儿童肥胖症中碳水化合物和脂蛋白代谢的改变——胰岛素抵抗和黑棘皮病的影响

Alterations of carbohydrate and lipoprotein metabolism in childhood obesity--impact of insulin resistance and acanthosis nigricans.

作者信息

Felszeghy E, Káposzta R, Juhász E, Kardos L, Ilyés I

机构信息

Department of Pediatrics, Medical and Health Science Center, University of Debrecen, Hungary.

出版信息

J Pediatr Endocrinol Metab. 2009 Dec;22(12):1117-26. doi: 10.1515/jpem.2009.22.12.1117.

DOI:10.1515/jpem.2009.22.12.1117

PMID:20333871

Abstract

AIM

To study the prevalence of alterations of glucose and lipoprotein metabolism and the impact of acanthosis nigricans (AN) in childhood obesity.

PATIENTS AND METHODS

113 obese children, 57 with simple obesity (SO) and 58 with obesity and AN (OAN). Oral glucose tolerance test was performed, serum glucose, insulin and lipoprotein parameters were determined, and insulin resistance/sensitivity indices were calculated.

RESULTS

Insulin resistance, basal and reactive hyperinsulinemia, impaired glucose tolerance (IGT) and dyslipidemia were found to be frequent conditions in children with OS as well as OAN. Reactive insulinemia was more pronounced in OAN than in SO, and insulin resistance was more frequent when AN was more prominent. Triglycerides were higher and HDL-C was lower, and atherogenic dyslipidemia was more frequent in OAN compared to SO.

CONCLUSION

Children with obesity form a risk population. AN is a factor which can be used in metabolic risk factor clustering estimation in childhood obesity.

摘要

目的

研究儿童肥胖症中葡萄糖和脂蛋白代谢改变的患病率以及黑棘皮病（AN）的影响。

患者与方法

113名肥胖儿童，57名单纯性肥胖（SO）儿童和58名伴有AN的肥胖（OAN）儿童。进行口服葡萄糖耐量试验，测定血清葡萄糖、胰岛素和脂蛋白参数，并计算胰岛素抵抗/敏感性指数。

结果

胰岛素抵抗、基础和反应性高胰岛素血症、糖耐量受损（IGT）和血脂异常在OS以及OAN儿童中均为常见情况。OAN儿童的反应性胰岛素血症比SO儿童更明显，且当AN更显著时，胰岛素抵抗更常见。OAN儿童的甘油三酯更高，高密度脂蛋白胆固醇（HDL-C）更低，与SO相比，动脉粥样硬化性血脂异常在OAN中更常见。