学龄期肥胖与体质量正常儿童血清25羟维生素D水平及其与儿童肥胖程度及糖脂代谢的关系

Serum levels of 25 hydroxy vitamin D in school age obesity and normal weight children and its relationship with obesity and glucose and lipid metabolism in children

目的探讨学龄期肥胖与体质量正常儿童血清25羟维生素D[25(OH)D]水平及其与儿童肥胖程度及糖脂代谢的关系。方法从学龄期儿童中选出肥胖儿童100例作为肥胖组,根据肥胖程度将肥胖组分为轻中度肥胖组42例及重度肥胖组58例,并选出年龄相仿、体质量正常儿童100例作为对照组。采用自动生化分析仪检测血液各项生化指标以及采用ELISA检测甲状旁腺素(PTH)及血清25(OH)D的水平,分析血清25(OH)D的水平与儿童肥胖程度及糖脂代谢的关系。结果 (1)三组儿童的体质量、体质量指数(BMI)、臀围、腰围、腰臀比,总能量/每日推荐摄入能量(RDA)和25(OH)D水平的数据比较均差异有统计学意义(P<0.05),经过q检验,以上项目中任意两组之间的数据均差异有统计学意义(P<0.05),而且体质量、BMI、臀围、腰围、腰臀比,总能量/RDA几个项目中,数据均为对照组<轻中度肥胖组<重度肥胖组,但是在25(OH)D水平中,数据为对照组>轻中度肥胖组>重度肥胖组;(2)25(OH)D<50 nmol·L^(-1)组儿童的三酰甘油明显高于25(OH)D≥50nmol·L^(-1)组,比较差异有统计学意义(t=6.021,P<0.05);(3)血清25(OH)D浓度与儿童三酰甘油呈负相关性,低血清25(OH)D浓度为儿童代谢综合征(MS)的危险因素。结论学龄期肥胖儿童血清内25(OH)D水平显著低于体质量正常儿童,血清25(OH)D浓度与儿童三酰甘油呈负相关性,由此推断低血清25(OH)D浓度为儿童肥胖及MS的危险因素。

Objective To explore the serum levels of 25 hydroxy vitamin D[25( OH) D] in school age obesity and normal weight children and its relationship with obesity and glucose and lipid metabolism in children. Methods A hundred obese children were selected from school age children as obese group,which was assigned into mild to moderate obesity group( 42 cases) and severe obesity group( 58 cases) according to the degree of obesity,and another 100 children of similar age and normal body mass were selected as control group. Automatic biochemical analyzer was used to detect the biochemical indexes of blood and the levels of parathyroid( PTH) and serum 25( OH) D were detected by ELISA to analyze the relationship between the level of serum 25( OH) D and the degree of obesity and glucose and lipid metabolism in children. Results( 1) There were significant differences in body mass,body mass index( BMI),hip circumference,waist circumference,waist-to-hip ratio,total energy/RDA and 25( OH) D level among the three groups( P < 0. 05). After q test,the differences between the data of any two groups were statistically significant( P < 0. 05),and as to the body mass,BMI,hip circumference,waist circumference,waist-to-hip ratio and total energy/RDA,the data were increased in sequence in the control group,mild to moderate obesity group and severe obesity group,but as to the 25( OH) D level,the data were decreased in sequence in the control group,mild to moderate obesity group and severe obesity group.( 2) Triglyceride in the group with 25( OH) D < 50 nmol·L^(-1) was significantly higher than that in the group with 25( OH) D ≥50 nmol·L^(-1); the difference was statistically significant( t = 6. 021,P <0. 05).( 3) Serum 25( OH) D concentration was negatively correlated with the children's triglyceride,and low serum 25( OH) D concentration was a risk factor for children with metabolic syndrome( MS). Conclusions The serum level of 25( OH) D in school age children with obesity is significantly lower than that in children with normal body mass. Serum 25( OH) D concentration is negatively correlated with the level of children's triglyceride,which can be inferred that low serum 25( OH) D concentration is a risk factor for obesity and metabolic syndrome in children.