上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (1): 32-.

• 专题报道（营养学研究） • 上一篇    下一篇

门诊肥胖儿童代谢综合征状况分析

沈婉蓉, 万燕萍, 徐仁应, 张晓敏, 汪佳璐   

  1. 上海交通大学 医学院仁济医院临床营养科, 上海 200127
  • 出版日期:2010-01-26 发布日期:2010-01-26
  • 通讯作者: 万燕萍, 电子信箱: wanyp204@yahoo.com.cn。
  • 作者简介:沈婉蓉（1973—）, 女, 主治医师, 学士；电子信箱: lizzyshen08@sina.com.cn。

Analysis of metabolic syndrome among obese children in clinics

SHEN Wan-rong, WAN Yan-ping, XU Ren-ying, ZHANG Xiao-min, WANG Jia-lu   

  1. Department of Clinical Nutrition, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
  • Online:2010-01-26 Published:2010-01-26

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摘要：

目的 分析门诊肥胖儿童代谢综合征（MS）的发病情况。方法 选择113名肥胖病营养专科门诊就诊的7~14岁肥胖儿童为病例组，以同期366名7~14岁健康学生为对照组，测量两组的身高、体质量、腰围、臀围、血压、肝脏超声，并检测空腹血糖、空腹胰岛素、血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）等相关生化指标，诊断MS的发病率。采用HOMA-IR的四分位数分割点来定义有无胰岛素抵抗。结果 病例组与对照组的年龄和性别比无统计学差异（P>0.05），而体质量、体质量指数（BMI）、腰围、臀围、腰臀比（WHR）、收缩压（SBP）、舒张压(DBP)、空腹血糖、空腹胰岛素、HOMA指数和TG均明显高于对照组（P<0.01）。对照组HOMA指数第75位百分位值为3.28，以此为切点将病例组分胰岛素抵抗组和非胰岛素抵抗组。病例组中胰岛素抵抗儿童体质量、BMI、腰围、TG均明显高于非胰岛素抵抗组儿童（P<0.05）；病例组中有51例（45.1%）儿童发生MS。胰岛素抵抗组儿童MS发病率高于非胰岛素抵抗组儿童(50.0% vs 21.1%)（P<0.05）。结论 超重和肥胖儿童MS发病率较高；MS发生与胰岛素抵抗明显相关。

关键词: 肥胖,儿童, 胰岛素抵抗, HOMA指数, 代谢综合征

Abstract:

Objective To investigate the incidence of metabolic syndrome among obese children in clinics. Methods One hundred and thirteen obese children aged 7 to 14 years were selected from clinics of nutrition (case group), and another 366 healthy students aged 7 to 14 years were served as controls. Height, body weight, waist circumference, hip circumference, blood pressure and liver ultrasound were measured, related biochemical parameters such as fasting blood glucose, fasting insulin, serum total cholesterol, triglyceride (TG), high density lipoprotein and low density lipoprotein were detected, and the incidences of metabolic syndrome were obtained in two groups. Insulin resistance (IR) was evaluated by homeostasis model assessment (HOMA). Results There was no significant difference in age and gender between case group and control group (P>0.05). Body weight, body mass index (BMI), waist circumference, hip circumference, waist to hip ratio, systolic blood pressure, diastolic blood pressure, fasting blood glucose, fasting insulin, HOMA index and TG in case group were significantly higher than those in control group (P<0.01). The 75th percentile of HOMA index in control group was 3.28, and IR subgroup and non-IR subgroup were divided according to this cutpoint. In case group, body weight, BMI, waist circumference and TG in non-IR subgroup were significantly higher than those in IR subgroup （P<0.05）. Metabolic syndrome occurred in 51 cases (45.1%) in case group. The incidence of metabolic syndrome was higher in IR subgroup than that in non-IR group (50.0% vs 21.1%) (P<0.05). Conclusion The prevalence of metabolic syndrome is higher in overweight and obese children. IR has a close relationship with metabolic syndrome.

Key words: obesity, children, insulin resistance, HOMA index, metabolic syndrome