肥胖儿童糖脂代谢状况及其与性早熟的相关性  

Glucose and lipid metabolism in obese children and its correlation with precocious puberty

作　　者：吴鸿波[1] 王露 李丽华[1] Wu Hongbo;Wang Lu;Li Lihua(Children′s Center(Department of Pediatrics),Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院儿童中心(儿科),北京101100

出　　处：《中国医师进修杂志》2025年第2期164-168,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨肥胖儿童糖脂代谢状况与儿童发生性早熟的相关性。方法回顾性选取2021年3月至2023年3月在首都医科大学附属北京潞河医院体检的65例肥胖儿童(肥胖组)和65例体质量正常儿童(对照组),检测两组糖脂代谢指标,参照Tanner分期标准评估性早熟,采用Spearman检验分析糖脂代谢指标与性早熟的相关性,采用Logistic回归分析筛选肥胖儿童发生性早熟的危险因素。结果肥胖组空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA_(1)c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)水平高于对照组[5.90(5.50,6.50)mmol/L比4.90(4.40,5.30)mmol/L、(8.46±1.38)mmol/L比(7.39±0.87)mmol/L、5.90(5.10,6.70)%比5.30(4.50,5.70)%、(10.67±2.46)mU/L比(5.14±1.22)mU/L、2.10(1.90,2.30)比1.10(1.00,1.30)、(141.95±34.92)mmol/L比(95.21±12.40)mmol/L、(153.82±25.44)mmol/L比(143.59±18.47)mmol/L、80.50(72.10,94.50)mmol/L比65.10(59.30,69.80)mmol/L、293.20(271.80,330.70)μmol/L比250.90(210.80,286.90)μmol/L],高密度脂蛋白胆固醇(HDL-C)水平低于对照组[53.70(50.10,58.00)mmol/L比59.30(56.70,62.60)mmol/L],差异有统计学意义(P<0.05)。肥胖组男童、女童性早熟发生率高于对照组[23.68%(9/65)比0;37.04%(10/65)比7.41%(2/65)],差异有统计学意义(P<0.05)。Spearman检验结果显示,肥胖组男童睾丸、阴毛Tanner评分,女童乳房、阴毛Tanner评分均与FPG、2 h PG、HbA_(1)c、FINS、HOMA-IR、TG、TC、LDL-C、UA呈正相关(P<0.05),与HDL-C呈负相关(P<0.05)。多因素Logistic回归分析结果显示,FPG、HbA_(1)c、FINS、HOMA-IR、TG、TC、UA水平升高是肥胖儿童发生性早熟的危险因素(OR>1,P<0.05)。结论肥胖与性早熟存在关联,且肥胖儿童糖脂代谢紊乱与性早熟之间存在密切相关性。Objective To explore glucose and lipid metabolism in obese children and its correlation with precocious puberty.Methods A total of 65 obese children(obese group)and 65 children with normal body weight(control group)who underwent physical examination at the Beijing Luhe Hospital Affiliated to Capital Medical University from March 2021 to March 2023 were retrospectively selected.Glucose and lipid metabolism indexes of the two groups were detected,and precocious puberty was evaluated according to Tanner staging criteria.Spearman test was used to analyze the correlation between glucose and lipid metabolism indexes and precocious puberty.Logistic regression analysis was used to screen the risk factors of precocious puberty in obese children.Results The levels of fasting blood glucose(FPG),2-hour postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA_(1)c),fasting insulin(FINS),insulin resistance index(HOMA-IR),triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and uric acid(UA)in the obese group were higher than those in the control group:5.90(5.50,6.50)mmol/L vs.4.90(4.40,5.30)mmol/L,(8.46±1.38)mmol/L vs.(7.39±0.87)mmol/L,5.90(5.10,6.70)%vs.5.30(4.50,5.70)%,(10.67±2.46)mU/L vs.(5.14±1.22)mU/L,2.10(1.90,2.30)vs.1.10(1.00,1.30),(141.95±34.92)mmol/L vs.(95.21±12.40)mmol/L,(153.82±25.44)mmol/L vs.(143.59±18.47)mmol/L,80.50(72.10,94.50)mmol/L vs.65.10(59.30,69.80)mmol/L,293.20(271.80,330.70)μmol/L vs.250.90(210.80,286.90)μmol/L;while the level of high-density lipoprotein cholesterol(HDL-C)was lower than that in the control group:53.70(50.10,58.00)mmol/L vs.59.30(56.70,62.60)mmol/L,there were statistical differences(P<0.05).The incidence of precocious puberty in boys and girls in the obesity group was higher than those in the control group:23.68%(9/65)vs.0;37.04%(10/65)vs.7.41%(2/65),there were statistical differences(P<0.05).The results of the Spearman test showed that the Tanner scores of testis and pubic hair in boys and breast and pubic hair in girls in the obesity gro

关 键 词：肥胖 性发育 糖代谢 脂代谢 胰岛素抵抗 

分 类 号：R58[医药卫生—内分泌]