维生素D联合复合肠道微生态制剂治疗单纯性肥胖儿童的效果

Effect of Vitamin D Combined With Compound Intestinal Microecological Preparation in the Treatment of Simple Obesity Children

目的探讨维生素D联合复合肠道微生态制剂治疗单纯性肥胖儿童的效果及对体格指标和糖脂代谢的影响。方法选取南京医科大学第一附属医院儿童保健科2022年1月—2023年12月收治的150例单纯性肥胖儿童为研究对象。采用随机数字表法分为对照组与观察组,各75例。2组均常规给予生活方式干预、心理行为干预,在此基础上,对照组给予复合肠道微生态制剂治疗,观察组联合维生素D治疗。比较2组疗效、体格指标[体质量、身体质量指数(body mass index,BMI)、体脂率、腰围身高比(waist-to-height ratio,WHtR)]、糖脂代谢指标[甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、空腹胰岛素(fasting insulin,FINS)、空腹血糖(fasting blood glucose,FBG)]、25羟基维生素D[25-hydroxyvitamin D,25-(OH)D]水平及不良反应。结果观察组治疗总有效率为90.67%,高于对照组的77.33%,差异有统计学意义(P<0.05)。治疗后,观察组体质量、BMI、体脂率、WHtR分别为(51.75±5.23)kg、(22.32±2.29)kg/m2、(30.89±4.20)%、(0.50±0.05),均低于对照组的(55.12±6.25)kg、(23.79±2.51)kg/m2、(35.84±5.81)%、(0.55±0.07),差异有统计学意义(P<0.05)。治疗后,观察组TG、TC、LDL-C分别为(1.38±0.20)mmol/L、(5.03±0.28)mmol/L、(2.08±0.24)mmol/L,均低于对照组的(1.64±0.14)mmol/L、(5.47±0.31)mmol/L、(2.58±0.32)mmol/L,差异有统计学意义(P<0.05);且观察组HDL-C为(1.62±0.27)mmol/L,高于对照组的(1.31±0.24)mmol/L,差异有统计学意义(P<0.05)。治疗后,观察组FINS、FBG分别为(7.05±1.40)mIU/L、(4.16±0.53)mmol/L,均低于对照组的(9.47±1.82)mIU/L、(5.34±0.67)mmol/L,差异有统计学意义(P<0.05);观察组25-(OH)D水平为(70.38±7.40)nmol/L,高于对照组的(50.06±5.08)nmol/L,差异有统计学意义(P<0.05)。2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论维生素D联合复合肠道微生态制剂可以改善单纯性肥胖儿童的体格指标、糖脂代谢指标,纠正糖脂代谢紊乱,并可以升高25-(OH)D水平,改善患儿预后。

Objective To investigate the effect of vitamin D combined with compound intestinal microecological preparation on simple obesity children and its influence on physical indexes and glucose and lipid metabolism.Methods A total of 150 children with simple obesity admitted to the First Affiliated Hospital with Nanjing Medical University from January 2022 to December 2023 selected as the study objects.They were divided into control group and observation group by random number table method,75 cases in each group.Both groups were given routine lifestyle intervention and psychological behavior interventiond,on this basis,the control group was given compound intestinal microecological preparation treatment,and the observation group was combined with vitamin D treatment.The therapeutic effects,physical indexes[body weight,body mass index(BMI),body fat percentage,waist-to-height ratio(WHtR)],glycemic metabolism indexes[triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),fasting blood glucose(FBG)],25-hydroxyvitamin D[25-(OH)D]levels and adverse reactions were compared.Results The total effective rate of observation group was 90.67%,which was higher than 77.33%of control group,the difference was statistically significant(P<0.05).After treatment,the body weight,BMI,body fat percentage and WHtR of the observation group were(51.75±5.23)kg,(22.32±2.29)kg/m2,(30.89±4.20)%and(0.50±0.05),respectively,which were lower than(55.12±6.25)kg,(23.79±2.51)kg/m2,(35.84±5.81)%,(0.55±0.07)of the control group,the differences were statistically significant(P<0.05).After treatment,TG,TC and LDL-C in the observation group were(1.38±0.20)mmol/L,(5.03±0.28)mmol/L and(2.08±0.24)mmol/L,respectively,which were lower than(1.64±0.14)mmol/L,(5.47±0.31)mmol/L and(2.58±0.32)mmol/L of control group,the differences were statistically significant(P<0.05).The HDL-C of observation group was(1.62±0.27)mmol/L,which was higher than(1.31±0.24)mmol/L of control group,the difference was statistically significant(P<0.05).After treatment,FINS and FBG in the observation group were(7.05±1.40)mIU/L and(4.16±0.53)mmol/L,respectively,which were lower than(9.47±1.82)mIU/L and(5.34±0.67)mmol/L in the control group,the differences were statistically significant(P<0.05).The level of 25-(OH)D in observation group(70.38±7.40)nmol/L,which was higher than(50.06±5.08)nmol/L in control group,the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Vitamin D combined with compound intestinal microecological preparation can improve the physical indexes and glucose and lipid metabolism indexes of children with simple obesity,correct the disorder of glucose and lipid metabolism,increase the level of 25-(OH)D,and improve the prognosis of children.