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。

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。

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)。

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。

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

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.

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).

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.