肥胖儿童的动脉粥样硬化危险因素
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A Study of Risk Factors for Arteriosclerosis in Obese Children
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    摘要:

    目的通过比较肥胖和非肥胖儿童动脉粥样硬化的危险因素,探讨肥胖对儿童发生动脉粥样硬化的影响。方法对51例肥胖儿童和32例非肥胖儿童常规进行24h动态血压测定,检测胰岛素、高敏C反应蛋白、游离脂肪酸、甘油三酯、总胆固醇、空腹血糖、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平,采用B超检测颈动脉内膜中膜厚度、内皮依赖性血管舒张功能、最大的腹膜前脂肪厚度和最小的皮下脂肪厚度,酶联免疫吸附法检验血清抵抗素、脂联素,并计算稳态模型胰岛素抵抗指数。结果肥胖儿童组高敏C反应蛋白、胰岛素抵抗指数高于非肥胖儿童组(分别为1.57±0.06mg/L、4.567±2.621和1.38±0.05mg/L、1.70±0.712),空腹胰岛素、最小皮下脂肪厚度、最大腹膜前脂肪厚度、24h平均收缩压、甘油三酯、低密度脂蛋白胆固醇、游离脂肪酸也明显增高(p<0.05);肥胖组高密度脂蛋白胆固醇、脂联素低于非肥胖组(分别为0.27±0.22mmol/L、1.477±0.609mg/L和1.14±0.25mmol/L、2.795±1.124mg/L;p<0.05)。但两组颈动脉内膜中膜厚度、24h平均舒张压、内皮依赖性血管舒张功能无明显差异。体质指数与24h平均收缩压(r=0.43,P=0.006)、高敏C反应蛋白(r=0.461,P=0.018)、胰岛素抵抗指数(r=0.463,P=0.007)、游离脂肪酸(r=0.358,P=0.029)呈正相关,而与脂联素(r=-0.356,P=0.031)呈负相关。结论肥胖儿童导致动脉粥样硬化的危险因素水平明显增高,肥胖儿童已经存在动脉粥样硬化慢性炎症的早期改变,但是还未出现动脉内膜粥样斑块形态学上的改变。

    Abstract:

    Aim To investigate the effect of obesity on the arteriosclerosis development in children by comparing the risk factors for arteriosclerosis in obese children with those in non-obese children.Methods Fifty-one obese children and thirty-two non-obese children were evaluated for endothelium-dependent arterial dilation,intima-media thickness(IMT)of the common carotid artery,the maximum preperitioneal fat thickness(Pmax)and minimum subcutaneous fat thickness(Smin)by B ultra sonograthy;24 h average systolic blood pressure(SBP)and diastolic blood pressure(DBP)were detected;the serum levels of triglyceride(TG),total cholesterol(TC),blood glucose and free fatty acids(FFA),low density lipoprotein cholesterol(LDLC),high density lipoprotein cholesterol(HDLC)were deteced by chemistry;insulin(FIns),by RIA;adiponectin(AD),resistin by ELISA,and high-sensitivity c-reactive protein(hs-CRP),by scatter nephelomete method.Results The values of Hs-CRP,HOMA-IR,INS,Smin,Pmax,SBP,TG,LDLC,and FFA were higher in the obese children than in the non-obese children(p<0.05),while HDL-C and adiponectin in the obese children were lower than those in the non-obese children(p<0.05).However,no statistical difference was found between the levels of IMT,DBP,and Endothelium-dependent arterial dilation in the obese children and those in the non-obese children(p>0.05).The BMI was correlated with SBP(r=0.43,P=0.006),hs-CRP(r=0.461,P=0.018),HOMA-IR(r=0.463,P=0.007),FIns(r=0.404,P=0.013),FFA(r=0.358,P=0.018),while it was negatively correlated with AD(r=-0.356,P=0.031).However,there was no statistically different relationship between ITM and other biochemical indicators.Conclusions The levels of the risk factors for arteriosclerosis were much higher in obese children than those in non-obese children.The results showed that the chronic inflammation situation of arteriosclerosis has already existed in the obese children,but no morphological change in the endarterium was found.

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刘蕴玲,梁红日,程慧玲,聂玮.肥胖儿童的动脉粥样硬化危险因素[J].中国动脉硬化杂志,2007,15(1):64~66.

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  • 收稿日期:2006-07-19
  • 最后修改日期:2007-01-05
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