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目的:研究浙江余杭单纯性肥胖儿童血脂谱的变化,探讨其与体格发育指标的关系及其影响因素。方法:余杭区第二人民医院儿科门诊就诊的单纯性肥胖患儿47例作为病例组,按1∶1比例与47名同性别、同身高、同年龄的正常儿童配对。同时测定两组儿童的身高、体重、腰围和臀围,抽取静脉血进行血脂检测,通过问卷调查法进行儿童肥胖影响因素的调查。结果:单纯性肥胖组儿童的体重、BMI指数、腰围(WC)、臀围(HC)和腰/臀指数(WHR)均显著高于对照组儿童(P<0.05);同时血脂谱中总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)也显著高于正常组儿童(P<0.05),但是高密度脂蛋白胆固醇(HDL-C)以及载脂蛋白A(apoA)则较正常组儿童为低(P<0.05)。偏相关分析显示,单纯性肥胖儿童血脂谱中的TC、TG、LDL-C分别与儿童W、BMI、WC和WHR指数呈明显正相关(P<0.05);而HDL-C和apoA则与上述指标呈明显负相关(P<0.05);多因素配比条件Logistic回归分析,婴儿时期超重病史、出生巨大儿、运动时间少、喜食高脂肪、高热卡食物以及母亲、父亲肥胖以及家庭其他肥胖患者是儿童肥胖患病的危险因素。结论:浙江余杭单纯性肥胖儿童存在着明显的脂质代谢紊乱,预示着单纯性肥胖儿童发生动脉粥样硬化的危险性明显增加。
Objective: To study the changes of blood lipid profile in simple obese children in Yuhang, Zhejiang Province, and to explore its relationship with physical development and its influencing factors. Methods: 47 cases of simple obesity in Pediatric Outpatient Department of Second People ’s Hospital of Yuhang District were selected as case group. Paired with 47 same - sex, same - height and same - age normal children according to the ratio of 1: 1. At the same time, the height, weight, waist circumference and hip circumference of two groups of children were measured at the same time. The venous blood was taken for lipids detection. The influencing factors of childhood obesity were investigated by questionnaire. Results: The body mass, BMI, waist circumference (WC), hip circumference (HC) and waist / hip index (WHR) in children with simple obesity were significantly higher than those in the control group (P < (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) were also significantly higher than those in the normal group (P <0.05), but high density lipoprotein cholesterol (HDL-C) and apolipoprotein A (apoA) was lower than normal children (P <0.05). Partial correlation analysis showed that the levels of TC, TG and LDL-C in the lipid profiles of children with simple obesity were positively correlated with the scores of W, BMI, WC and WHR (P <0.05), while those of HDL-C and apoA (P <0.05). Logistic regression analysis of multifactorial matching conditions, history of overweight in infancy, huge maternal age, less exercise time, eating high fat and high calorie diet as well as mothers, father fat and other obesity in the family The patient is a risk factor for childhood obesity. Conclusion: Obvious lipid metabolism disorders exist in simple obese children in Yuhang, Zhejiang Province, which indicates that the risk of atherosclerosis in simple obesity children is obviously increased.