间差别无统计学意义。(2)超重组、肥胖组与对照组比较,除HDL-C外其余MS各组分检出率升高,差别有统计学意义,检出率随体质量指数升高逐渐增加(趋势检验P<0.01)。(3)对照组未检出MS患者,超重组检出MS 3名(5.3%),肥胖组检出MS 56名(36.1%),MS检出率随体质量指数升高而增加(趋势检验P<0.01)。(4)超重组、肥胖组Lg HOMA-IR和Lg HOMA-β均较对照组升高(P<0.01)。(5)胰岛素抵抗指数与MS各单项指标显著相关(P均<0.01)。结论超重肥胖儿童青少年MS发生率较正常体质量者显著升高。儿童青少年超重肥胖与MS的发生密切相关,应重视并积极防治。

Objective To explore the relationship between obesity and metabolic syndrome（MS） in children and adolescents.Methods The clinical data of 57 overweight and 155 obese adolescents and 228 normal controls were extracted from the medical recorders.The incidences of MS among the three groups were compared,and the trend analysis was performed.Results（1）The levels of waist circumference（WC）,blood pressure（BPs）,FPG,serum TG,TC,LDL-C in overweight and obese group were higher than those of the control group（P0.05）,but the level of HDL-C had no statistic difference.（2）The prevalence of individual MS component increased with BMI（P0.01）.（3）No MS case was found in control group.The incidences of MS were 5.3% and 36.1% in overweight and obese group respectively.With the increasement of BMI,the incidences of MS increased remarkably（P0.01）.（4）The LgHOMA-IR and LgHOMA-β of overweight and obese group were higer than those of the control group（P0.01）.（5）HOMA-IR had positive relationship with WC,BPs,FPG and TG.Conclusions The overweight and obese children and adolescents have higher incidence of MS than those with normal body weight.There is close relationship between obesity and MS in children and adolescents.