新疆伊犁地区2438例哈萨克族儿童血压现况分析

目的：了解新疆伊犁地区哈萨克族儿童血压水平和高血压的发生状况及影响因素。方法：2009年5~6月采用随机整群抽样方法,抽取新疆伊犁地区哈萨克族学龄儿童2438例,进行身高、体重、腰围、臀围、皮褶厚度、血压测量,并计算体质指数（BMI）。结果：2438名儿童收缩压（SBP）平均水平为94±13 mm Hg,舒张压（DBP）平均水平为60±9 mm Hg,低于国内同年龄段汉族平均水平;检出高血压儿童138名,患病率5.66%（138/2438）,其中男童患病率4.38% （54/1232）,女童患病率6.97%（84/1206）,女童患病率高于男童（P<0.05）;血压及高血压患病率与BMI、腰围、臀围、皮褶厚度、性别、年龄均呈正相关。结论新疆伊犁地区哈萨克族儿童血压平均水平较国内儿童低;女童高血压患病率高于男童;肥胖与哈萨克族儿童高血压患病率密切相关。     

乌鲁木齐市家长喂养行为现状及其与儿童体重指数的相关性

目的 探讨家长喂养行为与儿童体重指数（BMI）间的相关性,为预防和干预儿童超重、肥胖提供科学依据。方法 采用分层随机整群抽样的方法,抽取乌鲁木齐市新市区7所幼儿园976名儿童,通过问卷调查和体格测量获得相关数据。结果 共发放调查问卷976份,收回有效问卷924份（94.7%）。儿童体重不足、超重、肥胖总检出率分别为3.1%（29例）、9.2%（85例）、6.7%（62例）。家长喂养行为以监督饮食水平最高,其次为限制饮食,逼迫进食水平最低。其中汉族儿童家长采用限制饮食及逼迫进食的水平高于维吾尔族儿童家长（P < 0.01）。家长喂养行为中,限制饮食与汉族及维吾尔族男童BMI均呈正相关（P < 0.01）;逼迫进食与汉族男童及女童BMI均呈负相关（P < 0.01）,与维吾尔族男童及女童BMI均呈正相关（P < 0.01）;监督饮食与维吾尔族和汉族男童及女童BMI均呈负相关（P < 0.05）。汉族及维吾尔族男童中超重/肥胖儿童其父母限制饮食得分高于正常体重儿童家长（P < 0.05）;维吾尔族男童及女童中,超重/肥胖儿童其父母逼迫进食得分高于正常体重儿童其家长（P < 0.01）;汉族、维吾尔族男童及女童中超重及肥胖儿童其父母监督饮食得分低于正常体重儿童家长（P < 0.01）。结论 乌鲁木齐市家长喂养行为状况总体较好,其中维吾尔族儿童家长喂养行为略优于汉族儿童家长。家长喂养行为与儿童BMI密切相关,其相关性在不同民族及性别间存在差异。高水平的监督饮食及低水平的限制饮食、逼迫进食可能有利于预防和控制儿童超重、肥胖的发生与发展。     

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目的调查四川省藏族儿童青少年肥胖指标体重指数(BMI)、腰围(WC)、腰臀比(WHR)、腰围身高比(WhtR)与血压、血脂,并对其相关性进行分析。方法采用多阶段、分层、整群随机抽样的方法,选取2007年10月调查的四川省阿坝自治州松潘县藏族儿童青少年818名资料完整者进行数据分析。测量计算BMI、WC、WHR、WhtR,并分别检测收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)以及低密度脂蛋白(LDL-C)的血清浓度,并进行相关性分析。结果女童超重肥胖率(12.78%)高于男童(3.30%),男童和女童超重肥胖组的血压、血脂与同性别BMI正常组相比差异有统计学意义。对血压、血脂与年龄、肥胖指标进行不同性别单因素相关性分析显示,男童和女童的BMI和WC均与SBP、DBP呈正相关。血脂四项与肥胖指标有不同程度的相关性。结论四川省藏族儿童青少年的BMI、WC、WHR、WhtR和血压、血脂存在不同程度的性别、年龄差异,尤其体现在16～17岁年龄组。监测儿童青少年期的BMI、WC和WhtR对于血压和血脂的控制和维持具有重要意义。     

瘦素和脂联素在儿童肥胖相关性高血压发病中的作用

目的探讨瘦素和脂联素在儿童肥胖相关性高血压发病中的作用。方法基于北京市儿童青少年代谢综合征研究项目的现况调查结果，非随机选择3 502名6~18岁学龄儿童（其中男1 784名，女1 718名）为研究对象，按照超重（包括肥胖）和高血压状态将研究对象分为4组，正常体重正常血压组（对照组，1 497名）、正常体重高血压组（HBP组，125名）、超重但血压正常组（OB组，1 349名）和超重合并高血压组（OB+HBP组，531名）。通过比较4组人群血清瘦素和脂联素水平，以及瘦素和脂联素与血压之间的相关回归分析，探讨其与肥胖和血压之间的关系。结果超重肥胖人群BMI、血压、胰岛素和瘦素水平显著升高，脂联素水平降低。HBP组与对照组BMI、瘦素、脂联素水平差异无统计学意义。OB组和OB+HBP组与对照组比较，BMI、SBP、DBP、胰岛素和瘦素水平升高，脂联素水平降低，与HBP组比较仍可见BMI、胰岛素和瘦素水平升高，脂联素水平降低。与OB组比较，OB+HBP组BMI和胰岛素水平及男性的瘦素水平明显升高。血压与年龄、BMI、胰岛素、瘦素均呈显著正相关（r=0.260~0.643,P<0.01），与脂联素呈显著负相关（r=-0.171~-0.332, P<0.01）。但在调整胰岛素或BMI后，瘦素、脂联素与血压的相关性减弱或消失。结论 超重人群血压、胰岛素及瘦素水平均高于对照人群，脂联素水平低于对照人群。瘦素、脂联素可能通过肥胖或胰岛素抵抗与血压相关。     

人体测量指标与儿童血压的相关性研究

目的调查分析人体测量指标对儿童血压的影响。方法随机抽样检查郑州地区6 790名6~13岁儿童,测量体质指数(BMI)、腰围(WC)、臀围(HC)、血压,计算腰围/臀围比(WHR)及腰围/身高比(WHtR),采用SPSS16.0软件进行统计分析。结果儿童高血压检出率为5.57%。控制年龄因素后采用偏相关分析发现,男、女童的BMI、WC、HC、WHtR与收缩压和舒张压均呈显著正相关(P均0.05)。无论男女,高血压组的BMI、WC、HC、WHR和WHtR的水平均高于正常血压组,差异均有统计学意义(P均0.05)。共检出肥胖儿童280名(4.12%),超重622名(9.16%)。肥胖、超重及正常体质量组的高血压比例的差异有统计学意义(P0.01),肥胖组高血压比例高于超重及正常体质量组。肥胖、超重组的收缩压、舒张压水平均高于正常体质量组,差异均有统计学意义(P0.05)。结论郑州地区6~13岁儿童高血压患病率处于同年龄段儿童的中低等水平。BMI、WC、HC、WHtR与男、女童血压具有显著相关性,尤以HC较为显著。     

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。     

肥胖儿童血浆内源性硫化氢水平变化的研究

目的 探讨肥胖儿童血浆硫化氢(H2S)水平及其影响因素.方法 2007年3月至6月选取北京大学第一医院儿科常规体检肥胖儿童36例(肥胖组),超重儿童40例(超重组),正常儿童40名(对照组).测量身高、体重,得出体重指数(BMI);常规测量血压;对其家族史进行调查.测量其血浆总胆固醇、三酰甘油(甘油三酯)、低密度脂蛋白和高密度脂蛋白水平;测定血浆H2S水平.结果 肥胖、超重组儿童体内H2S含量较对照组下降,差异有统计学意义(P<0.05).肥胖组、超重组三酰甘油高于对照组,高密度脂蛋白较对照组显著降低,差异有统计学意义(P<0.05).肥胖组收缩压较对照组升高,差异有统计学意义(P<0.05).结论 肥胖、超重儿童血浆H2S水平降低,提示肥胖儿童体内存在舍硫氨基酸体系代谢失衡.     

我国6～11岁儿童血压升高与出生体重的关系北大核心CSCD

目的分析我国8省（自治区、直辖市）6～11岁儿童出生体重与儿童期血压升高的关系。方法采用分层系统随机整群抽样方法,2010年9至11月中国疾病预防控制中心以我国8省为抽样框,抽取18920名6—11岁儿童作为研究对象,测量其身高、体重、腰围和血压。血压值以Korotkoff音开始（K1）出现时为收缩压,Korotkoff音消失（K5）为舒张压。血压升高定义为收缩压或舒张压大于等于同年龄、同性别和身高者血压的第95百分位数。通过父母自填问卷获得儿童出生体重和高血压家族史等信息。采用方差分析比较低、正常和高出生体重三组儿童身体测量指标和血压水平的差异,采用多因素Logistic回归逐步法分析出生体重、目前体重指数对儿童期血压升高的影响。结果6～8岁和9～11岁组男童可见身高、体重、腰围、体重指数、收缩压和舒张压水平随出生体重分组的升高呈上升趋势,仅6—8岁组男童的腰围在不同出生体重组问差异无统计学意义（P=0．112）,其余各指标在不同出生体重组间差异均有统计学意义（P〈0．05）。6—8岁和9～11岁组女童可见身高、体重、腰围、体重指数和舒张压水平随m生体重分组的升高呈上升趋势,差异有统计学意义（P〈0．05）,但收缩压在不同出生体重组间差异无统计学意义（P＝0．099）。在调整年龄、高血压患病家族史后,与正常出生体重儿童相比,高出生体重男童和女童发生儿童期血压升高相对风险OR值分别为1．23（1．06—1．43）和0．89（0．71～1．10）;增加调整儿童当前体重指数后,与正常出生体重儿童相比,高出生体重男童和女童发生儿童期血压升高的OR值分别为1．06（0．90～1．24）和0．73（0．58～0．91）。低出生体重组与正常儿童相比,发生儿童期血压升高的相对风险无统计学意义。6—11岁男童和女童当前体重指数每增加1个单位,发生血压升高的相对风险分别为1．16和1．20倍。结论6-11岁儿童血压升高与其当前体重指数密切相关,而与出生体重无明显关系。     

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。     

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。     

Association of Serum Alanine Aminotransferase Levels with Cardiometabolic Risk Factors in Normal-Weight and Overweight Children

Objective

This study aimed to determine the prevalence of increased alanine aminotransferase (ALT), defined by a gender-specific cutoff value, among normal weight and overweight children; and to assess the relationship of increasing ALT levels with cardiometabolic risk factors.

Methods

This cross-sectional study was conducted among school students, aged 6-18 years in Isfahan, Iran. Based on the body mass index (BMI) percentiles, a group of normal-weight was compared with a group of overweight and obese students. Gender differences were considered for increased levels of ALT, i.e. 19U/L and 30U/L for girls and boys respectively.

Findings

The study participants consisted of 1172 students (56.2% girls), with a mean (SD) age of 12.57 (3.3) years. Among overweight/obese students the mean triglycerides (TG) and diastolic blood pressure was significantly higher in those with increased ALT than in those with normal ALT levels. The logistic regression analysis showed that among overweight/obese boys, for each 1 unit increase in ALT, the odds ratio (OR) of TG, total cholesterol and systolic blood pressure increased significantly. After adjusting for age, these associations remained significant, and the OR of high density lipoprotein cholesterol (HDL-c) decreased significantly. In the model adjusting for age and BMI, the ORs of TG and HDL-c remained significant. After adjusting for age and waist circumference, HDL-c was the only parameter with significant OR. Among overweight/obese girls, in all models applied, the OR was significant for TG and total cholesterol. A significant independent association was documented for waist circumference and increase in ALT after adjustment for BMI.

Conclusion

This study documented significant relationship of increased ALT levels, defined by a gender-specific cutoff point, with cardiometabolic risk factors and hypertriglyceridemic-waist phenotype in Iranian children and adolescents.     

Relation of circulating oxidized LDL to obesity and insulin resistance in children

Kelly AS, Jacobs DR Jr, Sinaiko AR, Moran A, Steffen LM, Steinberger J. Relation of circulating oxidized LDL to obesity and insulin resistance in children. Introduction: Circulating oxidized low‐density lipoprotein (LDL), a marker of oxidative stress, is associated with obesity, insulin resistance, metabolic syndrome, and cardiovascular disease in adults. However, little is known about its relation to insulin resistance and cardiovascular risk factors in children. The purpose of this study was to assess the relation of oxidative stress, measured by circulating oxidized LDL, with measures of adiposity and insulin resistance in children. Methods: Oxidized LDL, measures of body fatness (body mass index: BMI, percent body fat, waist circumference, percent trunk fat, abdominal visceral and subcutaneous fat), insulin resistance with euglycemic insulin clamp (Mlbm), blood pressure, and blood lipids were obtained in 78 children. Oxidized LDL was compared between normal weight children (BMI < 85th percentile) and overweight/obese children (BMI ≥ 85th percentile) and levels were evaluated for associations with body fatness and insulin resistance. Results: Oxidized LDL levels were significantly higher in overweight/obese vs. normal weight children (p < 0.0001). Oxidized LDL was significantly correlated with BMI, percent body fat, waist circumference, percent trunk fat, abdominal visceral fat, and abdominal subcutaneous fat (all p‐values <0.0001). Moreover, oxidized LDL was negatively correlated with Mlbm, even after adjustment for adiposity (p < 0.01). Conclusions: Oxidized LDL is significantly associated with adiposity and with insulin resistance, independent of body fatness, in children. Oxidative stress may be independently related to the development of insulin resistance early in life, especially in obese youth.     

长沙市开福区小学生肥胖现状及影响因素分析

目的：了解长沙市开福区小学生超重、肥胖情况及单纯性肥胖的影响因素,为小学生肥胖的防治工作提供科学依据。方法：随机抽取长沙市开福区7~12周岁小学生4 140名,按照体重指数(BMI)法判定出单纯性肥胖,将肥胖和正常儿童设为肥胖组和对照组,对影响小学生肥胖的有关因素进行分析。结果：①长沙市开福区小学生超重及肥胖检出率分别为9.76%和7.39%,男女生肥胖率分别为9.37%和5.13%。②与正常小学生相比,肥胖小学生的BMI,腰围(WC),腰臀比(WHR),体脂百分比(%BF),收缩压(SBP),血清甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)明显升高,高密度脂蛋白胆固醇(HDL-C)明显降低。③肥胖小学生的WC,WHR与TG,LDL-C的偏相关系数大于BMI,%BF与其的偏相关系数。④儿童肥胖的危险因素可归结为常暴饮暴食、看电视时间长、进餐速度快、常吃油腻食物,而喜欢运动、运动时间长具有保护作用。结论：长沙市开福区小学生肥胖的发生率在国内处于高水平,控制儿童肥胖有助于慢性疾病的早期预防,预防儿童肥胖关键在于普及营养保健知识、注意平衡膳食和增加体力活动。     

Obesity and associated cardiovascular risk factors in Iranian children: A cross-sectional study

BACKGROUND: Obesity is a growing public health problem in developing countries considering its association with cardiovascular risk factors. Relationship between childhood obesity and these risk factors has not been attested in the Iranian population before. The aim of the present study was to investigate frequency of cardiovascular risk factors and their association with severity of obesity in a sample of Iranian obese children. METHODS: A total of 13 086 children aged 7-12 years were screened and those with waist circumference = 90th percentile of their age were invited for further evaluations. Participants were divided into two groups of overweight or obese according to International Obesity Task Force criteria. Cardiovascular risk factors were defined as high fasting total cholesterol, high low density lipoprotein, low high density lipoprotein, high triglycerides, and systolic or diastolic hypertension. These factors were compared between obese and overweight children and their correlations with body mass index and other measures of obesity were tested. RESULTS: Of 532 children (274 boys, mean age 9.5 +/- 1.3) enrolled in the study, 194 were overweight and 338 were obese. Mean levels of triglyceride and Apo-lipoprotein B in obese children were significantly higher than overweight participants. A total of 81.9% of obese children and 75.4% of overweight children had at least one cardiovascular risk factor. There were significant correlations between body mass index and systolic blood pressure, diastolic blood pressure, serum triglyceride, and Apo-lipoprotein B levels (P values <0.01). CONCLUSION: The high prevalence of cardiovascular risk factors in overweight and obese children and positive correlation of these factors with severity of obesity emphasizes the need for prevention and control of childhood obesity from early stages.     

CD40-CD40L系统与儿童肥胖的相关性

目的 探讨CD40-CD40L系统与儿童肥胖的相关性。方法 选取肥胖儿童76例为肥胖组，同时选取体重指数（BMI）正常的74例儿童为对照组。比较两组儿童形态学指标和生化指标，以及血清CD40和CD40L水平，并采用偏相关分析和多元线性回归分析研究肥胖组儿童CD40和CD40L与其他临床指标的相关性。结果 肥胖组BMI、腰围/身高之比、收缩压、舒张压、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、尿酸、三酰甘油、载脂蛋白B、空腹血糖、空腹胰岛素、糖化血红蛋白、血小板计数、CD40L及平均颈动脉内膜中层厚度均高于对照组（P < 0.05），而高密度脂蛋白胆固醇和载脂蛋白A1均低于对照组（P < 0.05）。以年龄和性别为控制因素，偏相关分析显示，CD40L与身高、体重、BMI、舒张压、胆汁酸、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B及血小板计数呈正相关（P < 0.05）；CD40与腰围/身高之比和血小板计数呈正相关（P < 0.05）。多元线性回归分析显示，ALT、AST、总胆固醇、血小板计数是CD40L水平的独立影响因素（R²=0.266，P < 0.05）。结论 CD40-CD40L系统与肥胖及肥胖相关的血脂紊乱和高血压密切相关，CD40和CD40L可能成为代谢综合征早期预警的新指标，为相关慢性病的防治提供新思路。     

Can waist circumference identify children with the metabolic syndrome?

OBJECTIVE: To determine in children the association between waist circumference (WC) and insulin resistance determined by homeostasis modeling (HOMA-IR) and proinsulinemia and components of the metabolic syndrome, including lipid profile and blood pressure (BP). METHODS: Eighty-four students (40 boys) aged 6 to 13 years and matched for sex and age underwent anthropometric measurements; 40 were obese; 28, overweight; and 16, nonobese. Body mass index (BMI), WC, BP, and Tanner stage were determined. An oral glucose tolerance test, lipid profile, and insulin and proinsulin assays were performed. Children were classified as nonobese (BMI < 85th percentile), overweight (BMI, 85th-94th percentile), and obese (BMI > or = 95th percentile). RESULTS: There was univariate association (P < .01) between WC and height (r = 0.73), BMI (r = 0.96), Tanner stage (r = 0.67), age (r = 0.56), systolic BP (r = 0.64), diastolic BP (r = 0.61), high-density lipoprotein cholesterol level (r = 0.45), triglyceride level (r = 0.28), proinsulin level (r = 0.59), and HOMA-IR (r = 0.59). Multiple linear regression analysis using HOMA-IR as the dependent variable showed that WC (beta coefficient = 0.050 [95% confidence interval, 0.028 to 0.073]; P = .001) and systolic BP (beta coefficient = 0.033 [95% confidence interval, 0.004 to 0.062]; P = .004) were significant independent predictors for insulin resistance adjusted for diastolic BP, height, BMI, acanthosis nigricans, and high-density lipoprotein cholesterol level. CONCLUSION: Waist circumference is a predictor of insulin resistance syndrome in children and adolescents and could be included in clinical practice as a simple tool to help identify children at risk.     

Childhood obesity-related cardiovascular risk factors and carotid intima-media thickness

The purpose of this study was to investigate the relationship between childhood obesity and carotid intima-media thickness (IMT). This is a cross-sectional study in obese children and non-obese control subjects. This study included 75 obese children and 40 non-obese control children. Systolic and diastolic blood pressure (SBP, DBP) values and waist and hip circumferences were measured. Fasting blood glucose and insulin concentrations, total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were assayed. The carotid IMT was measured by high resolution B-mode ultrasonography. Waist/hip ratios, SBP and DBP were significantly increased in the obese group compared to the non-obese children (all p < 0.001). The total cholesterol, LDL-C, HDL-C, and TG in the obese children were significantly different from values in the control subjects (all p < 0.001). Compared to the controls, the obese children demonstrated significant differences in a number of clinical risk factors including body weight, body mass index (BMI), BMI-standard deviation score (SDS), SBP/DBP, waist circumference, hip circumference, and waist/hip ratio (all p < 0.001). Compared to the controls, the obese children showed increased mean carotid IMT values [0.52 mm (95% confidence interval [CI], 0.40-0.64 mm) vs. 0.35 mm (95% CI, 0.24-0.38 mm), p < 0.001]. Univariate correlation analysis revealed that the carotid IMT was closely related to the BMI-SDS, SBP/DBP, waist and hip circumferences, serum TG, cholesterol, LDL-C, HDL-C, fasting serum insulin level, and insulin resistance indices including the homeostasis model assessment of insulin resistance (HOMA-IR), fasting glucose-to-insulin ratio (FGIR), and quantitative insulin-sensitivity check index (QUICKI). Multiple regression analysis showed that the BMI-SDS, TG and QUICKI were independent predictive risk factors for increased carotid IMT. Measurements of BMI-SDS, blood pressure, waist and hip circumferences, serum TG levels, the QUICKI insulin resistance index, and carotid IMT by ultrasonography are suitable in pediatric patients in a clinical setting and may be used for screening of obese children.     

Moderately elevated body mass index is associated with metabolic variables and cardiovascular risk factors in Swedish children

Aim: To evaluate associations between anthropometrics and metabolic variables as well as cardiovascular risk factors among children. Methods: Subjects were recruited from a cohort of 274 healthy children in Umeå, Sweden. Anthropometric measures, blood pressure and venous blood samples were collected at age 10 years and simultaneously from parents. Results: Altogether 144 children (53%), 142 mothers and 123 fathers participated. The prevalence of overweight and obesity among the children was 18 and 2%, respectively. Overweight children (above age‐ and sex‐specific cut offs corresponding adult BMI ≥ 25 kg/m²), compared to normal weight children, had significantly higher BMI already during infancy and higher S‐insulin and Homeostatic Model Assessment (HOMA) index at 10 years. The children’s BMI was positively associated with waist (boys’ r = 0.67, girls’ r = 0.81), hip (r = 0.68), waist/hip ratio (girls’ r = 0.37), waist/height ratio (boys’ r = 0.59, girls’ r = 0.80), sagittal abdominal diameter (r = 0.75), S‐insulin (r = 0.45), HOMA index (r = 0.49), systolic blood pressure (r = 0.24), mothers’ BMI (girls’ r = 0.42) and mothers’ waist (girls’ r = 0.42). Conclusion: Children at 10 years of age with moderately elevated BMI had higher levels of some metabolic variables and cardiovascular risk factors than did normal weight children, and there was a correlation between BMI and some metabolic variables as well as cardiovascular risk factors.     

血尿酸水平与维吾尔族超重/肥胖儿童青少年代谢综合征的关系

目的 探讨维吾尔族超重/肥胖儿童青少年的血尿酸（SUA）水平与代谢综合征（MS）之间的关系。方法 研究对象为维吾尔族儿童青少年超重/肥胖患者（n=173）和体重正常者（n=200）。测量其身高、体重、腰围及总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）、空腹血糖及 SUA。结果 超重组和肥胖组的 SUA 水平分别为 235±42、285±42 μmol/L,均明显高于对照组（199±32 μmol/L）,差异有统计学意义（PPP2,SUA 水平增加 5.74 μmol/L。结论 维吾尔族超重/肥胖儿童青少年的 SUA 水平明显升高;SUA水平升高,MS 及其组分发生率增加;SUA 与体重指数呈正相关。     

高敏C反应蛋白水平与肥胖及糖代谢异常儿童相关因素的研究

目的 了解高敏C反应蛋白（hs-CRP）与肥胖及糖代谢异常儿童的体量指标及血清参数相关性;探讨hs-CRP与儿童肥胖患者及糖尿病或糖代谢异常的关系。方法 选择肥胖儿童70例作为研究对象,并选择正常儿童30例作为对照组（组1）,根据OGTF试验将肥胖儿童分为不伴糖代谢异常组54例（组2）和糖代谢异常组16例（组3）,测定体量指标及相关参数。结果 肥胖儿童hs-CRP水平2．44（0．01～14．6）mg／L,明显高于对照组[0．1（0．01-2．1）mg／L]。血糖和血脂于正常范围时,肥胖儿童的hs-CRP水平为2．4（0．01-9．0）mg／L,胰岛素抵抗指数（IRI）明显升高。糖脂代谢异常时,hs-CRP水平为2．6（0．1-14．6）mg／L。Pearson相关分析显示,血清hs-CRP水平与BMI、腰围、臀围、腰臀比呈正相关,其中与BMI的相关性最强,多元线性回归分析示,BMI是惟一与hs-CRP相关的指标。结论 肥胖儿童存在低度炎症状态和胰岛素抵抗。hs-CRP与BMI独立相关。hs-CRP和胰岛素抵抗指数的异常升高早于血糖和血脂,hs-CRP增高对糖脂代谢的异常有较好的预测能力。