中国实用儿科杂志2011，Vol.26Issue(8)：587-591,5.
儿童及青少年肥胖症糖脂代谢异常早期诊断和干预的研究
Research into abnormal glucose and lipid metabolism in early diagnosis and intervention in obese children and adolescents.
穆亚平 1韩萍 2辛颖 2赵方 1马洪刚 1刘立旻 3李娜 1王岩 1李玢 1关丽君 1李书琴4
作者信息
- 1. 沈阳市儿童医院,沈阳110032
- 2. 中国医科大学附属盛京医院,沈阳 110004
- 3. 中国医科大学,沈阳110001
- 4. 中国医科大学附属盛京医院,沈阳110004
- 折叠
摘要
Abstract
Objective To explore the relationship between obesity and glucose and lipid metabolism , and the damage of the related target organs such as liver and heart in order to take early intervention. Methods Totally 516 children with simple obesity made up obesity group, 100 normal-weight children as a control group. Detect the fasting plasma glucose (FPC) , triglyceride (TC) , total cholesterol (TC) , alanine aminotransferase (ALT) , fasting insulin (FINS) and other projects; calculate the insulin resistance index (HOMA-IR) and insulin value of f$-cell function (HOMA-p ) ; oral glucose tolerance test (OGTT) and insulin release test were done in obese children; perform liver and heart ultrasonogra-phy in all children. Results Obese children's systolic and diastolic blood pressure were higher than the control group (P< 0.05) .hypertension was detected in 12.0% (62/516)of obese children; the FBG, FINS, HOMA-IR and HOMA-B of obese children were higher than the control group (P < 0.05) ; the TC, TC, LDL-C were higher than the control group, while HDL-C lower than the control group, the differences being significant (P < 0.05) ; the incidence of fatty liver of the light moderate and severe groups were significantly different (P < 0.001). With the increase of the obesity degree, fatty liver was significantly increased ( X2 = 12.97, P < 0.001). External fat thickness of the pericardium increasedin 268 cases of obese group, external fat thickness of the pericardium being 3.372 ± 0.098 (mm) ;compared with the control group the difference was significant (P < 0.001). Early joint intervention was done in 97 MS pa-tients, including dieting and increasing physical activity, combined with oral metformin drugs,and the FINS and HDL-C improvement was of significant difference (P < 0.001) .Conclusion The risk of hypertension in obese children is higher than non-obese children.Abnormal glucose metabolism is more comman in obese children than in non-obese children; children with mild obesity can have abnormal glucose metabolism such as IFGJGTJR NHINS and reduced P -cell function.Obese children have dyslipidemia. Fatty liver is likely to occur in obese children, and the incidence of fatty liver and obesity level of severity is relevant. After the age of 10, fatty liver in obese children was significantly higher.Left ventricular hypertrophy and fat thickness of external pericardia] are more often seen in fat group than children of normal weight. With the degree of obesity increaseing, the proportion of cardiac change is also increasing. Metformin treatment of obesity and other joint intervention can significantly reduce the FINS and increased HDL-C values, which can prevent the development of IGT and diabetes.关键词
儿童/青少年/肥胖/代谢综合征/脂肪肝/左心室肥大/心包外脂肪厚度Key words
children/youth/adolescents/metabolic syndrome/fatty liver/left ventricular hypertrophy/external pericardial fat thickness分类
医药卫生引用本文复制引用
穆亚平,韩萍,辛颖,赵方,马洪刚,刘立旻,李娜,王岩,李玢,关丽君,李书琴..儿童及青少年肥胖症糖脂代谢异常早期诊断和干预的研究[J].中国实用儿科杂志,2011,26(8):587-591,5.
