肥胖儿童血尿酸联合年龄、腰围、体质量指数预测代谢综合征的价值

Value of serum uric acid combined with age, waist circumference and body mass index in the prediction of metabolic syndrome in obese children

目的 评价肥胖儿童血尿酸（UA）水平联合年龄、腰围、体质量指数（BMI）在预测代谢综合征（MS）中的价值。方法 对300例肥胖儿童进行身高、体质量指数、腰围、臀围、血脂、血糖及胰岛素释放试验和血清学检查。300例肥胖儿童中男180例，女120例，按UA水平的四分位数将男女儿童各分为4组，比较各组间一般临床特征，分析UA与各临床指标及MS各组的相关关系，比较4组肥胖儿童及其MS各组患病风险的Logistic回归分析以及尿酸水平联合年龄、腰围、BMI预测的受试者工作特征曲线（ROC曲线）下面积。结果 随着年龄、BMI、腰围的升高，UA水平逐渐升高，UA水平与三酰甘油（TG）、糖负荷后（餐后）2 h血糖（2 h PG）关系密切（男童r＝0.196、0.174；女童r＝0.291、0.179）。在二分类Logistic回归中，调整年龄、BMI及其他危险因素后，UA水平第4分位组男童TG是第1分位的2.71倍（95%CI：0.77～9.58），UA水平第4分位组女童血糖、血压分别是第1分位的8.45倍（95%CI：1.76～40.52）、3.93倍（95%CI：0.66～23.33），差异有统计学意义（均P〈0.05）。男童UA水平、年龄、腰围、BMI预测MS的ROC曲线下面积分别为0.652、0.626、0.621、0.620，差异均有统计学意义（均P〈0.05）。结论 肥胖儿童UA水平与MS组分关系密切，UA检测的同时联合年龄、腰围、BMI有助于高危人群的识别。

Objective To evaluate the value of serum uric acid（UA） levels with reference to the age, waist circumference, and body mass index（BMI） in predicting the metabolic syndrome（MS） in obese children.Methods A total of 300 obese children, including 180 boys and 120 girls, were enrolled in this study.The height, BMI, waist and hip circumference, blood pressure, serum glucose, insulin and lipid profile in all participants were measured.Oral glucose tolerance test and insulin releasing test were performed.The boys or girls were divided into 4 groups according to the 4 quantile of UA level, respectively.The clinical characteristics and correlation of UA with the clinical indexes and MS components were compared.The binary Logistic regression analysis was applied in the risk of MS and its components for the 4 groups of obese children.The area under the receiver operating characteristic curve（ROC curve） of UA level, age, waist circumference and BMI were used to predict the MS.Results UA level was increased with the increase of age, waist circumference and BMI, and the UA level was significantly correlated with triacylglycerol, postprandial 2 h glucose（2 h PG）（r=0.196, 0.174 in boys; r=0.291, 0.179 in girls）. In boys, the adjusted odds ratio and 95%CI of the highest quartile of UA for triglyceridemia was 2.71（95%CI： 0.77-9.58）; which in girls, the adjusted odds ratio and 95%CI of the highest quartile of UA for hyperglycemia, hypertension were 8.45（95%CI： 1.76-40.52） and 3.93（95%CI： 0.66-23.33）, respectively, with significant differences.In boys, the area under the ROC curve of UA level, age, waist circumference and BMI which predict the MS were 0.652 0.626, 0.621, 0.62, respectively, and the differences were significant（all P〈0.05）.Conclusions The UA level is significantly correlated with the composition of MS, UA detection combining with reference to the age, waist circumference, and BMI is helpful for the identification of high risk groups of metabolic syndrome.