儿童青少年代谢综合征心率减速力变化与糖脂代谢异常关系的研究

Relationship between deceleration capacity of heart rate and glucose and lipid metabolism disorders in children and adolescents with metabolic syndrome

目的探讨儿童青少年MS心率减速力(DC)变化与血糖、血脂代谢异常的关系。方法选取2015年1月至2016年5月于南阳市中心医院内分泌科确诊为MS的100例10~16岁儿童青少年(MS组);同期于我院体检健康的100名儿童青少年为正常对照(NC)组。检测两组DC、血糖及血脂指标变化,随访心血管事件的发生率及其影响因素。结果两组WC、BMI、FPG、2 hPG、HbA1c、HDL-C、LDL-C、TG、DC比较,差异有统计学意义(P<0.05或P<0.01)。MS组治疗前后WC、BMI、FPG、2 hPG、HbA1c、HDL-C、LDL-C、DC比较,差异有统计学意义(P<0.05)。与低危亚组比较,中、高危亚组超重/肥胖、血糖、血脂异常发生率差异有统计学意义(P<0.01)。Pearson相关性分析显示,DC与HDL-C呈正相关(r=0.494,P<0.05),与TG、FPG、WC、HbA1c呈负相关(r=-0.497、-0.496、-0.474、-0.501,P<0.05或P<0.01)。多因素Cox回归分析显示,2 hPG、HbA1c、LDL-C、TG是儿童青少年MS发生不良心血管事件的危险因素,DC是预后的保护因素。结论 DC检测对儿童青少年MS的危险分层及心血管事件有一定预测价值。

Objective To explore the relationship between deceleration capacity(DC)of heart rate and abnormal glucose and lipid metabolism in children and adolescents with metabolic syndrome(MS).Methods 100 children and adolescents aged 10 to 16 years old with MS were selected. 100 healthy children and adolescents who underwent physical examination in our hospital at the same time were selected as control group(NC). The changes of DC,blood glucose and blood lipids and the incidence of cardiovascular events during follow-up between two groups were compared.Results Before treatment,the waist circumference(WC),BMI,FPG,HDL-C,TG,2 h PG,HbA1c,and DC in the MS group were significantly different from those in the NC group(P<0. 05 or P<0. 01). the levels of WC,BMI,FPG,HDL-C,2 h PG,HbA1c,DC in the MS group were significantly improved after treatment(P<0. 05). The incidence of overweight/obesity,abnormal blood glucose and dyslipidemia in high-risk group was statistically higher than low-risk group(P<0. 01). Pearson correlation analysis showed that DC value was positively correlated with HDL-C(r=0. 494,P<0. 05),and negatively correlated with TG,FPG,WC and HbA1c(r=―0. 497,―0. 496,―0. 474 and -0. 501,P<0. 05 or P<0. 01). Cox regression analysis showed that 2 h PG,HbA1c,LDL-C,and TG were independent risk factors for adverse cardiovascular events in children and adolescents,while DC was a protective factor for prognosis.Conclusion The detection of DC has certain predictive value for risk stratification and cardiovascular events in children and adolescents with MS.