儿童青少年直立不耐受与体质量指数、血脂及血清蛋白水平的相关性

Relationship between orthostatic intolerance and body mass index,blood lipids and serum protein levels in children and adolescents

目的探讨儿童青少年直立不耐受(OI)与体质量指数(BMI)、血脂及血清蛋白水平的相关性。方法选取2018年4月至2019年4月在兰州大学第二医院小儿心血管科诊断为OI的6~17岁儿童青少年122例为研究对象。选取同期本院儿少健康管理中心健康体检56例儿童青少年为健康对照组。研究对象根据临床病史中有无晕厥事件发生分为晕厥组和非晕厥组。测量所有儿童的身高、体质量,并于清晨空腹抽取静脉血检测血脂及血清蛋白,采用SPSS 22.0软件进行数据分析。结果1.OI组三酰甘油水平低于健康对照组[(0.98±0.45)mmol/L比(1.28±1.04)mmol/L],差异有统计学意义(t=2.025,P<0.05);晕厥组BMI为(17.56±3.23)kg/m2,非晕厥组BMI为(16.46±2.58)kg/m2,晕厥组BMI高于非晕厥组(t=2.085,P<0.05)。2.二分类Logistic回归分析结果表明,三酰甘油是OI的独立危险因素(OR=0.504,95%CI:0.272~0.931,P<0.05)。3.受试者工作特征曲线评价三酰甘油对OI预测价值,结果显示三酰甘油为1.09 mmol/L时诊断OI的敏感性为72.1%,特异性为48.2%。结论低三酰甘油、高BMI均可能成为OI发生的易感因素,OI患儿饮食结构需引起临床医师及家长高度重视。

Objective To investigate the relationship between orthostatic intolerance(OI)and body mass index(BMI),blood lipid and serum protein levels in children and adolescents.Methods A total of 122 children and adolescents aged from 6 to 17 years old,who were diagnosed with OI at the Department of Pediatric Cardiology,the Second Hospital of Lanzhou University from April 2018 to April 2019,were selected as the subjects.While,56 children and adolescents in the health management center were selected as the healthy control group during the same period.Subjects were divided into syncope group and non-syncope group according to whether there was syncope in clinical history.The height and body mass of all children were measured,and venous blood were taken to detect blood lipids and serum protein in the morning.Date analysis were conducted with SPSS 22.0 software.Results(1)The level of triglyceride in the OI group was lower than that in the healthy control group[(0.98±0.45)mmol/L vs.(1.28±1.04)mmol/L],and there was statistically significant(t=2.025,P<0.05);the BMI were respectively(17.56±3.23)kg/m2 and(16.46±2.58)kg/m2 in syncope group and non-syncope group,whose result indicated that the BMI in syncope group was higher than that in non-syncope group(t=2.085,P<0.05).(2)The results of binary Logistic regression analysis showed that the triglyceride level was an independent risk factor for OI(OR=0.504,95%CI:0.272-0.931,P<0.05).(3)The receiver operating characteristic curve evaluated the predictive value of triacylgly-cerol to OI.Results showed the sensitivity and specificity of OI were respectively 72.1%and 48.2%when the triacylglycerol was 1.09 mmol/L.Conclusions Low triglyceride level and high BMI may be susceptible factors to OI in children and adolescents.Therefore,the diet of children with OI should be highly valued by clinicians and parents.