肥胖儿童的骨代谢与胰岛素抵抗的相关性研究

Relationship between bone metabolism and insulin resistance in obese children

目的探讨肥胖儿童的骨代谢与胰岛素抵抗的相关性。方法收集2016年12月~2017年12月青岛市市立医院儿童保健门诊体检中的同意纳入本研究并接受过骨密度检查的儿童共553例。根据受试者BMI分为肥胖组(164例)和正常组(389例)。利用Logistic回归对肥胖组与正常组差异因素进行多因素分析,筛选可能导致肥胖的潜在影响因素。利用Pearson相关分析骨密度与其他研究指标的相关性。结果肥胖组受试者中男性比例、BMI、血磷、ALP、PTH、空腹血糖、TG、LDL、HOME-IR均高于正常组(P<0.05),而血钙、血清骨钙素、HDL、BGP均低于正常组(P<0.05);BMI升高(OR=1.17)、男性(OR=1.21)、TG升高(OR=2.32)、HOME-IR指数升高(OR=2.51)、LDL升高(OR=1.92)升高、BGP降低(OR=0.81)是儿童肥胖发生的可能危险因素。BMI(r=-0.631)、TG(r=-0.524)及HOME-IR指数(r=-0.645)与受试者体内的骨钙素含量均为负相关(P<0.05)。结论儿童骨密度与胰岛素抵抗存在负相关,HOME-IR指数可指导儿童骨密度检测目标人群筛选。

Objective To explore the correlation between bone metabolism and insulin resistance in obese children.Methods 553 children consented to be included in this study and received bone mineral density examinations during the physical examination of children's health clinics from December 2016 to December 2017 in Qingdao Municipal Hospital were collected.Subjects were divided into obese and normal groups according to BMI.Logistic regression was used for multivariate analysis of the differences between the obese and normal groups,and to screen for potential risk factors that may lead to obesity.Pearson correlation was used to analyze the correlation between bone mineral density and other research indicators.Results There were 164 children in obese group and 389 children in normal group.The proportion of males,BMI,serum phosphorus,ALP,PTH,fasting blood glucose,TG,LDL,and HOME-IR in the obesity group were higher than those in the normal group ( P <0.05),while serum calcium,serum osteocalcin,HDL,BGP were lower than the normal group ( P <0.05).BMI increased (OR=1.17),male (OR=1.21),TG increased (OR=2.32),HOME-IR index increased (OR=2.51),LDL increased (OR=1.92),BGP decreased (OR= 0.81) is a possible risk factor for childhood obesity.BMI ( r =-0.631),TG ( r =-0.524),and HOME-IR index ( r =-0.645) were negatively correlated with BGP ( P <0.05).Conclusion There is a negative correlation between BGP and insulin resistance in children.The HOME-IR index can guide the screening of target population for bone mineral density detection in children.