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目的 了解肥胖和超重儿童糖代谢及胰岛细胞功能状况。方法 对 52例单纯性肥胖与超重儿童进行口服糖耐量试验,并测定其血糖及胰岛素水平。计算胰岛素抵抗指数 (IR),胰岛素敏感指数(IS),服糖后 30min胰岛素增加值与血糖增加值的比值。并查甘油三酯、肝脏B超。体重指数(BMI)与IR之间、不同BMI组之间、糖耐量减低组与对照组之间进行比较。结果 发现糖尿病1例(1 9% ),IGT者 5例(9 6% )。IR≥2 8为胰岛素抵抗,占 76 9%。BMI与IR之间无相关关系。不同BMI组之间IR、IS、服糖后 30min胰岛素增加值与血糖增加值的比值差异均无统计学意义。糖耐量减低组与对照组之间IR、IS差异无统计学意义,服糖后 30min胰岛素增加值与血糖增加值的比值之间差异有统计学意义。甘油三酯升高 19例(37% ),脂肪肝 16例 (53% )。结论 肥胖与超重儿童普遍存在胰岛素抵抗和敏感性下降,其与BMI程度无关。肥胖伴糖耐量减低儿童除胰岛素抵抗外存在明显的B细胞功能减退。许多肥胖和超重儿童同时存在脂代谢紊乱。
Objective To understand the status of glucose metabolism and islet cell function in obese and overweight children. Methods Oral oral glucose tolerance test was performed on 52 simple obese and overweight children and their blood glucose and insulin levels were measured. Insulin resistance index (IR) and insulin sensitivity index (IS) were calculated. The ratio of added value of insulin and added value of blood glucose 30 minutes after taking sugar was calculated. And check triglycerides, liver B ultrasound. Body mass index (BMI) and IR, between different BMI groups, impaired glucose tolerance group and control group were compared. The results showed that 1 case of diabetes (19%), IGT in 5 cases (96%). IR ≥ 28 for insulin resistance, accounting for 76 9%. There is no correlation between BMI and IR. There was no significant difference in the ratio of insulin added value to blood sugar added value between IR, IS, and 30 minutes after taking sugar among different BMI groups. There was no significant difference between IR and IS in the group of impaired glucose tolerance and the control group, and there was a significant difference between the ratio of added value of insulin and added value of blood glucose 30 minutes after taking glucose. Elevated triglycerides were found in 19 (37%) and fatty liver in 16 (53%). Conclusion There is a general decline in insulin resistance and sensitivity in obese and overweight children, which is not related to the BMI. Obesity with impaired glucose tolerance in children with the exception of insulin resistance there is a clear B cell dysfunction. Many obese and overweight children have disorders of lipid metabolism.