肥胖儿童代谢综合征临床特征及其代谢异常情况分析

Metabolic syndrome in childhood obesity and its characteristic of metabolic abnormality in a single centre outpatients from 2008 to 2010

目的分析肥胖儿童代谢综合征发生过程的临床特征及代谢异常发生情况。方法以本院儿科门诊2008-2010年确诊为单纯性肥胖症的患者为研究对象,检测空腹血糖、空腹血脂,计算胰岛素抵抗指数。采用我国2012年6月最新制定的中国儿童青少年代谢综合征定义及诊断建议,根据满足上述指标数量的不同,将患者分为单一指标组、两项指标组和代谢综合征组进行分析比较。结果共88例肥胖儿童,其中63例≥10岁,平均年龄(11.60±1.47)岁,患代谢综合征者8例,占12.70%,伴有1项代谢综合征指标者28例,占44.44%;伴2项代谢综合征指标者24例,占38.09%。代谢综合征组患儿FPG、HOMA-IR水平均比单一指标组和两项指标组明显升高(P均<0.05)。三组患者检出率最高者均为中央型肥胖。代谢综合征组和两项指标组TG水平无明显差异,但均比单一指标组高(P均<0.01),6岁≤年龄<10岁肥胖儿童共25例,其中男性11例,女性14例,平均年龄(7.81±0.8)岁,11例(44%)具备2项心血管疾病危险因素。结论肥胖儿童患者代谢综合征的检出率高。脂代谢紊乱和胰岛素抵抗导致的糖代谢异常是肥胖儿童代谢综合征的突出表现。中央型肥胖可能是引起其他代谢异常的主要原因。高TG血症可能是中央型肥胖引起糖代谢异常的中间环节。

Objective To investigate the prevalence of metabolic syndrome in obese children and adolescents and the clinical characteristic in outpatient. Method According to the newest diagnosis criteria of metabolic syndrome in children in China,the databases of the clinical and experimental characteristics in simple obesity children and adolescents diagnosed from 2008 to 2010 in the First Affiliated Hospital of SUN Yat-sen University were analysed. Results Eighty-eight pa- tients with simple obesity were enrolled in the study,63 were above 10 years old 60 had at least one component of metabolic syndrome,8 （12.7%） were diagnosed as metabolic syndrome,28 （44.44%） had one component,24 （38.09%） had 2 com- ponents. Among 88 obese children,25 were aged 6 to 10 year-old,of which, 11 （44%） had cardiovascular risk factors. Conclusions Obese children in outpatient has high prevalence of the metabolic syndrome. There are high prevalences of in- sulin resistance,hyperinsulinemia and impaired fasting glucose in patients with the metabolic syndrome.