儿童生长激素缺乏症患者血清血脂水平与心外膜脂肪厚度的相关性研究  

The correlation between serum lipid level and epicardial fat thickness in children with growth hormone deficiency

作　　者：李艳英[1] 张梅[1] 王少春[2] 刘丹丹[2] 晏文华 班博[1] Li Yanying;Zhang Mei;Wang Shaochun;Liu Dandan;Yan Wenhua;Ban bo(Department of Endocrinology,the Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Ultrasound,the Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院内分泌科,272029 [2]济宁医学院附属医院超声科,272029

出　　处：《中华诊断学电子杂志》2018年第1期48-52,共5页Chinese Journal of Diagnostics(Electronic Edition)

基　　金：济宁市科技局资助项目[济科字(2015)57号-11]

摘　　要：目的观察儿童生长激素缺乏症(GHD)患者心外膜脂肪组织(EAT)厚度的变化,探讨生长激素缺乏对GHD患儿体脂代谢的影响。方法应用巢式病例对照研究方法,收集2017年1月至10月在济宁医学院附属医院内分泌科住院的身材矮小患者,共59例,按照生长激素激发试验结果将患者分为3组:A组为生长激素完全缺乏组[生长激素峰值(GHmax)<0.24 nmol/L],20例;B组为生长激素部分缺乏组(0.24 nmol/L≤GHmax<0.47 nmol/L),24例;C组为生长激素正常组(GHmax>0.47 nmol/L),15例。应用超声心动图检测每例患者EAT厚度,同时收集患者的一般资料、血清血脂、生长激素水平,胰岛素样生长因子(IGF-1)及骨龄等指标。结果 3组EAT厚度比较差异有统计学意义(F=4.13,P<0.05),其中A组(2.70±0.87)较B组(2.20±0.81)及C组(2.00±0.47)高(P<0.05),而B组与C组比较差异无统计学意义(P>0.05);应用平滑曲线拟合与阈值效应分析发现在甘油三酯(TG)≥0.9 mmol/L时,EAT厚度与TG水平呈正相关(β=2.0,P<0.05)。结论 GHD患儿EAT厚度增加,该表现早于脂代谢异常出现之前。Objective To observe the change of epicardial adipose tissue(EAT)thickness in children with growth hormone deficiency(GHD),and explore the effect of growth hormone deficiency on lipid metabolism.Methods Using nested case-control study method,59 patients who were diagnosed with short stature in the Affiliated Hospital of Jining Medical University from January 2017 to October 2017 were selected.According to the growth hormone stimulation test results,all patients were divided into three groups:growth hormone deficiency group(GHmax<0.24 nmol/L)(group A),partial growth hormone deficiency group(0.24 nmol/L≤GHmax<0.47 nmol/L)(group B),normal growth hormone group(GHmax≥0.47 nmol/L)(group C).EAT thickness was tested by echocardiography,meanwhile general information and related results were collected,such as blood lipid,growth hormone,insulin-like growth factor(IGF-1)and bone age etc.Results EAT thickness was different in three groups(F=4.13,P<0.05),which was thicker in group A(2.70±0.87)compared with group B(2.20±0.81)and group C(2.00±0.47)(P<0.05),and there was no statistical difference between group B and group C(P>0.05).Smooth curve fitting and threshold effect analysis showed that EAT thickness and triglyceride(TG)were positively correlated(β=2.0,P<0.05),when TG level was higher than 0.9 mmol/L.Conclusion EAT thickness is increased in children with GHD and occurrs before abnormality lipid appears.

关 键 词：生长激素缺乏 心外膜脂肪 脂代谢障碍 

分 类 号：R725.8[医药卫生—儿科]