单纯性肥胖患儿非酒精性脂肪肝病与胰岛素抵抗

目的探讨单纯性肥胖(肥胖)儿童发生非酒精性脂肪肝病(NAFLD)的情况及与胰岛素抵抗(IR)、血脂、体质量指数(BMI)、腰臀比(WHR)的关系。方法选择肥胖儿童90例,年龄2.5～14.3岁。其中NAFLD 24例(NAFLD组),无NAFLD 66例(无NAFLD组)。另选35例年龄、性别与其相匹配的健康儿童为健康对照组。清晨空腹测量其体质量、身高、腰围和臀围,计算BMI和WHR,同时静脉采血检测其血清胰岛素(FINS)、糖(FBG)、胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和ALT、AST等,计算稳态模型胰岛素抵抗指数(HOMA-IR=FINS×FBG/22.5),并做肝胆等部位超声检查。结果 NAFLD占肥胖儿童的26.67%;NAFLD组儿童BMI、WHR最高,其次为无NAFLD组,差异均有统计学意义(Pa<0.001);3组儿童FINS和HOMA-IR值差异均有统计学意义(Pa<0.001),NAFLD组最高,其次为无NAFLD组,均明显高于健康对照组,但FBG无明显差异;NAFLD组血清TG、LDL-C和TC水平明显高于无NAFLD组和健康对照组(Pa<0.01);HOMA-IR值与BMI、WHR、血TG、LDL-C呈正相关(r=0.402、0.256、0.239、0.180,P=0.000、0.004、0.008、0.046);BMI、WHR诊断NAFLD的受试者工作特征(ROC)曲线下面积分别为0.805和0.765(Pa=0.000)。结论肥胖儿童NAFLD的发生与IR,血TG、LDL-C、TC升高及BMI、WHR增高关系密切,BMI、WHR对儿童肥胖NAFLD具有一定的诊断价值。控制体质量,减少腰围,可减轻IR,阻止NAFLD的发生、发展。     

儿童肥胖代谢综合征血促肾上腺皮质激素及皮质醇变化分析

目的通过观察代谢综合征(MS)患儿血促肾上腺皮质激素(ACTH)、皮质醇(COR)变化及其与MS相关指标的相关性,探讨垂体及肾上腺皮质功能在儿童MS发病机制中的意义。方法选取门诊确诊肥胖儿童263例,根据腰围、血压、血脂及血糖等指标将患儿分为MS组101例及非MS组162例,进行人体参数测量并收集临床基本资料,测定身高、体质量、腰围、血压、血ACTH、COR、空腹血糖(FPG)、空腹胰岛素(FINS)、血脂等指标,计算体质指数(BMI)、胰岛素抵抗指数(HOMA-IR)等,对上述资料进行统计学分析。结果 MS组患儿的体质量、腰围、收缩压、舒张压、血FINS、HOMA-IR、三酰甘油(TG)、ACTH、COR高于非MS组,差异具有统计学意义(P均0.05);MS组患儿血高密度脂蛋白胆固酮(HDL-C)低于非MS组,差异具有统计学意义(P均0.05);MS组患儿血ACTH与腰围、收缩压、舒张压、HOMA-IR和MS组分数(nMSc)呈正相关(P均0.01),血COR与腰围、收缩压、舒张压和nMSc呈正相关(P均0.05),与血HDL-C呈负相关(P0.05)。结论 MS儿童血ACTH及COR增高,血ACTH及COR与腰围、血压、血HDL-C、HOMA-IR和nMSc等相关,下丘脑—垂体—肾上腺皮质功能改变可能是儿童MS的发病机制之一。     

肥胖伴黑棘皮病儿童代谢综合征的高危因素

目的 探讨肥胖伴黑棘皮病儿童代谢综合征(MS)的高危因素.方法 2006年11月-2007年9月在本院儿科就诊25例肥胖伴黑棘皮病儿童(病例组).男15例,女10例;年龄8.4～16.0岁,平均10.6岁;体质量(72.11±17.66)kg;身高(155±14)cm.32例身高别体质量正常的健康儿童为健康对照组.男18例,女14例;年龄7.6～15.8岁,平均9.8岁.比较二组儿童体质量指数(BMI)、胆固醇(12HO)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、血压、空腹和葡萄糖耐量试验(OGTT)2 h血糖、胰岛素和稳态模型评估法胰岛素抵抗指数(HOMA-IR)的差异,并对所有儿童进行肝脏超声波检查.采用SPSS 12.0软件进行统计学分析.结果 病例组儿童BMI、TG、LDL-C、收缩压和舒张压均显著高于健康对照组(Pa<0.01);空腹和OGTT 2h血糖、OGTT 2h胰岛素和HOMA-IR均显著高于健康对照组(Pa<0.01);BMI与收缩压、舒张压、CHO、TG、LDL-C、空腹血糖(FBG)、空腹胰岛素(FINS)以及HOMA-IR均无相关性(Pa>0.05).病例组患儿中超声诊断脂肪肝发生率为84%,健康对照组儿童肝脏B超检查均未见异常.结论 肥胖伴黑棘皮病儿童BMI增加、胰岛素抵抗、血脂紊乱和血压增高是MS的危险因素,密切随访监测此类患儿有助于早期发现MS.积极治疗肥胖症,阻断儿童血糖、血脂代谢紊乱的发生,有助于减少儿童2型糖尿病和心血管疾病的危险性.     

循环Alarin在肥胖儿童中的水平及与胰岛素抵抗的相关性

目的 本研究拟探讨循环Alarin在肥胖儿童中的表达水平及与代谢参数的关系。方法 招募体重指数（BMI）高于第95百分位数的肥胖儿童86例为肥胖组,82例年龄和性别与肥胖组匹配的BMI低于第85百分位数的健康儿童作为健康对照组。根据是否发生胰岛素抵抗（IR）,将86例肥胖组儿童分为IR组（n=27）和非IR组（n=59）。测量身高、体重、收缩压（SBP）和舒张压（SDP）,并计算体重指数（BMI）。检测总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、尿酸（UA）、空腹胰岛素（FINS）及空腹血糖（FBG）水平,并计算葡萄糖和胰岛素曲线下面积（AUC）、稳态模型胰岛素抵抗指数（HOMA-IR）、全身胰岛素敏感性指标（WBISI）。ELISA法检测循环Alarin水平。结果 肥胖组儿童循环Alarin水平较健康对照组显著升高,IR组儿童循环Alarin水平较非IR组显著升高（P < 0.01）。循环Alarin与BMI、TG、FBG、AUC_葡萄糖、AUC_胰岛素、HOMA-IR呈正相关,与WBISI呈负相关（P < 0.05）。循环Alarin的变化与BMI、FBG、HOMA-IR有线性回归关系,其中HOMA-IR对循环Alarin的影响最大（P < 0.05）。结论 循环Alarin水平在肥胖儿童中显著升高,可能与肥胖和IR的发生有关。     

不同指标在评价肥胖儿童胰岛素抵抗中的价值

目的探讨单纯性肥胖儿童胰岛素抵抗临床评估的指标。方法对单纯性肥胖和正常对照儿童进行葡萄糖耐量试验和胰岛素释放试验,在试验前及试验后30、60、120、180 min分别测血糖和胰岛素,并计算稳态模型胰岛素抵抗指数(HOMA-IR)、敏感指数(HOMA-IAI)、胰岛素分泌功能(HOMA-IS)、血糖曲线下面积与胰岛素曲线下面积比及空腹血糖和空腹胰岛紊的比值(FBG/FINS)等胰岛素抵抗评价指标。结果肥胖组FINS明显高于对照组,FBG、HOMA-IS与对照组无显著差异。HOMA-IR和HOMA-IAI之间具有显著相关性,r为-1,与FINS的r分别为0.913和-0.913,与FBG/FINS的r分别为-0.889和0.889,与曲线下面积比的r分别为-0.523和-0.523,P均<0.01。结论FINS、HOMA-IR、HOMA-IAI、血糖与胰岛素曲线下面积比、FBG/FINS均适用于肥胖儿童胰岛素抵抗的评估,尤以FINS、HOMA-IR、HOMA-IAI更可取。     

儿童青少年腰围与代谢综合征危险因素关系的研究

目的比较南宁地区不同腰围水平青少年罹患代谢综合征(MS)及各相关代谢指标异常率,探讨腰围与MS危险因素的相关性。方法采用分层整群随机抽样方法从南宁市396所中小学中抽取14所学校中6~18岁的中小学生共7 893名,进行体格检查及相关代谢生化数据的检测,包括空腹血糖(FBG)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)。结果南宁地区男女生均于10岁以后才逐渐出现各检测指标的异常,与IDF(2007)诊断标准中<10岁不诊断MS结果一致。MS相关指标异常率比较,男女生均依次为:HDL-C、TG、FBG、血压,且男生的血压和FBG异常率显著高于女生,差异有统计学意义(P<0.05)。MS检出率随着腰围的增大而增加。腰围值P90者中该比例则增加400%。除与HDL-C负相关外,腰围与其余指标呈正相关。结论儿童青少年腰围与MS危险因素密切相关,各危险因素的均值(除HDL-C外)及异常率随着腰围的增大而增加。     

肥胖儿童血浆脂联素与肿瘤坏死因子-α的变化及意义

目的儿童肥胖症与血浆脂联素（ADPN）和肿瘤坏死因子-α（TNF-α）水平的变化密切相关。该文通过分析肥胖儿童血浆ADPN和TNF-α的变化及其相互关系,探讨儿童肥胖症的发病原因,为儿童肥胖症的预防提供科学依据。方法265名儿童随机分为肥胖组（147人）和正常对照组（118人）,分别测定腰围（WC）,臀围,腰臀比（WHR）,体脂百分比（%BF）,收缩压（SBP）,舒张压（DBP）,甘油三酯（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）,空腹血糖（FBG）,空腹胰岛素（FINS）,ADPN,TNF-α,计算稳态模型胰岛素抵抗指数（HOMA-IR）,并分析ADPN,TNF-α与体质量指标、糖脂代谢指标及二者的相关关系。结果①肥胖组儿童ADPN水平低于正常组儿童（P<0.05）,且与TNF-α,BMI,WHR,HOMA-IR,%BF,FINS,SBP,TG呈显著负相关（均P<0.05）;②肥胖组儿童TNF-α水平高于正常组儿童(P<0.01),且与BMI,WHR,%BF,FINS,HOMA-IR,TG,SBP呈显著正相关（P<0.01）,与HDL（P<0.05）呈负相关;③多元逐步回归分析显示ADPN,BMI和TNF-α是影响BF%的主要因素（R2=0.926）,且ADPN和TNF-α的交互作用有统计学意义。结论 肥胖儿童ADPN水平显著下降、TNF-α水平显著升高,且均是影响儿童体脂的主要因素。ADPN与TNF-α的交互作用提示二者在机体内可相互影响,共同参与儿童肥胖的形成。［中国当代儿科杂志,2009,11（1）：47-50］     

单纯性肥胖患儿胰岛素抵抗与血脂的关系

目的探讨单纯性肥胖(肥胖)患儿胰岛素抵抗与血脂的关系。方法选取肥胖患儿50例为肥胖组(男23例,女27例),同期健康儿童30例为健康对照组(男14例,女16例)。对每位对象采用同一磅秤标准,测量其身高、体质量,并计算其体质量指数(BMI)。采用儿童标准血压测定法测定2组儿童血压。采用发光免疫法、快速测血糖法分别对2组儿童的血糖、血胰岛素、血脂进行检测,并计算稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-ISI)、胰岛素和葡萄糖曲线下的面积比值反映组织对胰岛素的敏感性(AUC)、肝脏组织对胰岛素的敏感性(FINS/FBG),并应用SPSS12.0软件进行统计学分析。结果与健康对照组比较,肥胖组患儿HOMA-IR、AUC、FINS/FBG均显著增高(t=3.939、6.314、3.723,Pa<0.01),空腹三酰甘油(TG)亦显著增高(t=2.573,P<0.05),高密度脂蛋白(HLD)、HOMA-ISI显著低于健康对照组(t=-2.982、-4.75,P<0.05、0.01)。多因素Pear-son相关分析显示,肥胖组TG与HOMA-IR、AUC、FINS/FBG呈显著正相关(r=0....     

血清microRNA-122与肥胖儿童胰岛素抵抗的关系

目的 研究肥胖儿童血清microRNA-122（miR-122）与胰岛素抵抗的关系。方法 选取47例7~14岁重度肥胖儿童为肥胖组,另选取与肥胖组性别及年龄匹配的正常体重健康儿童45例作为健康对照组,分别检测并记录两组儿童的身高、体重、腰围、臀围、空腹血糖（FBG）、空腹胰岛素（FINS）、甘油三酯（TG）、总胆固醇（TC）、游离脂肪酸（FFA）、白介素-6（IL-6）、miR-122水平,计算体重指数（BMI）、腰臀比（WHR）、胰岛素抵抗指数（HOMA-IR）,并进行统计分析。结果 与健康对照组相比,肥胖组儿童身高、体重、BMI、WHR及FINS、HOMA-IR、TG、FFA、IL-6、miR-122水平均升高（P < 0.05）;肥胖组miR-122水平与FINS、HOMA-IR、IL-6水平呈正相关（分别r=0.408、0.442、0.464,P < 0.05）;miR-122的变化与IL-6有线性回归关系,且呈正相关（b'=0.318,P < 0.05）。结论 肥胖儿童血清miR-122可能与胰岛素抵抗相关,具体机制尚需进一步研究。     

儿童代谢综合征尿酸变化及其与心血管危险因素的关系

目的 探讨肥胖代谢综合征儿童血清尿酸(SUA)水平与心血管疾病危险因素之间的相关性.方法 肥胖儿童157例,代谢综合征(MS)77例,非代谢综合征(非MS)80例.分析两组患儿人体测量参数、血尿酸、血脂、血糖及胰岛素等指标间差异,观察SUA与人体测量参数、血压、糖脂代谢紊乱的相关性,并对影响SUA水平的指标进行多元逐步回归分析.结果 MS组血尿酸、腰围、血压、三酰甘油(TG)均高于非MS组,高密度脂蛋白胆固醇(HDL-C)低于非MS组(P<0.05).Spearman相关分析提示SUA水平与体质指数、腰围、腰围身高比、舒张压、收缩压、空腹胰岛素水平、胰岛素抵抗指数(HOMA-IR)、TG及患儿已表现出的MS组分个数呈正相关(P<0.05);与HOMA-IS及HDL-C呈负相关(P<0.05).结论 MS儿童除血压、血脂、血糖异常,也伴有嘌呤代谢紊乱.腰围、TC、舒张压、HDL-C为SUA水平的重要影响指标.高尿酸血症与中心性肥胖、高血压、高血脂关系密切.SUA水平增高可能成为心血管疾病的一个重要的危险因素,参与心血管相关疾病的发生、发展过程.     

Waist circumference for the screening of the metabolic syndrome in children

Aim: To identify the best anthropometric predictor of the metabolic syndrome in children. Methods: Screening performance was evaluated in a clinical setting. The study included 140 children: 72 non-obese and 68 with non-syndromal obesity. Body mass index (BMI), waist circumference and triceps/subscapular skinfolds ratio were used as predictor variables, and systolic blood pressure, diastolic blood pressure, glucose, uric acid, fasting insulin, triglycerides and HDLC as metabolic syndrome variables. Results: The areas under the receiver operating characteristic (ROC) curves were 0.849 (95% CI: 0.780, 0.919) for BMI, 0.868 (95% CI: 0.801, 0.934) for waist circumference and 0.834 (95% CI: 0.757, 0.910) for the triceps/subscapular skinfolds ratio. No statistically significant differences were found for the three areas under the ROC curves. The point on the ROC curve closest to 1 corresponded to the 65th percentile for BMI, to the 70th percentile for waist, and to the 40th percentile for the triceps/subscapular skinfolds ratio. Conclusion: Waist circumference seems to be the best predictor of children with the metabolic syndrome in paediatric clinical settings.     

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目的 分析肥胖儿童骨密度(BMD)及其影响因素,为早期预防骨质疏松提供科学依据.方法 2007年1-12月从长沙市开福区5所小学7～12岁学龄儿童中,按照体质指数(BMI)法诊断单纯性肥胖,随机抽取119例单纯性肥胖儿童及103名正常儿童.采用双能X线骨密度仪(DEXA)全身扫描,测量BMD和身体成分.结果 单纯性肥胖儿童的身高、体重、BMI、腰围和腰臀比均显著高于正常儿童.单纯性肥胖儿童的各部位瘦组织含量(LM)、脂肪组织含量(FM)、体脂百分比(PBF)及躯干脂肪组织百分比均显著高于正常儿童,但四肢FM百分比却显著低于正常儿童.肥胖儿童各部位BMD和骨矿物质含量(BMC)均大于正常儿童.控制FM后,BMD(或BMC)与LM呈显著正相关:控制LM后,BMC与FM亦呈正相关.多元逐步回归分析显示,影响儿童BMD的主要因素是LM.结论 肥胖儿童BMD高于正常儿童,LM对儿童成长中骨的BMD起重要作用.     

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??Objective??To investigate the correlations between plasma monocyte /macrophage chemoattractant protein and related parameters of insulin resisitance in children with simple obesity. Methods??70 children with simple obesity were enrolled as study group??30 healthy children as control group. Body mass index??BMI ??and waist circumference ??WC??were detected as indices of obesity .Plasma levels of macrophage inflammatory protein-1????MIP-1??????monocyte chemoattractant protein-1??MCP-1 ??were measured by ELISA.The rate of CD68 positive cells in blood were detected by flow cytometry??FCM???? Plasma levels of insulin ??adiponectin were measured by RIA?? Insulin resisitance index ??InRI?? were caculated by homeostasis model assessment of insulin resistance ??HOMA-IR??. The associations between MIP-1????MCP-1 levels and adiponectin and related parameters were analyzed with Pearson correlation analysis or partial correlation analysis??Results??The concentration of MIP-1?? and MCP-1 in plasma in children with simple obesity were higher than that in control group. There was a significant difference between the two groups ??P < 0. 05??. The rate of CD68 positive cells in blood of simple obesity had no significant difference between that in control group ??P > 0.05??.The concentration of MIP-1?? and MCP-1 in plasma had positive correlations with BMI and WC and InRI??P < 0. 05??. The concentration of adiponectin in plasma had negetive correlations with BMI and WC and InRI ??P < 0. 05??. The rate of CD68+ cell in blood had no correlation with BMI and WC and InRI??P < 0. 05??.Conclusion??We found that a differential low-grade inflammation is associated with obesity of children .The levels of MIP-1????MCP-1 in blood of obesity were associated with insulin resistance and abdominal obesity. The levels of plasma MIP-1????MCP-1??adiponectin may predict the onset of obesity related complications.     

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??Abstract??Objective??To analyze the relationship between blood pressure and BMI??waist circumference??WC?? and fat mass percentile??FMP?? among children and adolescents??7??17 years?? in Beijing. Methods??As part of the Beijing Children and Adolescent Metabolic Syndrome Study??BCAMS????data of weight?? height?? FMP??WC?? and blood pressure were collected from 19 488 subjects aged 7??17 years from April to October in 2004. Overweight and obesity were defined according to BMI??WC and FMP criteria. Analyze the relationship between blood pressure and BMI??WC and FMP??as well as the change and trend of hypertension. Results??The levels of SBP and DBP increased in the order of normal weight to overweight and obesity. With age and gender controlled??BMI??WC and FMP were independently positively correlated with SBP and DBP ??P < 0.001??. The incidence of hypertension was significantly higher in the BMI??WC and FMP overweight and obesity groups than in the normal group??and the difference had statistical significance. The relative risk of hypertension in the obesity group is 3 to 7 times that of the normal group??and the risk in BMI obesity/FMP obesity group and the BMI obesity/abdominal obesity group was 7.3 and 6.8 times that of the normal group respectively.Conclusion??BMI??WC and FMP are closely related to SBP and DBP in children and adolescents. BMI is a better index for hypertension??the heavier the childrn??the higher the risk of hypertension.     

Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents

Abdominal obesity is associated with risk of cardiovascular disease and type 2 diabetes mellitus. Waist circumference as a measure of obesity may be clinically useful as a predictor of metabolic syndrome in children. To develop age- and sex-specific reference values for waist circumference we evaluated the data obtained from Turkish children and adolescents. Waist circumference measurements from 4,770 healthy schoolchildren were obtained. Smoothed percentile curves were produced by the LMS method. The median curves of Turkish children were compared with four other countries: Australia, the UK, USA (Bogalusa) and Japan. Smoothed percentile curves and values for the 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th percentiles were calculated for boys and girls. We found that waist circumference increased with age both in boys and girls. The 50th percentile waist circumference curve of Turkish children was over the British and Japanese but lower than the Bogalusa children and adolescents. This study presents data and smoothed percentile curves for waist circumference of healthy Turkish children aged 7–17 years. The differences in waist circumference of different countries can be explained by lifestyles and cultural characteristics. These data can be added to the existing international reference values for waist circumference of children and adolescents.     

Body mass index, triceps skinfold and waist circumference in screening for adiposity in male children and adolescents

Simple anthropometric measurements and indices are the most commonly used tools for assessing body composition. Only a few papers have examined the sensitivity and specificity of the body mass index (BMI) against total body fat percentage (TBF%) from underwater weighing in children and adolescents. The objective of the study was to evaluate the screening performance of BMI, triceps skinfold thickness and waist circumference for excess TBF%. A total of 175 healthy volunteer males, aged 7.0-16.9 y, participated in the study. TBF% was measured using underwater weighing as the reference method. Receiver operating characteristic (ROC) curves were constructed to assess the value of the three anthropometric measurements as a screening measure for total adiposity. Sensitivity and specificity were calculated at several percentile cut-offs for BMI, triceps skinfold and waist circumference. The areas under the ROC curves were also calculated, and were 0.86 for BMI, 0.90 for triceps skinfold and 0.88 for waist circumference. The point on the ROC curve closest to 1 corresponded to the 70th percentile for BMI, to the 75th percentile for triceps skinfold, and to the 70th percentile for waist circumference. Conclusion: BMI, triceps skinfold and waist circumference predicted total fat content well in male children and adolescents.     

北京市超重和肥胖学龄儿童中代谢综合征的流行特征

目的了解北京市6—18岁超重、肥胖儿童青少年中代谢综合征（MS）的流行现状和临床表型特征;比较美国国家胆固醇教育计划和国际糖尿病联盟定义的标准诊断儿童青少年MS的差异。方法以2004年北京儿童青少年MS调查中筛查出的超重和肥胖儿童为研究对象,并选取一组正常体重儿童为对照组,检测空腹血浆葡萄糖和胰岛素、血清甘油三酯和高密度脂蛋白胆固醇水平,采用稳态模式评估法计算胰岛素抵抗指数。符合以下5项指标中3项及以上者为MS：腹型肥胖（腰围≥P90）、高血压（≥P90）、低高密度脂蛋白胆固醇[〈1．03mmol／L（40mg／dl）]、高甘油三酯[≥1．24mmol／L（110mg／dl）]和空腹血糖升高[≥5．6mmol／L（100mg／dl）]。结果（1）采用美国国家胆固醇教育计划定义,MS检出率分别为,对照组0．9％,超重组7．6％,肥胖组29．8％,高于国际糖尿病联盟定义的检出率（0．1％,5．2％,28．6％）;两定义标准诊断的MS检出率均呈现随体重指数升高而增加的趋势（趋势检验,P〈0．001）;（2）肥胖儿童中MS单项异常检出率依次为：腹型肥胖81．6％,高血压47．7％,高甘油三酯35．6％,低高密度脂蛋白胆固醇16．9％,高空腹血糖13．4％;超过四分之一的超重儿童具有高血压（29．8％）、腹型肥胖（27．4％）和高甘油三酯（26．0％）;随体重指数增加,MS指标多项异常者和胰岛素抵抗者呈增加趋势（P〈0．001）。结论北京市肥胖儿童青少年中MS已呈现严重流行趋势;腹型肥胖、高血压、高甘油三酯是超重肥胖儿童最常见的代谢异常。采用美国国家胆固醇教育计划定义的儿童MS检出率高于国际糖尿病联盟定义的检出率。     

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??Objective??To characterize the clinical symptoms of all enrolled microcephalic children with cerebral palsy??CP????to provide evidence for rehabilitation management. Methods??To summarize the results of a cross-sectional survey of a total of 422 children??0-18 years old?? who were registered as cerebral palsy by Disabled Persons’ Federation of Chengdu from February to April in 2013. All children were grouped according to head circumference. We analyzed the correlation between head circumference with gross motor function classification system??GMFCS????intelligence and complications. Results??There were statistically significant between the two different degrees of head circumference group and the classification of GMFCS and cognition respectively??P??0.001??. Spearman correlation analysis showed that the number of comorbidities??GMFCS and degree of cognitive damage in children with cerebral palsy with microcephaly were negatively correlated with head circumference??P??0.001??. Conclusion??The degree of head circumference reduction in children with cerebral palsy complicated by microcephaly is negatively correlated with GMFCS??the number of comorbidities and the degree of cognitive impairment.     

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??Abstracts?? Objective To study serum 25-hydroxyvitamin D ??25-hydroxyvitamin D??25??OH??D?? distribution in May in preschool children in Suzhou area?? giving scientific basis for the intake and supplementation of vitamin D for children. Methods Totally 852 cases of preschool children??454 cases of male??398 cases of female?? aged from 3 to 7 years were selected in May of 2012??and all cases were divided into four groups named as 3??4 year group????4??5 year group????5??6 year group and ??6??7 year group.The height and weight of every case were measured and were used to calculate the Body Mass Index??BMI??for evaluating the body shape?? according the normal reference values of P85 and P95 of BMI for children below 7 years old provided by WHO??all cases were classified into overweight or no-overweight??obesity or no obesity groups. Serum 25??OH??D levels were measured by ELISA. Results There were 42.37%??361/852??of cases for preschool children in Suzhou area who showed deficiency of serum 25??OH??D??and insufficiency was presented in 40.38%??344/852?? of cases.For the distribution of 25??OH??D among age groups?? they were 61.20??53.30??75.20??nmol/L??55.50??45.5??65.10??nmol/L??48.30??40.40??57.50??nmol/L and 48.90??40.40??60.20??nmol/L from 3??4 year group to ??6??7 year group in turn. Comparing every two groups?? the serum 25??OH??D declined with the increasing age except between ??5??6 year and??6??7 year group??χ2 =18.10??P=0.47????and it was higher in 3??4 year group than that in ??4??5 year group??χ2 =110.43??P??0.05????higher in ??4??5 year group than that in ??5??6 or ??6??7 year group??χ2 was 106.11 and 87.75??P??0.05 for all??.The distribution of serum 25??OH??D in overweight and no-overweight group was 53.97??45.27??66.45??nmol/L and 52.64??42.85??63.80??nmol/L?? and they were 55.24??47.29??66.56??nmol/L and 52.71??43.11??63.92??nmol/L for obesity and no-obesity group??there existing significant difference for the distribution of 25??OH??D between every two groups??χ2 was 7.10 and 6.73??P??0.05??. Serum 25??OH??D and BMI showed positive correlation??r = 0.11??P??0.05??. Conclusion The overall insufficiency of serum 25??OH??D exists in preschool children in Suzhou area??and positive correlation exists between BMI and serum 25??OH??D in children. It suggests that we should reinforce the monitoring of serum 25??OH??D in preschool children??taking scientific measures to strengthen the intake and supplementation of vitamin D.