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目的探讨不同类型肥胖儿童代谢紊乱的特点。方法纳入2006年7月-2009年3月重庆医科大学附属儿童医院门诊确诊的单纯性肥胖儿童145例,同期80例体检正常儿童作为对照组。测量所有儿童的身高、体重、腰围、臀围、血压、体重指数(BMI),并检测血脂、血糖、胰岛素水平,计算胰岛素抵抗指数(HOMA-IR)。根据BMI和腰围再将肥胖儿童分为腹型肥胖组及非腹型肥胖组,比较各组间血压、血脂、血糖、胰岛素水平的差异。结果145例肥胖儿童中,腹型肥胖组127例(87.6%),非腹型肥胖组18例(12.4%)。腹型肥胖组空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)和血压均高于非腹型肥胖组和对照组(P<0.05);非腹型肥胖组FPG、TC、LDL、高密度脂蛋白(HDL)、血压与对照组比较差异无统计学意义(P>0.05),但TG高于正常儿童(P<0.05)。腹型肥胖组检出胰岛素抵抗77例,空腹血糖受损14例,糖耐量受损7例,高TG血症24例,高TC血症13例,高LDL血症10例,血压升高者15例。非腹型肥胖组中仅检出胰岛素抵抗2例。结论儿童肥胖以腹型肥胖为主,腹型肥胖儿童比非腹型肥胖儿童更易出现代谢紊乱。
Objective To investigate the characteristics of metabolic disorders in different types of obese children. Methods A total of 145 simple obese children diagnosed in Chongqing Children’s Hospital affiliated to Chongqing Medical University from July 2006 to March 2009 were enrolled in this study. 80 healthy children were enrolled as the control group. All children’s height, weight, waist circumference, hip circumference, blood pressure and body mass index (BMI) were measured. Blood lipids, blood glucose and insulin levels were measured. HOMA-IR was calculated. The obese children were divided into abdominal obesity group and non-abdominal obesity group according to BMI and waist circumference. Blood pressure, blood lipid, blood glucose and insulin levels were compared between groups. Results Among 145 obese children, 127 cases (87.6%) were abdominal obesity group and 18 cases (12.4%) were non-abdominal obesity group. The fasting blood glucose (FPG), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and blood pressure in abdominal obesity group were higher than those in non-abdominal obesity group and control group (P <0.05) The levels of FPG, TC, LDL, HDL, and blood pressure in abdominal obesity group were not significantly different from those in control group (P> 0.05), but TG was higher than that in normal children (P <0.05). In abdominal obesity group, there were 77 cases of insulin resistance, 14 cases of impaired fasting glucose, 7 cases of impaired glucose tolerance, 24 cases of hypertriglyceridemia, 13 cases of hypercholesteremia, 10 cases of hyperlipidemia, elevated blood pressure 15 cases. Only 2 cases of insulin resistance were detected in non-abdominal obesity group. Conclusion Children obesity is mainly abdominal obesity, abdominal obesity children are more prone to metabolic disorders than non-abdominal obesity children.