不同类型肥胖儿童代谢紊乱的特点  

Characteristics of metabolic disorders in children with different types of obesity

作　　者：余洁[1] 熊丰[1] 朱岷[1] 雷培芸[1] 邓蕾丽[1] 王付丽[1] 罗雁红[1] 曾燕[1] 祝之明[2,3] 

机构地区：[1]重庆医科大学附属儿童医院内分泌科,重庆400014 [2]第三军医大学全军高血压代谢中心 [3]重庆大坪医院高血压内分泌科

出　　处：《解放军医学杂志》2010年第1期101-103,共3页Medical Journal of Chinese People's Liberation Army

基　　金：重庆市卫生局资助课题(07-2-156)

摘　　要：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 children with different types of obesity.Methods From Jul.2006 to Mar.2009,145 obese children and 80 healthy children were recruited in Children＇s Hospital of Chongqing Medical University.Height,body weight,waist circumference（WC）,hip circumference and blood pressure were measured,body mass index（BMI）was calculated and blood fat,serum glucose and serum insulin were measured,and insulin resistance index（HOMA-IR）was calculated.Obese children were then divided into abdominal obesity group and non-abdominal obesity group according to BMI and WC.Blood pressure,blood lipids,glucose and insulin were compared between the two groups.Results The incidence of abdominal obesity was 87.59% among the 145 obese children（127/145）,while non-abdominal obesity accounted for 12.41%（18 cases）.Fasting plasma glucose（FPG）,total cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDL）and blood pressure were higher in abdominal obesity children than in non-abdominal obesity and normal children（P〈0.05）.There were no significant differences in FPG,TC,LDL,high-density lipoproteins（HDL）and blood pressure between non-abdominal obesity and normal group（P〉0.05）,but TG was higher in non-abdominal obesity group than that in normal group（P〈0.05）.Among the 127 abdominal obese children,insulin resistance was found in 77 cases,impaired fasting glucose in 14 cases,impaired glucose tolerance in 7 cases,hyperlipemia with high TG in 24 cases,hypercholesterinemia in 13 cases,hyperlipidemia with high LDL in 10 cases and hypertension in 15 cases.Only two cases of insulin resistance were detected in non-abdominal obesity children.Conclusion Abdominal obesity is the leading type of obesity in children and is more susceptible to abnormality of metabolism than non-abdominal obesity.

关 键 词：肥胖症 胰岛素抗药性 血脂异常 高血压 

分 类 号：R725.892.5[医药卫生—儿科]