学龄儿童及青少年单纯性肥胖症糖脂代谢异常现况调查

发布时间：2018-08-18 09:35

【摘要】：目的初步了解儿童及青少年肥胖患者糖脂代谢及肝脏、心脏等靶器官的异常情况，以期及早采取干预措施防止严重并发症的发生。方法选择2012年6月至2013年6月期间于郑州人民医院儿保门诊就诊的儿童及青少年，其中肥胖者199例，超重者291例，体检体重正常者110例为对照组。取空腹静脉血，分别检测空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、谷丙转氨酶（ALT）、空腹胰岛素（FINS）等指标，并计算胰岛素抵抗指数（HOMA～IR）及胰岛β细胞功能值（HOMA～β）；口服糖耐量试验（OGTT）和胰岛素释放试验仅用于测试肥胖及超重儿童的相应指标。肥胖组、超重组及对照组儿童均行肝脏和心脏超声检查。结果与对照组收缩压、舒张压相比，肥胖组及超重组的血压指标均升高（P 0.05），高血压的发生率在肥胖组、超重组及对照组分别为0.00%（0/110）、14.6%（29/199）、6.5%（19/291）。与对照组相比，FBG、FINS、HOMA～IR及HOMA～β在肥胖组及超重组均有所升高（P 0.05）；在脂代谢相关指标中，除HDL～C较对照组降低外，其余三项（TC、TG、LDL～C）均升高，经检验，差异均有统计学意义（P 0.05）。脂肪肝发生率在超重及肥胖组中差异有统计学意义（P 0.05）。肥胖组及超重组患儿共有268例出现心包外脂肪增厚，平均厚度（3.369±0.099）mm，与对照组相比差异有统计学意义（P 0.05）。结论与体重正常的儿童相比，肥胖及超重儿童的高血压发生风险及糖代谢异常发生率均有所升高，，糖代谢异常（包括空腹血糖受损、胰岛素抵抗、糖耐量减低、高胰岛素血症和β细胞功能减低等）在超重时即可出现。此外，血脂紊乱在肥胖儿童中表现较为明显，脂肪肝亦可同时发生，10岁后的肥胖儿童尤甚。与正常体重儿童相比，左心室肥大和心包外脂肪增厚在肥胖儿童尤为明显。
[Abstract]:Objective to investigate the abnormalities of glucose and lipid metabolism, liver, heart and other target organs in obese children and adolescents so as to take early intervention measures to prevent the occurrence of serious complications. Methods from June 2012 to June 2013, 199 obese, 291 overweight and 110 normal weight children and adolescents were selected from the outpatient clinic of Zhengzhou people's Hospital. Fasting blood samples were collected and fasting blood glucose (FPG), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), fasting insulin (FINS) were measured, and insulin resistance index (HOMA~IR) and islet 尾 cell function (Homa 尾) were calculated. Oral glucose tolerance test (OGTT) (OGTT) and insulin release test were used only to test the corresponding indexes of obese and overweight children. Liver and heart ultrasound were performed in obese group, superrecombinant group and control group. Results compared with the systolic blood pressure and diastolic blood pressure of the control group, the blood pressure indexes of the obese group and the hyperrecombination group were increased (P 0.05). The incidence of hypertension in the obese group, the superrecombinant group and the control group was 0.00% (0 / 110) or 14.6% (29 / 199) or 6.5% (19 / 291), respectively. Compared with the control group, HOMA-IR and HOMA- 尾 were increased in obese group and hyperrecombination group (P0. 05), except for the decrease of HDL~C in the control group, the other three items (TCU TGLDLX C) were higher than those in the control group (P 0. 05), and the difference was statistically significant (P 0. 05). The incidence of fatty liver was significantly different in overweight and obesity groups (P 0.05). In obesity group and superrecombinant children, the mean thickness of pericardial fat was (3.369 卤0.099) mm, which was significantly higher than that in control group (P 0.05). Conclusion compared with normal weight children, the risk of hypertension and the incidence of abnormal glucose metabolism in obese and overweight children are increased, including impaired fasting blood glucose, insulin resistance and impaired glucose tolerance. Hyperinsulinemia and 尾-cell dysfunction can occur when overweight. In addition, dyslipidemia was more evident in obese children, especially in obese children after 10 years of age. Left ventricular hypertrophy and extrapericardial fat thickening were more pronounced in obese children than in normal weight children.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R723.14

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