单纯性肥胖儿童糖耐量异常的特点及相关因素分析

The Characteristics of Impaired Glucose Tolerance and Related Factors in Obese Children

目的分析肥胖儿童糖耐量异常的特点,探究胰岛素和胰高血糖素分泌异常及相关因素在肥胖儿童糖代谢紊乱中的作用。方法选择2009年1月至2010年12月于西安市长安区妇幼保健院就诊的单纯性肥胖患者60例,选择同期门诊健康体检儿童30例作为健康对照组,对受试儿童进行口服糖耐量试验,测定空腹、2 h血糖胰岛素及胰高血糖素,同时测量其身高、体质量、血压、腰围臀围,计算体质量指数(BMI)、胰岛素抵抗指数及胰岛细胞功能指数。通过检测受试儿童糖耐量,判断空腹血糖受损和糖耐量受损情况,再将其列为两个受损组与健康对照组进行分析比较。结果糖耐量异常19例(31.7%)。三组空腹血糖、空腹胰岛素比较差异有统计学意义(P<0.05),三组2 h血糖、2 h胰岛素及2 h胰高血糖素水平比较差异均有统计学意义(P<0.05)。与对照组相比,空腹血糖受损组与糖耐量受损组BMI、腰围、臀围、腰臀比、收缩压均显著升高(P<0.05)。结论胰岛素及胰高血糖素分泌紊乱,共同参与了肥胖儿童糖耐量异常的发生,肥胖是糖耐量受损的重要危险因素。

Objective To analyze the characteristics of abnormal glucose tolerance in obese children, and explore the function of abnormal insulin and glucagon secretion and related factors in glucose metabolism disorder of obese childeren. Methods In our experiment,60 cases of obese children and 30 normal-weight children from Maternal and Child Health Hospital of Changan District during Jan. 2009 and Dec. 2010 were collected,they underwent an oral glucose tolerance test. Fasting and 2-hour glucose, insulin, and glucagon were tested, and their height, weight, blood pressure, waist circumference, hip circumference were measured. Then body mass indexes（BMI）, insulin resistance index（IR） and islet cell function indexes were calculated. The impaired fasting glucose and impaired glucose tolerance were judged by examining children glucose toler- ance,and they were set as two groups of damage and compared with the control group. Results The impaired glucose tolerance（IGT） constituent ratio was 31.7%. The fasting glucose ,fasting insulin differences between the three group were statistically significant （ P 〈 O. 05 ）, 2 h blood glucose, insulin and glucagon levels between the three groups were statistically significant （ P 〈 0.05 ）. Compared with the control group, BMI,waist circumference, hip circumference, waist-hip ratio, and systolic blood pressure of the impaired fating glucose group and IGT group were significantly increased （ P 〈 0. 05 ）. Conclusion The abnormal glubose tolerance is influenced by insulin and glucagon secretion disorder in obese children. Obesity is a major.risk factor for IGT.