深圳市南山区学龄前单纯性肥胖儿童血脂、脂蛋白及载脂蛋白的变化

目的通过对单纯性肥胖儿童血脂、脂蛋白及载脂蛋白的研究,初步了解其脂质代谢紊乱的状况,探讨其致动脉粥样硬化危险性增加的可能机制。方法对39名肥胖儿童和39名对照儿童空腹12小时以上抽静脉血检测甘油三脂（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白AI（APoAI）和载脂蛋白B（APoB）。结果单纯性肥胖儿童血清TG、LDL-C、APoB显著高于对照组（P〈0.05）,而TC、HDL-C、APoAI肥胖组与对照组无显著性差异（P〉0.05）。结论单纯性肥胖儿童脂质代谢出现紊乱,其发生动脉粥样硬化（AS）的危险性增加。     

单纯性肥胖儿童脂质代谢的研究

为了分析单纯性肥胖儿童体脂构成、分布与血清脂质代谢的变化情况 ,探讨其致 AS危险性增加的可能机制 ,对 5 8名肥胖儿童和 5 5名对照儿童测定其血清脂质、脂蛋白、载脂蛋白 ,并测定腰围、臀围、皮褶厚度 ,计算腰臀围比 (WHR)、体脂百分比 (BF)、脂肪组织 (FM)。结果显示肥胖组儿童 TG、 L DL - C、 L DL - C/HDL - C、 VL DL -C和动脉硬化指数 (AI)显著高于对照组 (P<0 .0 5 ) ,而 HDL - C、 HDL - C/TC却低于对照组 (P<0 .0 5 ) ,肥胖组与对照组儿童 TC浓度没有显著性差异 (P>0 .0 5 )。肥胖组儿童 apo AI水平较对照组显著降低 (P<0 .0 5 ) ,而 apo B1 0 0 、apo B1 0 0 /apo AI升高 ,差异有显著性 (P<0 .0 5 )。 BF、 FM、 WHR、 BMI与 TG、 L DL - C、 VL DL - C、 apo B1 0 0 、 AI呈明显正相关 (P<0 .0 5或 P<0 .0 1) ,而与 HDL- C、apo AI、 HDL- C/TC呈明显负相关 (P<0 .0 5或 P<0 .0 1)。单纯性肥胖儿童脂质代谢出现紊乱 ,机体脂肪构成、分布对血脂、脂蛋白和载脂蛋白有影响。     

儿童单纯性肥胖血脂、脂蛋白及血糖浓度变化

【目的】　通过研究儿童单纯性肥胖症血脂、脂蛋白及血糖浓度变化 ,为儿童单纯性肥胖症的防治工作提供依据。　【方法】　对 5 0名单纯性肥胖儿童和 5 0名对照儿童进行血脂、脂蛋白及血糖浓度测定。　【结果】　肥胖组儿童甘油三酯 (TG)、低密度脂蛋白胆固醇 (LDL C)显著高于对照组 (P <0 .0 1) ,而高密度脂蛋白胆固醇 (HDL C)却低于对照组 (P <0 .0 1)。肥胖组与对照组血清总胆固醇 (TC)浓度差异无显著性 (P >0 .0 5 )。血糖浓度依肥胖程度不同与对照组差异不同 ,轻、中度肥胖血糖浓度与对照组差异无显著性 (P >0 .0 5 ) ,重度肥胖血糖浓度显著高于对照组 (P <0 .0 1)。　【结论】　单纯性肥胖儿童出现脂质及糖代谢紊乱     

儿童单纯性肥胖与脉搏,血压,血脂和血糖关系的配对研究

本文采用单因素和多变量条件Logistic回归分析的方法研究了儿童单纯性肥胖与脉搏、血压、血脂和血糖的关系。结果表明．肥胖儿的收缩压和舒张压高于体重正常儿（均P＜0．001）；甘油三酯（TG）和高密度脂蛋白—胆固醇（HDL－C）分别高于和低于体重正常儿（均P＜0．05）；脉搏、胆固醇、血糖两者间差异无显著性（均P＞0．05）。进入回归模型的变量依次为：收缩压、HDL－C和舒张压。提示儿童期肥胖已存在高血压、高脂血症的倾向，应加强对儿童期肥胖的干预。     

脑血管病患者血脂、脂蛋白及载脂蛋白AI、B100测定的临床意义

目的 研究脑血管病患血脂，脂蛋白及载脂蛋白AI（apo AI），载脂蛋白B100（apoB100)测定的临床意义。方法 脑血管病人及健康人均晨起空腹静脉抽血，血清TC，TG及HDL－C采用酶法试剂盒及生化仪测定；apoAI,B100和免疫周围扩散法；LDL－C用Friedewald公式计算，即LDL-C=TC-(1/5TC＋HDL－C）。结果 脑动脉硬化组及脑梗死组与健康对照组的血脂，脂蛋白及apoAI,B100含量的比较，经过统计学处理，均有显差异至极显差异（P＜0．05－0．001）。脑出血组除TG有显差异（P＜0．05）外，其余均无显差异（P＞0．05）。结论 载脂蛋白测定对脑血管疾病预测的敏感度远比血脂及脂蛋白高。     

单纯性肥胖症儿童血脂、红细胞膜脂及其流动性的研究

目的：通过对单纯性肥胖儿童血脂、红细胞膜脂及其流动性的研究,初步了解其脂代谢紊乱的状况,并探讨其动脉粥样硬化危险性增加的可能机制。方法：对筛选出的４９ 名肥胖儿童及其正常对照,测定其血清脂质、红细胞膜磷脂（ Ｐ Ｌ） 、膜胆固醇（ Ｃ Ｈ Ｏ） 及膜流动性（ Ｐ） 。结果：肥胖组儿童 Ｔ Ｇ、 Ｖ Ｌ Ｄ Ｌ Ｃ 的浓度、动脉粥样硬化指数（ Ａ Ｉ） 、 Ｌ Ｄ Ｌ Ｃ／ Ｈ Ｄ Ｌ Ｃ 比值均显著高于正常组（ Ｐ＜ ０ ．０５） ;而 Ｈ Ｄ Ｌ Ｃ 的浓度及 Ｈ Ｄ Ｌ Ｃ／ Ｔ Ｃ 比值则显著低于正常组（ Ｐ＜ ０ ．０５） ,但两组的 Ｔ Ｃ 含量无显著性差异。肥胖组儿童 Ｐ Ｌ 含量显著低于正常组（ Ｐ＜ ０ ．０５） , Ｃ Ｈ Ｏ 和 Ｃ Ｈ Ｏ／ Ｐ Ｌ 比值显著高于正常组（ Ｐ＜ ０ ．０５） ;而 Ｐ 显著低于正常儿童。结论：单纯性肥胖症儿童血脂代谢出现紊乱,膜脂和膜流动性在血清胆固醇水平正常的情况下即出现异常变化,肥胖儿童脂代谢异常在红细胞膜脂质及其流动性方面可能比血脂更早表现出来,并对肥胖儿童 Ａ Ｓ的预测和预防可能会有更大的价值。     

单纯性肥胖症儿童血脂、载脂蛋白A1、B100的研究

通过对单纯性肥胖儿童血脂,载脂蛋白Ａ１,Ｂ１００的研究,以初步了解其脂质代谢紊乱的状况,并探讨其动脉粥样硬硬化危险性增加的可能机制。对筛选出的肥胖儿童及其正常儿童各４９名,测定其血清甘油三酯（ＴＧ）,总胆固醇（ＴＣ）,高密度脂蛋胆固醇（ＨＤＬ－ｃｈ）,低密度脂蛋白胆固醇（ＬＤＬ－ｃｈ）,极低密度脂蛋白胆固醇（ＶＬＤＬ－ｃｈ）,载脂蛋白Ａｌ（ａｐｏＡ１）;载脂蛋白Ｂ１００（ａｐｏＢ１００）。     

妊娠高血压综合征与血脂、载脂蛋白及脂蛋白（a）的关系

目的探讨妊娠高血压综合征（简称妊高征）患者血脂代谢水平的变化及其，临床意义。方法测定正常孕妇及妊高征患者的血清甘油三脂（TG）、总胆固醇（TC）、载脂蛋白AI（ApoAI）、载脂蛋白B（ApoB）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）及脂蛋白（a）水平。结果妊高征组血清TG（P〈0．01）、ApoB（P〈0．01）、LDL—c（P〈0．05）及LP（a）（P〈0．05）较正常孕妇显著升高，ApoAI、HDL—C则显著降低（P〈0．05），TC在两组间差别无显著性意义（P〉0．05）。在轻、中、重妊高征患者之间，ApoAI（P〈0．05）及HDL—C（P〈0．01）依次降低，组间比较有显著性意义，LDL—C（P〈0．01）及LP（a）（P〈0．01）依次升高，组间有极显著性差异。TG、TC和ApoB组间比较，差别无显著性意义。结论血脂代谢异常可能在妊娠高血压疾病的发病中起一定作用。     

单纯性肥胖儿童瘦素、胰岛素及其相关性研究

目的 研究单纯性肥胖儿童瘦素、胰岛素及其相关关系。方法 对筛选出来的54名肥胖儿童和60名正常体重儿童进行瘦素、胰岛素、C-肽、血糖水平的测定，并进行相关关系的研究。结果 肥胖组儿童瘦素、胰岛素、C-肽、血糖水平高于非肥胖组儿童，胰岛素敏感性指数肥胖组儿童低于非肥胖组儿童，差异有显性意义(P＜0．05)。瘦素与体质指数、体脂百分比、体脂肪、臀围、胰岛素、C-肽浓度均呈显正相关(P＜0．05)，与血糖、瘦体重、腰臀围比没有相关性。结论 肥胖儿童存在瘦素抵抗、高胰岛素血症和胰岛素抵抗，瘦素与体质指数、胰岛素浓度呈显正相关。     

单纯性肥胖儿童心理行为及智商的调查

目的：探讨单纯性肥胖症对儿童心理行为及智商的影响。方法 应用儿童适应行为评定量表和韦氏学龄儿童智力量表对单纯性肥胖组的对照组儿童各182名（年龄7－14岁）进行了心理行为的智商的测试。结果：肥胖组心理行为总得分及各因子得分均显著低于对照组（P＜0．05），肥胖组与对照组总平均适应行为商数（ADQ）分别为125．63与170．85，差异有统计学意义（P＜0．01），并且言语智商（IQ）、操作智商（IQ）及总智(IQ)肥胖组均低于对照组（P＜0．01）。结论；单纯性肥胖儿童存在着显著的心理障碍并且影响智力的发展。     

单纯性肥胖儿血脂及载脂蛋白AⅠ,B100,CⅡ和CⅢ的研究

本文测定了32例肥胖儿和年龄及性别配对的正常健康儿血脂和载脂蛋白水平,使用相对体重,Kaup指数,上臂围,体脂含量和皮褶厚度总和作为肥胖的评价指标,肩胛下与三头肌皮褶厚度比值(STR)评价脂肪分布情况。采用Sclaro法测定TG,TC和HDL-C。免疫圆周扩散法测定APO-AI,B100,CⅡ和CⅢ。结果表明:肥胖儿血HDL-C,HDL-C/TC,APO-AI和APO-CⅡ/CⅢ比显著降低,TG,VLDL-C,APO-B100,APO-CⅢ,动脉硬化指数和APO-BlOO/AⅠ显著升高,并与肥胖程度显著相关。多元分析表明:TSFT与HDL-C显著相关,STR主要影响VLDL-C和APO-CⅡ/CⅢ。结果提示:肥胖可影响血脂和载脂蛋白水平;载脂蛋白和脂肪异常分布是血脂变化的主要原因之一;肥胖儿的确有发生动脉粥样硬化的危险。     

抗阻训练对肥胖儿童身体成分血脂及血清瘦素的影响

了解8周抗阻训练对肥胖儿童身体成分、血脂及血清瘦素的影响,为改善肥胖儿童的健康水平以及寻求更好的减肥方法提供理论依据.方法 根据WHO推荐的身高标准体重法,选取晋中市18名肥胖儿童(男、女各9名)进行8周抗阻训练,然后对运动前后身体成分[体重、体质量指数(BMI)、肌肉量及躯干肌肉量、身体脂肪量、身体各部位脂肪量及身体脂肪比率]、血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]及血清瘦素水平进行比较.结果 肥胖儿童抗阻训练后血清瘦素、TG、LDL水平均下降(P值均<0.05),HDL水平上升(P<0.01);男性肥胖儿童抗阻训练后体重,BMI,身体脂肪量,左右上肢及躯干脂肪量均下降(P值均<0.05),肌肉量及躯干肌肉量均增加(P值均<0.05);女性肥胖儿童抗阻训练后BMI,身体脂肪量,右下肢、右上肢及躯干脂肪量均下降(P值均<0.05),肌肉量及躯干肌肉量增加(P值均<0.01).结论 8周抗阻训练可以降低肥胖儿童BMI、身体脂肪量和血清瘦素水平,增加肌肉质量,改善血脂紊乱.     

Total and regional fat and serum cardiovascular disease risk factors in lean and obese children and adolescents

OBJECTIVE: This study was conducted to evaluate the association of total and central adiposity with serum cardiovascular disease (CVD) risk factors in lean and obese Portuguese children and adolescents. RESEARCH METHODS AND PROCEDURES: A total of 87 girls (13.2 +/- 1.6 years old, 29.9 +/- 6.4% body fat [mean +/- SD]) and 72 boys (13.2 +/- 1.6 years old, 20.8 +/- 9.9% body fat) volunteered for the study. Whole-body composition and fat distribution, from DXA and anthropometry, and serum lipids, lipoproteins, and apolipoproteins were evaluated. RESULTS: The sum of three trunk skinfolds (STS) was highly correlated with total trunk fat mass measured by DXA (p < 0.001). Body mass index, DXA-measured percentage of body fat, trunk fat mass, STS, and the waist-to-height ratio were generally found to be associated with triacylglycerol, the ratio of total cholesterol (TC) to high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and apolipoprotein B levels, (significant age-adjusted r between 0.16 and 0.27, p < 0.05). Body mass index, STS, and the waist circumference were also associated with HDL-C (p < 0.05), whereas no body composition variable significantly correlated with TC or apolipoproteins A-I. The STS was significantly correlated with HDL-C (p < 0.01), TC/HDL-C (p < 0.05), and apolipoproteins A-I (p < 0.05) independently of whole-body fatness. Obese subjects (n = 73) had higher TC, LDL-C, TC/HDL-C, and apolipoprotein B than did non-obese subjects (n = 86), and significant associations between central adiposity and some lipid variables (triacylglycerol and HDL-C) were found in obese children and adolescents that were not present in leaner individuals. DISCUSSION: DXA- and anthropometry-based whole-body and central fat measures are associated with serum CVD risk factors in Portuguese boys and girls. Obese children and adolescents have a poorer lipid profile than do their leaner counterparts. Trunk skinfolds, which are easy to obtain even in large samples, predict CVD risk factors to the same extent as DXA-based variables, in some cases, independently of total fatness.     

非肥胖型PCOS不孕患者超声测量肥胖指标的临床研究

目的:探讨体重指数(BMI)正常的不孕症患者中,多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)即非肥胖型PCOS(NOB-PCOS)与非PCOS(对照组)患者之间内脏脂肪厚度(visceral fat thicknes,VFT)及判断肥胖相关的人体测量值的差异,为更好地治疗NOB-PCOS不孕症提供依据。方法:检测不孕症患者中BMI正常的140例PCOS及81例非P-COS患者的基础性激素,用超声检测腹部皮下脂肪、内脏脂肪、肝前脂肪、肝前皮下脂肪厚度,测量身高、体重、腹围、腰围、臀围等,对两组间上述指标进行分析。结果:NOB-PCOS组血清促黄体生成素(LH)、睾酮(T)明显高于非PCOS组(P<0.05);NOB-PCOS组腹围、腹部皮下脂肪厚度及内脏脂肪厚度明显高于非PCOS组(P<0.05)。结论:NOB-PCOS不孕症患者腹围、腹部皮下脂肪及内脏脂肪厚度等判断肥胖的指标大于非PCOS患者,治疗时应引起重视。     

Serum leptin level among non-obese students: relationship to body fat, blood pressure, serum lipids, physical activity, and eating habits]

Leptin, a product of the ob gene, is thought to play a key role in the regulation of adiposity. However, it is unclear in humans as to whether or not leptin influences the blood pressure, serum lipids, physical activity level, or eating behavior in relation to obesity. Recent reports have indicated both gender-based differences in the leptin levels and a correlation of the percentage of body fat with leptin levels has been observed among obese subjects. As far as we know, these relationships among non-obese young adults have yet to be studied. Therefore, the serum leptin concentrations among 107 non-obese students (72 males and 35 females) were measured by a radioimmunoassay(RIA). Fasting leptin levels ranging between 1.2 and 23.4 ng/mL were observed in all subjects, and the levels among females were 2.6 times higher than in males (7.64 vs 2.95 ng/mL; p < 0.001). A close correlation was observed regarding the log-transformed leptin levels with the percentage of body fat as determined by the bioelectrical impedance analysis method(r = 0.734, p < 0.001 in males and r = 0.579, p < 0.001 in females). In conclusion, these data thus suggest the serum leptin levels among non-obese students show significant gender-based differences while, in addition, the leptin levels also correlate positively with the percentage of body fat. However, it remains unclear as to whether or not the leptin levels are independently related to the blood pressure, serum lipids, physical activity level (sports activity and leisure-time activity), and eating behavior (eating breakfast, mid-day snacking and nighttime snacking).     

Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: the Quebec Family Study

BACKGROUND: A high waist-to-hip ratio is associated with unfavorable cardiovascular disease risk factors. This could be due to either a relatively large waist or a small hip girth. OBJECTIVE: We sought to define the separate contributions of waist girth, hip girth, and body mass index (BMI) to measures of body composition, fat distribution, and cardiovascular disease risk factors. DESIGN: Three-hundred thirteen men and 382 women living in the greater Quebec City area were involved in this cross-sectional study. Percentage body fat, anthropometric measurements, and abdominal fat distribution were obtained and BMI (in kg/m2) and waist-to-hip ratio were calculated. Serum blood lipids were determined from blood samples collected after subjects had fasted overnight RESULTS: A large waist circumference in men and women (adjusted for age, BMI, and hip circumference) was associated significantly with low HDL-cholesterol concentrations (P < 0.05) and high fasting triacylglycerol, insulin, and glucose concentrations (P < 0.01). In women alone, a large waist circumference was also associated with high LDL-cholesterol concentrations and blood pressure. A narrow hip circumference (adjusted for age, BMI, and waist circumference) was associated with low HDL-cholesterol and high glucose concentrations in men (P < 0.05) and high triacylglycerol and insulin concentrations in men and women (P < 0.05). Waist and hip girths showed different relations to body fat, fat-free mass, and visceral fat accumulation. CONCLUSIONS: Waist and hip circumferences measure different aspects of body composition and fat distribution and have independent and often opposite effects on cardiovascular disease risk factors. A narrow waist and large hips may both protect against cardiovascular disease. These specific effects of each girth measure are poorly captured in the waist-to-hip ratio.     

各型多囊卵巢综合征患者内分泌及代谢特点分析

目的:探讨各型多囊卵巢综合征(PCOS)患者内分泌及代谢特征,为PCOS的合理治疗及并发症防治提供依据。方法:将54例PCOS患者,根据体重指数(BMI)将其分为肥胖PCOS组30例、非肥胖PCOS组24例,同时选择肥胖对照组20例和非肥胖对照组22例。测定并计算所有研究对象的BMI、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、体脂含量、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI),抽血检测血清黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、泌乳素(PRL)、睾酮(T)、空腹血糖(FPG)和胰岛素(FINS)、低密度脂蛋白(TC)、甘油三酯(TG)水平。结果:两PCOS组的LH水平及T水平均显著高于其相应的对照组(P0.01);肥胖PCOS组的TG水平高于非肥胖PCOS组,而TC水平高于其对照组(P均0.05);肥胖PCOS组的FINS,HOMA-IR均显著高于非肥胖PCOS组(P0.01),且两PCOS组的HOMA-IR均显著高于其对照组(P0.05);肥胖PCOS组的ISI显著低于非肥胖PCOS组(P0.01),且非肥胖PCOS组的ISI显著低于其对照组(P0.05)。PCOS组血清T与LH和TC呈正相关,PCOS组HOMA-IR与BMI、WHR、体脂含量、收缩压、舒张压、FPG、FINS均呈正相关。结论:高雄激素血症(hyperandrogenemia,HA)、胰岛素抵抗(insulin resistance,IR)和高胰岛素血症(hyperinsulinemia,HI)为PCOS的基本特征,肥胖的PCOS患者更易出现IR,要重视PCOS的远期并发症。     

肥胖儿童脂肪肝与其糖脂代谢的初步探讨

目的探讨上海市部分肥胖儿童肥胖程度与脂肪肝发生率的关系以及这些儿童血清部分糖脂代谢指标改变。方法随机筛取1999年至2000年门诊体检儿童100名,同期内分泌门诊就诊单纯性肥胖儿童43名,年龄6~13岁,性别不限,无明显器质性疾病。收集病史资料,测量身高体重,B超检查肝脏,测定血清瘦素、C肽、空腹血糖、血脂(甘油三酯,胆固醇,高密度脂蛋白胆固醇,低密度脂蛋白胆固醇)。按体质指数(BMI)值和有无脂肪肝情况将这些儿童分组。比较各组血清瘦素、C肽、空腹血糖、血脂值有无差异。结果内分泌门诊就诊的肥胖儿童中脂肪肝发生率为13/43,最早发生脂肪肝年龄为7岁。脂肪肝组儿童BMI值明显高于非脂肪肝组儿童(P<0.05)。脂肪肝与非脂肪肝组肥胖儿童血脂、空腹血糖、C肽、瘦素无明显差异(P>0.05)。中重度肥胖儿童血清瘦素、C肽、空腹血糖、血脂(甘油三酯)明显升高(P<0.05)。结论中重度肥胖儿童已发生糖脂代谢紊乱,其中近1/3并发脂肪肝。BMI值可能有助于判断儿童脂肪肝的发生。     

单纯性肥胖儿童血清瘦素水平与血糖及血脂变化的关系

目的 研究单纯性肥胖儿童血清瘦素水平与血糖、胰岛素抵抗及血脂异常的关系。方法 采用放射免疫分析法、酶法对42对7-10岁肥胖及健康对照儿童进行血清瘦素、胰岛素水平及血糖、血脂水平的测定。结果 肥胖及对照儿童瘦素水平分别为2．74-45．125μg/L和0．53-10．18μg/L,经对数转换后肥胖组平均水平非常显著高于体重正常组。血清瘦素水平与体重指数(BMI)、腰臀围比(WHR)及体脂百分比均呈显著正相关关系。83％的肥胖儿童有瘦素抵抗,肥胖瘦素敏感组与体重正常组的血糖、胰岛素及血脂水平均差异无显著性,而肥胖瘦素抵抗组总胆固醇、甘油三酯(TG)、低密度脂蛋白胆固醇及胰岛素水平均显著高于体重正常组,肥胖瘦素敏感与瘦素抵抗儿童年龄、性别分布及BMI、WHR的差异无显著性,但瘦素抵抗组TG显著高于瘦素敏感组,高密度脂蛋白胆固醇显著低于瘦素敏感组。结论 肥胖儿童即存在瘦素抵抗,瘦素抵抗与代谢综合征及心血管疾病的危险因素密切相关,可作为筛查高危肥胖儿童的有用指标。