切换至 "中华医学电子期刊资源库"
高级检索
中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2016, Vol. 12 ›› Issue (02) : 148 -153. doi: 10.3877/cma.j.issn.1673-5250.2016.02.004

所属专题： 文献；

论著

超重或单纯性肥胖儿童人体质量指数与心血管疾病风险因子的相关性研究
林元涛1,*,*(), 杨光2, 王红宇1, 张燕1, 殷明刚3, 袁峰4   
  1. 1. 643000　四川，自贡市第一人民医院儿科
    2. 100853　北京，中国人民解放军总医院儿科
    3. 643000　四川，自贡市第一人民医院检验科
    4. 643000　四川，自贡市第一人民医院核医学科
  • 收稿日期:2016-01-13 修回日期:2016-03-04 出版日期:2016-04-01
  • 通信作者: 林元涛

Study on the correlation between body mass index and cardiovascular disease risk factors of overweight or simple obesity children

Yuantao Lin1(), Guang Yang2, Hongyu Wang1, Yan Zhang1, Minggang Yin3, Feng Yuan4   

  1. 1. Department of Pediatrics, Zigong First People's Hospital, Zigong 643000, Sichuan Province, China
    2. Department of Pediatrics, Chinese PLA General Hospital, Beijing 100853, China
    3. Department of Clinical Laboratory, Zigong First People's Hospital, Zigong 643000, Sichuan Province, China
    4. Department of Isotopic Laboratory, Zigong First People's Hospital, Zigong 643000, Sichuan Province, China
  • Received:2016-01-13 Revised:2016-03-04 Published:2016-04-01
  • Corresponding author: Yuantao Lin
  • About author:
    Corresponding author: Lin Yuantao, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

林元涛, 杨光, 王红宇, 张燕, 殷明刚, 袁峰. 超重或单纯性肥胖儿童人体质量指数与心血管疾病风险因子的相关性研究[J]. 中华妇幼临床医学杂志(电子版), 2016, 12(02): 148-153.

Yuantao Lin, Guang Yang, Hongyu Wang, Yan Zhang, Minggang Yin, Feng Yuan. Study on the correlation between body mass index and cardiovascular disease risk factors of overweight or simple obesity children[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2016, 12(02): 148-153.

目的

探讨超重或单纯性肥胖儿童人体质量指数(BMI)与心血管疾病风险因子的相关性。

方法

选择2013年3月至2015年1月，在自贡市第一人民医院儿科初次就诊即诊断为超重或单纯性肥胖的62例儿童纳入观察组，以及同期进行健康体检的46例正常体重儿童纳入对照组。统计学比较两组儿童一般临床指标[年龄、人体质量指数(BMI)、腰围、收缩压、舒张压]，脂代谢指标[动脉粥样硬化指数(AI)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、三酰甘油(TG)]，以及糖代谢指标[胰岛素抵抗指数(HOMA-IR)、口服葡萄糖耐量试验2小时血糖(OGTT GLU2h)、空腹血糖、空腹胰岛素]差异；并对观察组儿童BMI与上述9项心血管疾病风险因子(脂代谢和糖代谢指标)进行相关性分析。两组儿童年龄及性别构成比比较，差异无统计学意义(P>0.05)。所有参与本次研究的儿童，均由其监护人签署知情同意书，并获得自贡市第一人民医院伦理委员会同意。

结果

①观察组儿童一般临床指标BMI[(31.8±2.3) kg/m2]、腰围[(86.7±12.3) cm]及收缩压[(128.0±11.2) mmHg(1 mmHg＝0.133 kPa)]均较对照组[(19.4±0.8) kg/m2、(61.1±8.0) cm、(102.0±12.9) mmHg]高，且差异有统计学意义(t＝－38.171、－12.770、－2.120，P<0.05)。②观察组儿童脂代谢指标AI(4.0±0.8)及TC、LDL、TG浓度[(4.9±0.6) mmol/L、(3.07±0.23) mmol/L、(1.85±0.13) mmol/L]均较对照组高[(1.0±0.4)、(4.0±0.4) mmol/L、(1.46±0.13) mmol/L、(0.80±0.21) mmol/L]，而HDL浓度[(0.89±0.09) mmol/L]则较对照组[(2.14±0.49) mmol/L]低，且差异均有统计学意义(t＝－35.96、－7.66、－51.29、－22.03、36.62，P<0.01)。③观察组儿童糖代谢指标HOMA-IR(12.5±1.3)及OGTT GLU2h、空腹血糖、空腹胰岛素浓度[(7.5±0.9) mmol/L、(5.97±0.22) mmol/L、(47.0±4.2) pmol/L]均较对照组高[(2.8±0.3)、(4.0±0.4) mmol/L、(4.47±0.13) mmol/L、(14.0±1.4) pmol/L]，且差异均有统计学意义(t＝－38.64、－25.44、－43.65、－57.31，P<0.01)。④观察组儿童BMI与AI、TC、LDL、TG、HOMA-IR、OGTT GLU2h、空腹血糖及空腹胰岛素之间呈正相关关系(r＝0.964、0.707、0.960、0.948、0.974、0.969、0.967、0.965，P<0.001)；BMI与HDL间呈负相关关系(r＝－0.939，P<0.001)。

结论

与正常体重儿童比较，超重或单纯性肥胖儿童更易罹患心血管疾病，应加强对超重或单纯性肥胖儿童的合理饮食指导，采取健康生活方式，预防心血管疾病发生。

关键词: 小儿肥胖症, 超重, 人体质量指数, 心血管疾病, 危险因素, 儿童
Objective

To explore the correlation between body mass index (BMI) and cardiovascular disease risk factors of overweight or simple obesity children.

Methods

From March 2013 to January 2015, a total of 62 initial visit children who were diagnosed as overweight or simple obesity in department of Pediatrics, Zigong First People's Hospital, were included into observation group, and another 46 children with normal weight who received health examination at the same time were included into control group. The differences between two groups in the aspects of general clinical index [age, body mass index (BMI), waist circumference, systolic blood pressure, diastolic blood pressure], lipid metabolism index [atherosclerosis index (AI), total cholesterol (TC), high-density lipoprotein (HDL), low density lipoprotein(LDL), triglyceride(TG)], and sugar metabolism index [indexes of insulin resistance (HOMA-IR), glucose concentration after 2 hours of oral glucose tolerance test (OGTT GLU2h), fasting blood glucose, fasting insulin] were statistically compared. Meanwhile, the correlation between BMI and 9 risk factors for cardiovascular disease(lipid metabolism and sugar metabolism index above mentioned) in observation group were analyzed. There were no significant differences between two groups in age and gender constituent ratio(P>0.05). The guardian of all children participated in this study signed the informed consent, and the procedure of this study was approved by the Ethical Review Board of Investigation in Human Being of Zigong First People's Hospital.

Results

①The general clinical index of children in observation group including BMI[(31.8±2.3) kg/m2], waist circumference[(86.7±12.3) cm] and systolic blood pressure[(128.0±11.2) mmHg (1 mmHg=0.133 kPa] were higher than those of control group[(19.4±0.8) kg/m2, (61.1±8.0) cm, (102.0±12.9) mmHg], and the differences were statistically significant(t=-38.171, -12.770, -2.120; P<0.05). ②The lipid metabolism index of children in observation group including AI(4.0±0.8) and concentrations of TC, LDL, TG [ (4.9 ± 0.6) mmol /L, (3.07±0.23) mmol/L, (1.85±0.13) mmol/L] were higher than those of control group[(1.0±0.4), (4.0±0.4) mmol/L, (1.46±0.13) mmol/L, (0.80±0.21) mmol/L], but HDL concentration [ (0.89±0.09) mmol/L] was lower than that of control group[(2.14±0.49) mmol /L], and all the differences above were statistically significant(t=-35.96, -7.66, -51.29, -22.03, 36.62; P<0.01). ③The sugar metabolism index of children in observation group including HOMA-IR(12.5±1.3) and concentrations of OGTT GLU2h, fasting blood glucose, fasting insulin[(7.5±0.9) mmol/L, (5.97±0.22) mmol/L, (47.0±4.2) pmol/L] were higher than those of control group[(2.8±0.3), (4.0±0.4) mmol/L, (4.47±0.13) mmol/L, (14.0±1.4) pmol/L], and the differences were statistically significant(t=-38.64, -25.44, -43.65, -57.31; P<0.01). ④ The BMI of children in observation group had positive correlation with AI, TC, LDL, TG, HOMA-IR, OGTT GLU2h, fasting blood glucose and fasting insulin(r=0.964, 0.707, 0.960, 0.948, 0.974, 0.969, 0.967, 0.965; P<0.001), but had negative correlation with HDL (r=-0.939, P<0.001).

Conclusions

Compare to normal weight children, overweight or simple obesity children are more likely to suffer from cardiovascular diseases. We should give proper diet guidance to overweight or simple obesity children and take a healthy lifestyle for the prevention of cardiovascular disease.

Key words: Pediatric obesity, Overweight, Body mass index, Cardiovascular diseases, Risk factors, Child
表1 两组儿童一般临床指标比较(±s)
组别 例数 年龄(岁) BMI(kg/m2) 腰围(cm) 收缩压(mmHg) 舒张压(mmHg)
观察组 62 11.6±2.0 31.8±2.3 86.7±12.3 128.0±11.2 85.3±10.1
对照组 46 11.6±1.4 19.4±0.8 61.1±8.0 102.0±12.9 65.0±7.0
t值 　 －0.065 －38.171 －12.770 －2.120 －1.010
P值 　 0.113 0.005 0.006 0.023 0.089
表2 两组儿童脂代谢指标比较(±s)
组别 例数 AI TC(mmol/L) HDL(mmol/L) LDL(mmol/L) TG(mmol/L)
观察组 62 4.0±0.8 4.9±0.6 0.89±0.09 3.07±0.23 1.85±0.13
对照组 46 1.0±0.4 4.0±0.4 2.14±0.49 1.46±0.13 0.80±0.21
t值 　 －35.96 －7.66 36.62 －51.29 －22.03
P值 　 0.007 0.004 0.003 0.001 0.005
表3 两组儿童糖代谢指标比较(±s)
组别 例数 HOMA-IR OGTT GLU2h(mmol/L) 空腹血糖(mmol/L) 空腹胰岛素(pmol/L)
观察组 62 12.5±1.3 7.5±0.9 5.97±0.22 47.0±4.2
对照组 46 2.8±0.3 4.0±0.4 4.47±0.13 14.0±1.4
t值 　 －38.64 －25.44 －43.65 －57.31
P值 　 0.001 0.006 0.008 0.002
图1 观察组儿童BMI与AI相关性分析散点图
图2 观察组儿童BMI与TC相关性分析散点图
图3 观察组儿童BMI与HDL相关性分析散点图
图4 观察组儿童BMI与LDL相关性分析散点图
图5 观察组儿童BMI与TG相关性分析散点图
图6 观察组儿童BMI与HOMA-IR相关性分析散点图
图7 观察组儿童BMI与OGTT GLU2h相关性分析散点图
图8 观察组儿童BMI与空腹血糖相关性分析散点图
图9 观察组儿童BMI与空腹胰岛素相关性分析散点图
1
吕建中，华飞，黄晓燕，等．江苏省常州市城区7～12岁儿童肥胖与高血压的流行病学调查[J]．中华流行病学杂志，2009，30(8)：868-869.
2
Cole TJ, Bellizzi MC, Flegal KM, et al. Establishing a standard definition for child overweight and obesity worldwide: international survey[J]. BMJ, 2000, 320(7244):1240-1243.
3
李光伟．胰岛素敏感性评估及其在临床研究中的应用[J]．中华内分泌代谢杂志，2000，16(3)：198-200.
4
蒋竞雄，丁宗一．儿童期单纯肥胖症的综合治疗方案[J]．中华医学杂志，1991，71(8)：473-475.
5
李家宜．注意在儿童时期预防成人心血管病[J]．中华儿科杂志，1994，32(3)：137-138.
6
李晓娜，李兰秀．肥胖儿童脂代谢及血压与ACE基因多态性的临床研究[J]．临床儿科杂志，2010，28(9)：814-817.
7
于佳，倪唤春，罗心平．脂质代谢相关基因多态性与动脉粥样硬化[J]．国际心血管病杂志，2014，41(3)：173-175.
8
Owens S, Gutin B, Barbeau P, et al. Visceral adipose tissue and markers of the insulin resistance syndrome in obese black and white teenagers[J]. Obes Res, 2000, 8(4): 287-293.
9
Fagot-Campagna A, Pettitt DJ, Engelgau MM, et al. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective[J]. J Pediatr, 2000, 136(5): 664-672.
10
Liu LL, Yi JP, Beyer J, et al. Type 1 and Type 2 diabetes in Asian and Pacific Islander U.S. youth: the search for diabetes in youth study[J]. Diabetes Care, 2009,32(Suppl 2):S133-S140.
11
Haines L, Wan KC, Lynn R,et al. Rsing incidence of type 2 diabetes in children in the U.K.[J]. Diabetes Care,2007,30(5):1097-1101.
12
Kameswararao AA, Bachu A. Survey of childhood diabetes and impact of school level educational interventions in rural schools in Karimnagar district[J]. Int J Diabetes Dev Ctries, 2009, 29(2): 69-73.
13
Feltbower RG, Bodansky HJ, McKinney PA, et al. Trends in the incidence of childhood diabetes in south Asians and other children in Bradford,UK[J]. Diabet Med,2002,19(2):162-166.
14
Urakami T, Morimoto S, Nitadori Y, et al. Urine glucose screening program at schools in Japan to detect children with diabetes and its outcome-incidence and clinical characteristics of childhood type 2 diabetes in Japan[J]. Pediatr Res, 2007,61(2):141-145.
15
曹冰燕，米杰，巩纯秀，等．北京市19 593名儿童青少年糖尿病患病现况调查[J]．中华流行病学杂志，2007，28(7)：631-634.
16
南会兰，张蕴．2型糖尿病与心血管并发症研究新进展[J]．医学综述，2010，16(20)：3142-3145.
17
李枝萍，刘军，徐婷婷，等．我国2型糖尿病的流行病学及危险因素研究现状[J]．西南军医，2010，12(4)：754-756.
18
江丽，童南伟．从最新公布的"糖尿病和心血管病行动"研究看强化降糖治疗对糖尿病大血管病变的影响[J]．心血管病学进展，2009，30(4)：643-645.
19
Mihardja L, Delima, Manz HS,et al.Prevalence and determinants of diabetes mellitus and impaired glucose tolerance in Indonesia (a part of basic health research/riskesdas)[J].Acta Med Indones,2009,41(4):169-174.
[1] 张璇, 马宇童, 苗玉倩, 张云, 吴士文, 党晓楚, 陈颖颖, 钟兆明, 王雪娟, 胡淼, 孙岩峰, 马秀珠, 吕发勤, 寇海燕. 超声对Duchenne肌营养不良儿童膈肌功能的评价[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1068-1073.
[2] 张宝富, 俞劲, 叶菁菁, 俞建根, 马晓辉, 刘喜旺. 先天性原发隔异位型肺静脉异位引流的超声心动图诊断[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1074-1080.
[3] 韩丹, 王婷, 肖欢, 朱丽容, 陈镜宇, 唐毅. 超声造影与增强CT对儿童肝脏良恶性病变诊断价值的对比分析[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 939-944.
[4] 刘婷婷, 林妍冰, 汪珊, 陈幕荣, 唐子鉴, 代东伶, 夏焙. 超声衰减参数成像评价儿童代谢相关脂肪性肝病的价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 787-794.
[5] 周钰菡, 肖欢, 唐毅, 杨春江, 周娟, 朱丽容, 徐娟, 牟芳婷. 超声对儿童髋关节暂时性滑膜炎的诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 795-800.
[6] 刘欢颜, 华扬, 贾凌云, 赵新宇, 刘蓓蓓. 颈内动脉闭塞病变管腔结构和血流动力学特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 809-815.
[7] 马艳波, 华扬, 刘桂梅, 孟秀峰, 崔立平. 中青年人颈动脉粥样硬化病变的相关危险因素分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 822-826.
[8] 陈旭渊, 罗仕云, 李文忠, 李毅. 腺源性肛瘘经手术治疗后创面愈合困难的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 82-85.
[9] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[10] 吴方园, 孙霞, 林昌锋, 张震生. HBV相关肝硬化合并急性上消化道出血的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 45-47.
[11] 陆猛桂, 黄斌, 李秋林, 何媛梅. 蜂蛰伤患者发生多器官功能障碍综合征的危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1010-1015.
[12] 刘笑笑, 张小杉, 刘群, 马岚, 段莎莎, 施依璐, 张敏洁, 王雅晳. 中国学龄前儿童先天性心脏病流行病学研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1021-1024.
[13] 李达, 张大涯, 陈润祥, 张晓冬, 黄士美, 陈晨, 曾凡, 陈世锔, 白飞虎. 海南省东方市幽门螺杆菌感染现状的调查与相关危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 858-864.
[14] 李琪, 黄钟莹, 袁平, 关振鹏. 基于某三级医院的ICU多重耐药菌医院感染影响因素的分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 777-782.
[15] 李静, 张玲玲, 邢伟. 兴趣诱导理念用于小儿手术麻醉诱导前的价值及其对家属满意度的影响[J]. 中华临床医师杂志(电子版), 2023, 17(07): 812-817.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号