摘要
目的探讨单纯性肥胖儿童是否存在高同型半胱氨酸血症和早期动脉粥样病变.方法 68例6～14岁单纯性肥胖症儿童与26例正常同龄儿童对照,多普勒二维超声检测颈动脉内膜-中层厚度(IMT)、肱动脉血流介导的内皮依赖性扩张功能并探查肝脏形态结构,化学发光法测定血浆同型半胱氨酸.生化分析法检测全套血脂.结果肥胖儿童右颈总动脉IMT(0.54±0.13) mm,右颈内动脉IMT(0.69±0.14) mm,左颈总动脉IMT(0.52±0.12) mm,左颈内动脉IMT(0.67±0.14) mm;正常儿童右颈总动脉IMT(0.45±0.04) mm,右颈内动脉IMT(0.46±0.04) mm,左颈总动脉IMT(0.45±0.05) mm,左颈内动脉IMT(0.46±0.03) mm,肥胖儿童明显增厚(P＜0.01).肥胖儿童肱动脉血流介导的内皮依赖性扩张功能(11.0±4.3)%,与对照组(17.5±4.9)%比较,差异有统计学意义(P＜0.01).肥胖儿童血浆同型半胱氨酸含量(7.9±2.7) μmol/L,与正常儿童血浆同型半胱氨酸含量(5.6±2.1) μmol/L比较差异有统计学意义(P＜0.01).肥胖儿童总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-ch)、载脂蛋白B(apoB)明显高于对照组,差异有统计学意义(P＜0.01);高密度脂蛋白胆固醇(HDL-ch)、载脂蛋白A(apoA)与对照组比较,差异无统计学意义(P＞0.05).58%肥胖儿童存在脂肪肝或脂肪肝倾向.结论肥胖儿童存在早期动脉粥样病变.高同型半胱氨酸血症可能是引起肥胖儿童早期动脉粥样病变的重要因素.
Objective To understand whether hyperhomocysteinemia and early arterial atherosclerosis exist in simply obese children.Methods Totally 68 simply obese children (age 6-14 years, mean 10.8±2.3 years) were enrolled in this study, 50 were male and 18 were female. Body mass index (BMI) of the obese children was equal to or more than 22. The height of the chileren was (145±22) cm. Meanwhile, 26 normal children (age 6-14 years, mean 10.9±2.0 years) were selected as control group, 17 of these children were male and 9 were female. Their height was (148.5±5.8) cm. There were no significant differences in height and age between the obese and the control children. The carotid intimal-medial thickness (IMT), brachial artery flow-mediated vasodilation were examined by Doppler Flow/Dimension System and the liver was examined by B-mode ultrasound imager. Plasma homocysteine was determined by the automated chemiluminescent enzyme immunoassays. Serum lipid concentration was determined by biochemical analytic method. Blood pressure of the right upper limbs was measured. A detailed medical and family history was systematically recorded.Results BMI was (27.8±4.5) in the obese children and (16.2±2.5) in the controls. There was significant difference between two groups (P<0.01). The obese children had significantly increased values than the controls for the carotid intimal-medial thickness (P<0.01). Right carotid IMT, right inner-carotid IMT, left carotid IMT and left inner-carotid IMT were respectively (0.54±0.13) mm, (0.69±0.14) mm,(0.52±0.12) mm and (0.67±0.14) mm in obese children and were respectively (0.45±0.04) mm,(0.46±0.04) mm,(0.45±0.05) mm and (0.46±0.03) mm in control groups. Conversely, the flow-mediated brachial artery dilation of the obese children was significantly lower than that of the controls [(11.0±4.3)% vs.(17.5±4.9)%, P<0.01]. The obese children had higher level of plasma homocysteine than the controls [(7.9±2.7) μmol/L vs. (5.6±2.1) μmol/L, P<0.01]. Total cholesterol (TC) in the obese children dramatically increased, so did triglyceride concentration (TG), LDL-cholesterol (LDL-ch) and apolipoprotein-B (apo-B). Of the obese children, had fatty liver or the tendency to fatty liver. Six cases of the 68 obese children (8%) had hypertension. Of the 68 obese children, 57 (84%) had the history of consuming excessive food or taking less exercise. Forty-four percent of the obese children (30/68) came from the obese families in which at least one of the parents or grandparents was obese. Twenty-nine percent (20/68) and 22% (15/68)of the obese children respectively came from the families in which at least one of the parents or grandparents suffered from hypertension or coronary heart disease. Conclusion Early arterial atherosclerotic changes existed in simply obese children. Hyperhomocysteinemia may be an important factor of the obesity-induced early arterial atherosclerosis during childhood.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2005年第3期192-195,共4页
Chinese Journal of Pediatrics
