肥胖儿童脂质代谢与左心室肥厚及左心室重构的相关性

Correlation of lipid metabolism with left ventricular hypertrophy and left ventricular remodeling in obese children

目的探讨肥胖儿童脂质代谢与左心室肥厚(LVH)及左心室重构(LVR)的相关性,为肥胖儿童的早期临床干预提供参考依据。方法纳入2018年1月—2021年12月在江南大学附属医院就诊的86例肥胖儿童为肥胖组,以同期80例非肥胖儿童为非肥胖组。比较两组的脂质代谢指标[低密度脂蛋白(LDL)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)]及左心室肥厚(LVH)、左心室重构(LVR)发生率;分析脂质代谢指标与LVH、LVR的相关性及脂质代谢指标预测LVH、LVR发生的风险。结果与非肥胖组相比,肥胖组的LDL、TG、TC水平均较高(t=5.604、6.018、5.273,P<0.001),HDL水平较低(t=6.437,P<0.001);且肥胖组的LVH与LVR发生率均较高(χ^(2)=15.472、13.079,P<0.001)。LDL(r=0.506、0.430)、TG(r=0.547、0.429)、TC(r=0.528、0.475)均与LVH、LVR正相关(P<0.05或<0.01),HDL均与LVH、LVR负相关(r=-0.490、-0.411,P<0.05或<0.01)。Logistic回归显示:LDL(OR=1.280、1.271,95%CI:1.105~1.392、1.136~1.385)、TG(OR=1.268、1.183,95%CI:1.107~1.468、1.017~1.290)、HDL(OR=0.816、0.847,95%CI:0.705~0.984、0.763~0.992)能预测肥胖儿童LVH、LVR的发生风险(P<0.05)。结论肥胖儿童脂质代谢与LVH及LVR存在相关性,脂质代谢指标有望成为肥胖儿童LVH及LVR发生风险的预测因子。

Objective To analyze the correlation of lipid metabolism with left ventricular hypertrophy(LVH)and left ventricular remodeling(LVR)in obese children,so as to provide reference for early clinical intervention of obese children.Methods A total of 86 cases of obese children who visited Affiliated Hospital of Jiangnan University from January 2018 to December 2021were enrolled in this study,meanwhile 80 cases of non-obese children were taken as the non-obese group in the same period.The levels of lipid metabolism indicators[including low density lipoprotein(LDL),triglyceride(TG),total cholesterol(TC),and high density lipoprotein(HDL)]and the incidence rates of LVH and LVR were compared between the two groups.The correlation of lipid metabolism with LVH and LVR was analyzed by Spearman correlation.The lipid metabolism indicators which could predict the risk of LVH and LVR were analyzed by a non-conditional Logistic regression model.Results The levels of LDL,TG and TC of children in obese group were significantly higher than those in non-obese group(t=5.604,6.018,5.273,P<0.001),while the level of HDL of children in obese group was significantly lower than that in non-obese group(t=6.437,P<0.001).The incidence rates of LVH and LVR in obese group was significantly higher than those in non-obese group(χ^(2)=15.472,13.079,P<0.001).The levels of LDL(r=0.506,0.430),TG(r=0.547,0.429)and TC(r=0.528,0.475)were positively correlated with LVH and LVR(P<0.05 or<0.001),while thelevels of HDL were negatively correlated with LVH and LVR(r=-0.490,-0.411,P<0.05 or<0.01).Logistic regression analysis indicated that the levels of TG(OR=1.268,1.183,95%CI:1.107-1.468,1.017-1.290),LDL(OR=1.280,1.271,95%CI:1.105-1.392,1.136-1.385),HDL(OR=0.816,0.847,95%CI:0.705-0.987,0.763-0.992)could predict the risk of LVH and LVR in obese children.Conclusion The lipid metabolism is correlated with LVH and LVR in obese children,and the lipid metabolism indicators are expected to be risk predictors of LVH and LVR in obese children.