肥胖儿童血清25羟维生素D水平及其临床意义  

Serum 25-Hydroxyvitamin D concentrations in obese children and its clinical significance

作　　者：陈海燕[1] 陈梦莹[1] 彭璐婷[1] 王斐[1] 李小妹[1] 李荣[1] 李晓南[1] 

机构地区：[1]南京医科大学附属南京儿童医院儿童保健科,江苏南京210008

出　　处：《中国儿童保健杂志》2013年第3期247-250,共4页Chinese Journal of Child Health Care

基　　金：国家自然科学基金(81273064);南京医学科技发展基金(YKK10051)

摘　　要：【目的】观察学龄期肥胖与体重正常儿童血清25羟维生素D[25(OH)D]水平及其与儿童肥胖程度及糖脂代谢的关系。【方法】按照《中国0～18岁儿童青少年体块指数的生长曲线》标准,从学龄期儿童中筛选出超重和肥胖儿童作为肥胖组,并设置同年龄、体重正常儿童为对照组。采用ELSIA测定血清25羟维生素D[25(OH)D]、甲状旁腺素(parathyroid hormone,PTH),全自动生化分析仪测定血生化指标。【结果】肥胖儿童59人(男童45人,女童14人),平均年龄(9.58±2.39)岁,BMI为25.14±4.02;对照组35人(男童23人,女童12人),平均年龄(8.92±1.56)岁,BMI为15.56±1.51。肥胖组儿童血清25(OH)D(45.40±11.86)nmol/L明显低于对照组儿童(59.56±16.08)nmol/L,差异有高度统计学意义(P<0.001),骨密度低于正常组儿童(P<0.001);血清25(OH)D浓度与BMI SDS、腰围、腰臀比及血甘油三脂呈显著负相关(P<0.05);25(OH)D低于50nmol的肥胖儿童的甘油三脂水平[(2.08±0.26)mmol/L]明显高于25(OH)D大于50nmol的肥胖儿童[(1.41±0.14)mmol/L]。【结论】肥胖儿童血清25(OH)D浓度明显低于体重正常儿童,血清25(OH)D浓度与儿童BMI SDS、腰围、甘油三脂呈负相关提示维生素D缺乏可能是儿童中心性肥胖和代谢综合症的危险因素。[Objective] To compare the serum 25（OH）D concentrations between obesity children and normal weight children,and to investigate the relationships between 25 （OH）D and childhood obesity, glucose and lipid metabolism. [Methods] Obesity was defined according to ＂Body mass index growth curves for Chinese children and adolescents aged 0 - 18 years＂. The serum 25（OH）D concentrations and parathyroid hormone （PTH） were determined by enzyme linked im-munosorbent assay （ELISA）. Biochemistry index were assayed by automatic chemistry analysis. [Results] There were 59 obese children （male 45, female 14, BMI 25.14 ± 4.02） with average age （9.58 ± 2.39） years old, and 35 normal weight chil-dren （male 23,female 12,BMI 15.56±1.51） aged （8.92±1.56） years old as control recruited in this study. The serum 25 （OH）D concentrations E（45.40± 11.86）nmol/L] in obese children were lower compared to control group （59.56± 16.08） nmol/L（P〈0. 001）. The serum 25（OH）D concentration was inversely related with BMI SDS （P〈0. 001） ,waist circumfer-ence （P〈0. 001） ,waist-to-hip ratio （r=-0. 393 ,P=0. 001） and blood triglyceride （P=0. 036）. Moreover,triglyceride level in obese children with vitamin D deficiency Eserum 25（OH）D ≤50 nmol/L] was higher than that in obese children with 25 （OH）D 〉 50 nmol /L. [Conclusions] The serum 25（OH） D levels in obese children are lower than those in normal weight children ; the serum 25 （OH） D is negatively correlated with BMI SDS, waist circumference and blood triglyceride, which implying that vitamin D deficiency may be a risk factor of visceral obesity and metabolism syndrome.

关 键 词：肥胖 维生素D 儿童 

分 类 号：R723.14[医药卫生—儿科]