摘要
目的了解单纯性肥胖儿童葡萄糖代谢异常的相关危险因素以及各组分的相互关系。方法符合单纯性肥胖标准对象370例,分别测量体质量、腰围、臀围,常规方法检测血糖、血脂、血清胰岛素等生化指标,酶联免疫吸附法(ELISA)测定血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α),所有研究对象进行葡萄糖耐量试验检查。计算体质指数(BMI)、腰臀围比(WHR)、胰岛素抵抗指数(InRI),采用因子分析及Logistic回归模型分析葡萄糖代谢异常与各种相关因素的关系。结果 370例中葡萄糖代谢异常(IGM)检出率为21.08%。通过主成分因子分析方法在原始观察指标基础上提取7个因子,分别为WHR、BMI、总胆固醇(TC)、高密度脂蛋白(HDL)、InRI、TNF-α、IL-6,分别代表腹型肥胖、血脂异常、胰岛素抵抗和低度炎症反应,Logistic回归分析表明葡萄糖代谢异常(IGM)与WHR(OR=1.557,P<0.001)、TC(OR=1.246,P<0.001)、HDL(OR=0.861,P<0.001)、InRI(OR=1.255,P=0.005)、IL-6(OR=1.135,P=0.008)和TNF-α(OR=1.471,P=0.002)等因素独立相关。结论儿童时期肥胖常伴有明显的葡萄糖代谢异常,腹型肥胖、胰岛素抵抗、血脂异常和低度炎症反应与肥胖相关葡萄糖代谢异常密切相关。重视对葡萄糖代谢异常相关因素的监测与评价有助于肥胖相关并发症的预防及治疗。
Objective To investigate the risk factors of impaired glucose metabolism（IGM） in children with simple obesity and explore the relationship among the associated factors.Methods Total of 370 children with simple obesity were enrolled in the study.They were subdivided into two groups according to the results of oral glucose tolerance test.Body mass index（BMI）,circumferences of waist and hip were measured.Levels of glucose,total cholesterol（TC）,triglycerides（TG）,high density lipoprotein（HDL）,and serum insulin were tested by conventional methods.Serum levels of IL-6,TNF-α were measured by enzyme linked immunosorbent assay（ELISA）.BMI and waist to hip ratio（WHR） were calculated as indices of obesity.Insulin resistance index（InRI） was calculated by homeostasis model assessment of insulin resistance（HOMA-IR）.The relative factors associated with impaired glucose metabolism were studied by factor analysis of data reduction and multiple Logistic regression.Results The incidence of impaired glucose metabolism was 21.08%.Seven factors were extracted from the original variables by using principal component factor analysis.They were WHR,BMI,TC,HDL,InRI,TNF-α,IL-6,which indicated abdominal obesity,abnormal fat metabolism,insulin resistance,and low-grade inflammation.Logistic regression analysis revealed that IGM was independently associated with factors including WHR（OR = 1.557,P〈0.001）,blood TC（OR = 1.246,P〈0.001）,blood HDL（OR = 0.861,P〈0.001）,InRI（OR = 1.225,P = 0.005）,blood serum IL-6（OR = 1.135,P = 0.008）,serum TNF-α（OR = 1.471,P = 0.002）.Conclusions Impaired glucose metabolism（IGM） was very common in children with simple obesity.Abdominal obesity,abnormal fat metabolism,insulin resistance,and low-grade inflammation were closely associated with IGM.Monitoring and evaluating those factors may be helpful for prevention and treatment of obesity-related complications.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2010年第9期827-830,共4页
Journal of Clinical Pediatrics
基金
广西壮族自治区卫生厅自筹经费课题资助(No.Z2008151)
关键词
儿童
肥胖症
胰岛素抵抗
葡萄糖代谢
因子分析
children
obesity
insulin-resistance
glucose metabolism
factor analysis
