中至重度肥胖儿童尿酸水平与糖脂代谢相关性研究

doi:10.3877/cma.j.issn.1673-5250.2011.06.010

目的

探讨中至重度肥胖儿童尿酸(UA)水平与糖脂代谢之间的关系。

方法

选择2006年1月至2010年12月在本院内分泌代谢专科门诊和病区就诊并确诊的74例肥胖儿童为研究对象。其中，男性患儿为45例，女性为29例；年龄为2.7~16.6岁。诊断标准：体重指数(BMI)超过同年龄、同性别儿童95百分位(P₉₅，诊断为肥胖，以BMI超过同年龄、同性别儿童的30%，则诊断为中度肥胖，若超过40%，则诊断为重度肥胖。纳入标准：入选儿童既往均无严重肝、肾损害和使用影响UA的药物史。按照UA水平将其分为高UA水平组(n＝24，UA>416 μmol/L)和正常UA水平组(n＝50，UA≤416 μmol/L)(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与其签署临床研究知情同意书)。两组患儿性别、年龄等比较，差异无显著意义(P>0.05)。分别检测两组儿童BMI、空腹血糖(FBG)、空腹血胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL－C)、低密度脂蛋白胆固醇(LDL－C)及UA，并计算血糖/胰岛素比值(G/I)、稳态模型评估的胰岛素抵抗指数(HOMA－IR)和稳态模型评估的胰岛素敏感性(HOMA－IS)，TG及HDL－C比值(TG/HDL－C)。

结果

高UA水平组FBG，G/I，TG，TC，HDL，LDL和TG/HDL－C与正常UA水平组比较，差异无统计学意义(P>0.05)，而两组FINS，HOMA－IR和HOMA－IS比较，差异有统计学意义(P<0.05)。

结论

中至重度肥胖儿童合并高尿酸血症(HUA)与胰岛素敏感性密切相关，肥胖儿童需早期干预和长期随访血UA浓度。

关键词: 肥胖症, 高尿酸血症, 稳态模型评估的胰岛素抵抗指数, 稳态模型评估的胰岛素敏感性, 儿童

Objective

To investigate the relationship between uric acid(UA) level and glycometabolism and lipid metabolism in moderate and severe obesity children.

Methods

From January 2006 to December 2010, a total of 74 children aged 2.7-16.6 years-old who were diagnosed as obesity were recruited in this study, including 45 boys and 29 girls. The diagnostic criteria were: body mass index (BMI)>P₉₅ diagnosis as obesity, moderate obesity: BMI>30% average and severe obesity: BMI>40% average. Both groups excluded severe hepatic and kidney lesion and the drug which would influence UA. According to the level of UA, the moderate and severe obesity children were divided into high level UA group (n=24, UA>416 μmol/L)and normal level UA group(n=50, UA≤ 416 μmol/L). Informed consent was obtained from all participates. There were no significant difference in gender and age between two groups (P>0.05). The BMI, fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and UA were tested, and glucose/insulin (G/I), homeostasis model assessment-insulin resistance index (HOMA-IR), homeostasis model assessment insulin sensitive index (HOMA-IS) and TG/HDL-C were calculated.

Results

There were no significant differences in FBG, G/I, TG, TC, HDL, LDL and TG/HDL-C between two groups(P>0.05), and FINS, HOMA-IR and HOMA-IS in high level UA group were significant higher than those of normal level UA group(P<0.05).

Conclusion

Insulin sensitivity is closely related to the incidence of hyperuricemia in moderate and severe obesity child. It is necessary to follow up and intervene in early the level of blood UA in moderate and severe obesity children.

Key words: obesity, hyperuricemia, homeostasis model assessment-insulin resistance index, homeostasis model assessment insulin sensitive index, child

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Correlation Study on Blood Uric Acid Level and Glycometabolism and Lipid Metabolism in Moderate and Severe Obesity Children

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Correlation Study on Blood Uric Acid Level and Glycometabolism and Lipid Metabolism in Moderate and Severe Obesity Children