单纯性肥胖儿童脂肪肝、血糖及相关因素的研究

Studies on fatty liver, blood glucose and related factors in simple obese children

目的 探讨单纯性肥胖儿童脂肪肝、血糖及相关因素。方法 采用B超、快速微量血糖仪及其他有关仪器 ,对 6 2名 8～ 11岁儿童 (其中肥胖组 32名、正常组 30名 )进行了肝脏、血糖及有关形态与机能等指标的测定。结果 肥胖组脂肪肝患病率为 93 8% ,对照组为 10 % ,差异有非常显著性 ;肥胖组血糖为 5 42mmol L ,对照组为 4 5 4mmol L ,差异有显著性 ;心功能良好率肥胖组为6 2 5 % ,对照组为 93 3% ,差异有显著性。经相关分析 ,脂肪肝患病率与皮褶厚度、腰臀围比和体质指数均呈显著正相关 ,相关系数分别为 0 8786、0 6 2 5 6和 0 845 4。逐步回归分析表明 ,皮褶厚度和腰臀围比是脂肪肝主要危险因素。血糖与皮褶厚度和体质指数呈显著正相关 ,相关系数分别为 0 34 0 3和 0 315 5。逐步回归分析表明 ,皮褶厚度是高血糖的主要危险因素。结论 单纯性肥胖对儿童的肝脏、糖代谢和心功能均造成危害 ,是成人期心血管病、糖尿病及脂代谢障碍潜在的危险因素。

Objective To study the prevalence of fatty liver, blood glucose and related factors in simple obese children. Methods Their liver was scanned with B-type ultrasound and fasting blood glucose (with a microassay glucometer), as well as other related morphological and functional indices, were measured in 62 children aged 8 to 11 years, including 32 obese ones and 30 control ones. Results Prevalence of fatty liver in obese and control groups was 93.8% and 10%, respectively, with very statistically significant difference (P<0.01). Blood glucose level in obese and control groups was 5.42 mmol/L and 4.54 mmol/L, respectively, with statistically significant difference (P<0.05). Proportion of children with normal cardiac function was 62.5% and 93.3%, respectively, in obese and control groups, with significant difference (P<0.05). The prevalence of fatty liver correlated positively with skin-fold thickness, waist to hip ratio (WHR) and body mass index (BMI), with coefficients of correlation of 0.878 6, 0.625 6 and 0.845 4, respectively (P<0.01). Blood glucose correlated with skin-fold thickness and BMI positively, with coefficients of correlation of 0.340 3 and 0.315 5, respectively (P<0.05). Regression analysis showed that skin-fold thickness and WHR were major risk factor for fatty liver and skin-fold thickness was major risk factor for high blood glucose. Conclusions Simple obesity could cause damage to the liver, glucose metabolism and cardiac function in children, forming the potential risk factors for cardiovascular diseases, diabetes and disturbance of lipid metabolism in adults.