肥胖儿童non—HDL—C、remnant cholesterol与亚临床动脉粥样硬化的关系

目的：了解non—HDL-C和remnant cholesterol与肥胖儿童亚临床动脉粥样硬4E（AS）的关系。方法：根据甘油三酯（TG）水平将65例肥胖儿童（肥胖组）分为I组（TG≥2．3mmol／L）32例，II组（JIIG〈2．3mmol／L）33例，与肥胖组儿童性别年龄相匹配的正常体质量儿童30例为III组（对照组）。比较3组儿童血脂指标，对肥胖组各项血脂指标与血浆致动脉粥样硬化指数（AIP）进行相关性分析，肥胖患儿体质指数、血脂指标与颈动脉内径、内膜-中层厚度c—IMT）、血流参数进行相关性分析。结果：I组、II组的TG、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、nON—HDL-C、remnant cholesterol、AIP均较对照组升高，高密度脂蛋白胆固醇（HDL—C）较对照组降低，且I组的remnant cholesterol、AIP均较II组升高。肥胖组儿童AIP与TG、non—HDL—C、remnant cholesteml呈正相关，与HDL—C呈负相关。37例行颈动脉超声检查的肥胖儿童的c—IMT较正常儿童的增厚。结论：non—HDL—C、remnant cholesterol在肥胖儿童亚临床AS中有重要作用，在肥胖儿童血脂异常的治疗中应关注non—HDL—C、remnant cholesterol的变化。

Relationship between non-HDL-C,remnant cholesterol and subclinical atherosclerosis of obese children

Objective： To investigate the value of non-HDL-C and remnant cholesterol in the state of subclinical atherosclerosis for obese children. Methods： A total of 65 obese children were enrolled in this trial including 37 obese children who performed carotid ultrasound examination. According to the level of triglyeeride fiG）, these obese children were divided into two groups： group I （n=32, TG ≥ 2.3 mmol/L） and group II （n=33, TG〈2.3 mmol/L）. Thirty healthy children whose age and sex were matched served as the control group. Serum lipid parameters of the three groups were compared. The relationships between the lipid metabolic indices, non-HDL-C, remnant cholesterol and atherogenic index of plasma （AIP） in the obese group were analyzed. The relationships between all of the indices and the intima-media thickness（c-IMT）, inner diameter, peak flow of the carotid artery of the obese children who performed carotid ultrasound examination were also analyzed. Results： Triglyceride （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, non-HDL-C, remnant cholesterol, AIP in the obese group （group I and group II） were significantly higher than that of the control group, but HDL-C of the obese group was lower than that of the control group. The levels of remnant cholesterol and AlP in group I were higher than that in group II. TG, non-HDL-C and remnant cholesterol were correlated with AIP of the obese group. The c-IMT of the obese children who performed carotid ultrasound examination was thicker than that of the normal children. Conclusion： Non-HDL-C and remnant cholesterol play an important role in the state of subclinical atheroselerosis for obese children. Non-HDL-C and remnant cholesterol should be taken into account in the lipid-lowering for obese children.