超重肥胖儿童空腹胰岛素水平与高血压病家族史的关系

Fasting insulin level and hypertensive family history in overweighted children

为分析儿童血清胰岛素水平与体质指数 (BMI)、血压、血脂的关系 ,探讨高血压家族史对儿童血清胰岛素水平的影响 ,在北京城区 4所小学中随机选出 317名 8～ 11岁健康儿童 ,其中超重肥胖儿童 74名 ,非超重儿童 2 43名 ,均进行身体测量及血脂、胰岛素检测 ,并记录一级或二级亲属中的高血压病史。结果显示 ,在对年龄、性别修正后 ,超重肥胖儿童与非超重儿童相比 ,血压、胰岛素、总胆固醇及甘油三酯水平显著升高(P<0 .0 1) ,高密度脂蛋白 /低密度脂蛋白、载脂蛋白 A /载脂蛋白 B显著下降 (P<0 .0 1) ;在对 BMI修正后 ,胰岛素与甘油三酯、收缩压偏相关系数分别为 0 .2 0 (P<0 .0 1)和 0 .12 (P<0 .0 5 )。超重肥胖儿童中 ,有高血压家族史者血清胰岛素水平显著高于无高血压家族史者 (P<0 .0 1) ,但在非超重组中该差异无显著性 (P=0 .5 18)。结论 :高血压家族史与超重儿童血清胰岛素水平升高有关 ,而后者可能参与了超重儿童部分代谢紊乱的发生。

In order to analyze the relationship between fasting insulin level and body mess index (BMI), blood pressure and lipids, and to discuss the effect of hypertensive family history, 317 healthy children aged 8-11 years including 74 overweighted and 243 non overweighted were selected randomly from 4 primary schools in Beijing. Anthropometry, fasting insulin and lipids were measured, and the family history of hypertension (FHH) was recorded. After adjusting of age and sex, the levels of blood fasting insulin, cholesterol and triglyceride were significantly higher ( P <0 01) and the ratio of HDL/LDL and apoA/apoB were significantly lower ( P <0 01) in the overweighted than that in non overweighted children. After controlling BMI, the partial correlation coefficients between fasting insulin and TG, systolic pressure was 0 20 ( P <0 01) and 0 12 ( P <0 01) respectively. Moreover, among the overweighted children, but not among non overweighted children, those with FHH had a significantly higher fasting insulin than those without FHH ( P <0 01). It is concluded that hypertensive family history may play an important role in contributing to the higher level of serum insulin of overweighted children, and higher serum insulin may concerted with some metabolic disorders in overweighted childen.