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目的探讨体质量指数(BMI)、腰围与肥胖儿童心血管危险因素的关系。方法回顾性分析2001年1月至2005年12月在上海交通大学医学院附属仁济医院肥胖病专科门诊就诊的6~18(11.8±3.0)岁患儿283例,其中男179例(11.4±3.0)岁,女104例(12.3±3.0)岁,测体重、身高、腰围、臀围、血压、血清总三酰甘油(甘油三酯,TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C),并计算BMI和腰臀比。结果283例患儿血脂水平异常147例(51.9%),其中1项指标异常100例,2项异常34例,3项异常和4项全部异常为11例和2例。131例患儿TG升高,42例TC升高,HDL-C降低和LDL-C升高分别为20例和17例。283例患儿中高血压131例(46.3%),收缩压(SP)增高112例,舒张压(DP)增高88例,69例两者均增高。校正年龄和性别后,BMI与血清TG水平正相关(r=0.13,P<0.05)。腰围不仅与血清TG水平呈正相关(r=0.21,P<0.01),还与血清HDL-C负相关(r=-0.14,P<0.05)。腰围与血脂紊乱程度也呈正相关,而BMI则无类似关系。BMI和腰围均与SP、DP呈正相关。腰围异常患儿SP、DP和血清TG明显增高,而HDL-C明显降低。高血压组儿童腰围、血清TC、LDL-C水平明显高于血压正常组儿童。结论肥胖儿童易并发脂质代谢紊乱和高血压等心血管危险因素。BMI和腰围与肥胖儿童心血管危险因素关系密切。不同年龄、性别,腰围第95百分位值可作为腰围正常与否的临界点。
Objective To explore the relationship between body mass index (BMI), waist circumference and cardiovascular risk factors in obese children. Methods A retrospective analysis of 283 children aged 6-18 (11.8 ± 3.0) years admitted to the obesity department of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2001 and December 2005 was retrospectively reviewed. Among them, 179 (11.4 ± (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C), and calculate the BMI and waist-to-hip ratio. Results A total of 147 cases (51.9%) had abnormal blood lipid levels in 283 children. One of them had abnormality in 100 cases, two abnormalities in 34 cases, three abnormalities and four partial abnormalities in 11 cases and two cases. 131 cases of children with elevated TG, 42 cases of elevated TC, HDL-C and LDL-C were elevated in 20 cases and 17 cases. Among 283 children, 131 cases were hypertensive (46.3%), systolic blood pressure (112) increased, diastolic blood pressure (DP) increased in 88, and 69 cases both increased. After adjusting for age and gender, BMI was positively correlated with serum TG levels (r = 0.13, P <0.05). The waist circumference was not only positively correlated with serum TG level (r = 0.21, P <0.01), but also negatively correlated with serum HDL-C (r = -0.14, P <0.05). Waist circumference and dyslipidemia also showed a positive correlation, while BMI had no similar relationship. BMI and waist circumference were positively correlated with SP and DP. Children with abnormal waist circumference SP, DP and serum TG increased significantly, while HDL-C decreased significantly. Hypertension group of children with waist circumference, serum TC, LDL-C levels were significantly higher than those in normotensive children. Conclusions Obese children are easily associated with cardiovascular risk factors such as dyslipidemia and hypertension. BMI and waist circumference are associated with cardiovascular risk factors in obese children. Different age, gender, waist circumference 95th percentile value can be used as a critical point of normal or not waist circumference.