肥胖儿童代谢综合征临床特征及其代谢成分异常的相关性分析

Metabolic Syndrome in Childhood Obesity and Its Characteristic of Metabolic Abnormality in a Single Centre Outpatients

【目的】分析大于6岁肥胖儿童代谢综合征的临床特征及其代谢成分异常的相关性分析。【方法】收集2008-2011年在我院儿科门诊确诊为单纯性肥胖症的儿童的临床资料,检测空腹血脂、空腹血糖,计算胰岛素抵抗指数。以我国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为标准,根据其代谢异常指标数量的不同,将>6岁的肥胖儿童分为1项指标组、2项指标组和≥3项指标组进行比较分析。【结果】>6岁的单纯性肥胖儿童119例,其平均年龄(10.7±2.1)岁,≥3项指标组21(17.65%)例,2项指标组47(39.50%)例,1项指标组51(42.86%)例。≥3项指标组儿童TG、non HDLC、HOMA-IR水平均比1项指标组和2项指标组明显升高(P均<0.05)。三组肥胖儿童均为中央型肥胖。相关性分析:肥胖儿童non HDLC与TC、LDC-C、TG、代谢指标异常数目呈正相关;NAFLD与FINS、HOMA-IR等呈正相关。【结论】代谢综合征的检出率高。肥胖儿童均存在中央型肥胖,其可能是引起其他代谢异常的始动因素,高non HDLC血症是主要的脂代谢紊乱,胰岛素抵抗、高胰岛素血症导致非酒精性脂肪性肝病的主要因素。

[ 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 2011 in the First Affiliated Hospital of SUN Yat-sen University were analyzed. [Results] 119 patients with simple obesity were enrolled in the study, all were above 6 years old. 51 （42.86%） had at least one component of metabolic syndrome, 47 （39.50%） had two components. 21 （17.65%） had more than two components of metabolic syndrome. Triglyceride （TG）, non-high-density lipoprotein cholesterol （nonI-IDLC） and homeostasis model assessment-insulin resistance index （I-IOMA-IR） in three and over components of metabolic syndrome group were significant higher than these of the other groups （P 〈 0.05）. The three groups all were central obesity. Correlation analysis suggests that the level of nonHDLC was positively related with total cholesterol （TC）, low density lipoprotein cholesterin （LDC-C）, TG and the number of metabolic syndrome component. Non-alcoholic fatty liver disease （NAFLD） was positively related with FINS and HOMA-IR. [ Conclusions ] Obese children in outpatient have high prevalence of the metabolic syndrome. Central obesity （CO） may be the initiating factor of metabolic abnormality. NonHDLC was the main dyslipidemia. Insulin resistance, hypreinsulinemia were the main factors causing NAFLD.