肥胖兒童青少年血清非高密度脂蛋白膽固醇水平與代謝紊亂的相關(guān)性研究
發(fā)布時(shí)間：2019-07-10 11:25
【摘要】：目的 1.探討肥胖青少年血清非高密度脂蛋白膽固醇(Non-HDL-C)水平與體重正常兒童Non-HDL-C的差異。 2.研究肥胖兒童青少年Non-HDL-C水平變化及與糖脂代謝紊亂、非酒精性脂肪肝、高尿酸血癥的關(guān)系。 3.評(píng)估肥胖兒童青少年Non-HDL-C升高的危險(xiǎn)因素。 方法 收集2011年6月至2013年1月在天津醫(yī)科大學(xué)總醫(yī)院兒科內(nèi)分泌門診就醫(yī)的肥胖兒童青少年449例,同時(shí)選取219例地域、年齡、性別與之相匹配的健康體檢兒童青少年為正常對(duì)照組。采集所有研究對(duì)象的臨床資料；測定空腹血糖(FPG)、空腹胰島素(FINS)、糖負(fù)荷后2小時(shí)血糖(2h-PG)、糖負(fù)荷后2小時(shí)胰島素(2h-INS)糖化血紅蛋白(HbAlc)、血清尿酸(UA)、谷丙轉(zhuǎn)氨酶(ALT)、谷草轉(zhuǎn)氨酶(AST)、總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)。并計(jì)算非高密度脂蛋白膽固醇(Non-HDL-C=TC-HDL-C),采用穩(wěn)態(tài)模型評(píng)估胰島素抵抗指數(shù)(HOMA-IR)=(FPG X FINS)/22.5,動(dòng)脈粥樣硬化指數(shù)(AI)=1g10(TG/HDL-C)。對(duì)肥胖兒童青少年進(jìn)行腹部肝臟超聲波檢查。1.比較正常兒童青少年和肥胖及代謝綜合征兒童青少年血清Non-HDL-C水平之間的差異。2.根據(jù)包含代謝綜合征因素組分多少分為4組,第1組為有1個(gè)代謝綜合征因素組,第2組為有2個(gè)代謝綜合征因素組,第3組為有3個(gè)代謝綜合征因素組,第4組為有4個(gè)代謝綜合征因素組。并分析各組血清Non-HDL-C水平的差異。3.將肥胖兒童青少年按照非酒精性脂肪肝的診斷標(biāo)準(zhǔn)分為2組：肥胖不伴NAFLD組；肥胖伴NAFLD組,并分析兩組間Non-HDL-C的差異及其與Non-HDL-C的關(guān)系。3.根據(jù)高尿酸血癥診斷標(biāo)準(zhǔn)將肥胖兒童青少年分為2組：血尿酸正常組；高尿酸血癥組,并分析兩組間Non-HDL-C的差異及其與Non-HDL-C的關(guān)系。4.分析Non-HDL-C與各指標(biāo)的相關(guān)性及其影響因素。 結(jié)果 1.代謝綜合征組(MS)及單純肥胖組TC、TG、HDL-C、LDL-C、Non-HDL-C、 ALT.ASL均高于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),MS組TC、TG、LDL-C、 Non-HDL-C、ALT高于單純肥胖組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 2.隨著代謝綜合征組分的增加Non-HDL-C水平增高,第4組血Non-HDL-C平均水平最高。除第1組與第2組之間差異無統(tǒng)計(jì)學(xué)意義外,其他各組之間差異均存在統(tǒng)計(jì)學(xué)意義(P0.01)。 3.肥胖兒童青少年非酒精性脂肪肝分組,肥胖伴NAFLD組與肥胖不伴NAFLD組之間Non-HDL-C水平差異無統(tǒng)計(jì)學(xué)意義(P0.05),肥胖伴NAFLD組ALT高于肥胖不伴NAFLD組,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。logistic回歸分析,WC、AC、 HbAlc是非酒精脂肪肝的影響因素。 4.肥胖兒童青少年高尿酸血癥組血清Non-HDL-C水平明顯高于血尿酸正常組,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。Logistic回歸分析Non-HDL-C、HOMA-IR、AI為高尿酸血癥的影響因素。 5.相關(guān)分析顯示Non-HDL-C與WHR、TC、TG、LDL-C、ALT、AST、2h-PG、 UA、HbAlc、HOMA-IR、AI呈正相關(guān)(P0.05或P0.01)。多元線性逐步回歸分析顯示,TC、HDL-C、LDL-C. AI、HOMA-IR是Non-HDL-C的影響因素。 結(jié)論 1.MS組和單純肥胖組Non-HDL-C均高于正常對(duì)照組,且MS組Non-HDL-C高于單純肥胖組。隨著代謝綜合征組分的增加,Non-HDL-C水平增高。提示Non-HDL-C與肥胖兒童青少年的肥胖程度和代謝綜合征組分多少有關(guān),Non-HDL-C可以作為MS的預(yù)測因子。 2.肥胖兒童青少年Non-HDL-C與動(dòng)脈粥樣硬化指數(shù)存在正相關(guān),且動(dòng)脈粥樣硬化指數(shù)是Non-HDL-C的影響因素。因此,Non-HDL-C可能參與了動(dòng)脈粥樣硬化的形成機(jī)制,Non-HDL-C可用于預(yù)測心血管疾病發(fā)病的危險(xiǎn)性。 3.肥胖兒童青少年血清Non-HDL-C水平與胰島素抵抗指數(shù)、糖負(fù)荷后血糖2小時(shí)血糖呈正相關(guān)。表明Non-HDL-C可能在肥胖進(jìn)展為糖尿病的過程中發(fā)揮了一定的病生理作用。 4.肥胖伴NAFLD組與肥胖不伴NAFLD組之間Non-HDL-C水平差異無統(tǒng)計(jì)學(xué)意義,而相關(guān)分析發(fā)現(xiàn),Non-HDL-C與肥胖兒童青少年肝酶有密切聯(lián)系,因此隨著Non-HDL-C增高,可能會(huì)造成肝細(xì)胞損傷。 5.肥胖兒童青少年血清Non-HDL-C水平與血清尿酸呈正相關(guān),Non-HDL-C、胰島素抵抗指數(shù)、動(dòng)脈粥樣硬化指數(shù)為高尿酸血癥的影響因素,提示尿酸水平高的肥胖兒童更易發(fā)生動(dòng)脈粥樣硬化,因此,尿酸、Non-HDL-C及胰島素抵抗共同參與動(dòng)脈粥樣硬化的發(fā)生和發(fā)展。
[Abstract]:Purpose 1. To study the difference between the serum non-high-density lipoprotein cholesterol (Non-HDL-C) level and the normal weight of the normal children, Non-HDL-C. The changes of the non-alcoholic fatty liver and hyperuricemia were studied in the study of the changes of the non-alcoholic fatty liver and hyperuricemia in the obese children. 3. Assessment of the increase in the number of Non-HDL-C in obese children to be in danger Risk factors. Methods:449 children with obesity were collected from June 2011 to January 2013 in the pediatric endocrinology clinic of the General Hospital of Tianjin Medical University, and 219 healthy children with geographical, age and sex were selected. The adolescents were in the normal control group. The clinical data of all the subjects were collected; fasting blood glucose (FPG), fasting insulin (FINS), blood glucose (2h-PG) after the sugar loading,2 hours of insulin (2 h-INS), hemoglobin (HbAlc), serum uric acid (UA), and trough were measured after the sugar loading. alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol Sterol (LDL-C). The non-high-density lipoprotein cholesterol (Non-HDL-C = TC-HDL-C) was calculated and the insulin resistance index (HOMA-IR) = (FPG X FINS)/ 22.5, the atherosclerotic index (AI) = 1 g10 ( TG/ HDL-C). Abdomen for obese children and adolescents Liver ultrasound examination.1. Comparison of serum Non-HDL-C for adolescent and obese and metabolic syndrome in normal children 2. In group 1, there were 1 metabolic syndrome factor group, group 2 had 2 metabolic syndrome factor groups, group 3 had 3 metabolic syndrome factor groups, and 4 in group 4. A group of metabolic syndrome factors, and the serum Non-HDL in each group was analyzed. 3. The non-alcoholic fatty liver was divided into two groups: obesity without NAFLD, obesity with NAFLD, and analysis of the difference between the two groups of Non-HDL-C and its relationship with Non-H. 3. The relationship between the two groups: the normal group of the blood uric acid, the hyperuricemia group, and the difference between the two groups of Non-HDL-C and their relationship with the Non-H. The relationship of DL-C.4. Analysis of Non-HDL-C and index related Results 1. The contents of TC, TG, HDL-C, LDL-C, Non-HDL-C, ALT and ASL in the group of metabolic syndrome (MS) and the simple obesity group were higher than those in the normal control group (P0.05). The difference of TC, TG, LDL-C, Non-HDL-C and ALT in the MS group was higher than that of the simple obesity group. 2. With the increase of the component of the metabolic syndrome, the level of Non-HDL-C was increased, and the fourth group of blood The average of the Non-HDL-C was the highest. There was no significant difference between the other groups except for the difference between Group 1 and Group 2. There was no significant difference in the level of non-alcoholic fatty liver (P 0.01).3. There was no significant difference in the level of Non-HDL-C between the obese children and the non-alcoholic fatty liver group (P0.05). Logistic regression analysis, WC, AC, HbAlc was a non-alcoholic fatty liver.4. The level of serum Non-HDL-C in the hyperuricemia group in the obese children was significantly higher than that in the normal group of blood uric acid (P0.01). Logistic regression analysis of Non-HDL-C, HO The effects of MA-IR and AI on hyperuricemia.5. Correlation analysis showed that Non-HDL-C and WHR, TC, TG, LDL-C, ALT, AST, 2h-PG, UA, HbAlc, HOMA-I R and AI were positively correlated (P0.05 or P0.01). The multiple linear step-by-step Regression analysis showed that TC, HDL-C, LDL-C. AI, H OM Conclusion 1. The non-HDL-C of both the MS group and the simple obesity group were higher than that in the normal group. In the control group, the non-HDL-C of the MS group was higher than that of the simple obesity group. The increase of the component of metabolic syndrome and the increase of the level of Non-HDL-C. Non-HDL-C can be used as a predictor of the MS.2. The Non-HDL-C and the atherosclerosis index of the obese children are positive. Correlated, and the atherosclerosis index is the influence factor of Non-HDL-C. Therefore, Non-HDL-C may be involved in the formation of atherosclerosis System, Non-HDL-C can be used to predict the risk of cardiovascular disease.3. Non-obese children's serum Non-HD There was a positive correlation between the level of L-C and the insulin resistance index and the blood glucose of 2 hours after the sugar loading. L-C may play a certain physiological role in the progression of obesity.4. There is no statistical difference between the level of Non-HDL-C between the obese and NAFLD groups, and the correlation analysis found that the Non-HDL-C and the obese children's liver enzymes The serum Non-HDL-C level of the obese children is positively related to the serum uric acid, and the Non-HDL-C, the insulin resistance index and the atherosclerosis index are hyperuricemia. The influential factors indicate that the obese children with high uric acid level are more prone to atherosclerosis, and therefore, the urine
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R725.8
本文編號(hào)：2512570
[Abstract]:Purpose 1. To study the difference between the serum non-high-density lipoprotein cholesterol (Non-HDL-C) level and the normal weight of the normal children, Non-HDL-C. The changes of the non-alcoholic fatty liver and hyperuricemia were studied in the study of the changes of the non-alcoholic fatty liver and hyperuricemia in the obese children. 3. Assessment of the increase in the number of Non-HDL-C in obese children to be in danger Risk factors. Methods:449 children with obesity were collected from June 2011 to January 2013 in the pediatric endocrinology clinic of the General Hospital of Tianjin Medical University, and 219 healthy children with geographical, age and sex were selected. The adolescents were in the normal control group. The clinical data of all the subjects were collected; fasting blood glucose (FPG), fasting insulin (FINS), blood glucose (2h-PG) after the sugar loading,2 hours of insulin (2 h-INS), hemoglobin (HbAlc), serum uric acid (UA), and trough were measured after the sugar loading. alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol Sterol (LDL-C). The non-high-density lipoprotein cholesterol (Non-HDL-C = TC-HDL-C) was calculated and the insulin resistance index (HOMA-IR) = (FPG X FINS)/ 22.5, the atherosclerotic index (AI) = 1 g10 ( TG/ HDL-C). Abdomen for obese children and adolescents Liver ultrasound examination.1. Comparison of serum Non-HDL-C for adolescent and obese and metabolic syndrome in normal children 2. In group 1, there were 1 metabolic syndrome factor group, group 2 had 2 metabolic syndrome factor groups, group 3 had 3 metabolic syndrome factor groups, and 4 in group 4. A group of metabolic syndrome factors, and the serum Non-HDL in each group was analyzed. 3. The non-alcoholic fatty liver was divided into two groups: obesity without NAFLD, obesity with NAFLD, and analysis of the difference between the two groups of Non-HDL-C and its relationship with Non-H. 3. The relationship between the two groups: the normal group of the blood uric acid, the hyperuricemia group, and the difference between the two groups of Non-HDL-C and their relationship with the Non-H. The relationship of DL-C.4. Analysis of Non-HDL-C and index related Results 1. The contents of TC, TG, HDL-C, LDL-C, Non-HDL-C, ALT and ASL in the group of metabolic syndrome (MS) and the simple obesity group were higher than those in the normal control group (P0.05). The difference of TC, TG, LDL-C, Non-HDL-C and ALT in the MS group was higher than that of the simple obesity group. 2. With the increase of the component of the metabolic syndrome, the level of Non-HDL-C was increased, and the fourth group of blood The average of the Non-HDL-C was the highest. There was no significant difference between the other groups except for the difference between Group 1 and Group 2. There was no significant difference in the level of non-alcoholic fatty liver (P 0.01).3. There was no significant difference in the level of Non-HDL-C between the obese children and the non-alcoholic fatty liver group (P0.05). Logistic regression analysis, WC, AC, HbAlc was a non-alcoholic fatty liver.4. The level of serum Non-HDL-C in the hyperuricemia group in the obese children was significantly higher than that in the normal group of blood uric acid (P0.01). Logistic regression analysis of Non-HDL-C, HO The effects of MA-IR and AI on hyperuricemia.5. Correlation analysis showed that Non-HDL-C and WHR, TC, TG, LDL-C, ALT, AST, 2h-PG, UA, HbAlc, HOMA-I R and AI were positively correlated (P0.05 or P0.01). The multiple linear step-by-step Regression analysis showed that TC, HDL-C, LDL-C. AI, H OM Conclusion 1. The non-HDL-C of both the MS group and the simple obesity group were higher than that in the normal group. In the control group, the non-HDL-C of the MS group was higher than that of the simple obesity group. The increase of the component of metabolic syndrome and the increase of the level of Non-HDL-C. Non-HDL-C can be used as a predictor of the MS.2. The Non-HDL-C and the atherosclerosis index of the obese children are positive. Correlated, and the atherosclerosis index is the influence factor of Non-HDL-C. Therefore, Non-HDL-C may be involved in the formation of atherosclerosis System, Non-HDL-C can be used to predict the risk of cardiovascular disease.3. Non-obese children's serum Non-HD There was a positive correlation between the level of L-C and the insulin resistance index and the blood glucose of 2 hours after the sugar loading. L-C may play a certain physiological role in the progression of obesity.4. There is no statistical difference between the level of Non-HDL-C between the obese and NAFLD groups, and the correlation analysis found that the Non-HDL-C and the obese children's liver enzymes The serum Non-HDL-C level of the obese children is positively related to the serum uric acid, and the Non-HDL-C, the insulin resistance index and the atherosclerosis index are hyperuricemia. The influential factors indicate that the obese children with high uric acid level are more prone to atherosclerosis, and therefore, the urine
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R725.8
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 張德平;劉靜民;鄭秀瑗;;內(nèi)臟脂肪與血脂的關(guān)系及其對(duì)血脂異常的臨床預(yù)測價(jià)值[J];腸外與腸內(nèi)營養(yǎng);2012年05期
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