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儿童肥胖慢性治疗期间血脂变化。

Changes in lipidemia during chronic care treatment of childhood obesity.

机构信息

Children’s Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbak, Holbak, Denmark.

出版信息

Child Obes. 2012 Dec;8(6):533-41. doi: 10.1089/chi.2011.0098.

Abstract

BACKGROUND

Childhood obesity and related co-morbidities are increasing. This intervention study assessed the associations between weight changes and lipidemia in obese children and adolescents.

METHODS

A total of 240 obese children and adolescents (median age, 11.3 years; range, 3.9-20.9) were enrolled in a best-practice multidisciplinary chronic care treatment program. The concentrations of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TGs) and anthropometric data comprising height and weight were collected at baseline and after up to 39 months of continuous treatment.

RESULTS

The BMI standard deviation score (SDS) decreased in 51% of patients and maintained unchanged in 32% of patients during the treatment. At baseline, 65 (27.1%) of the patients exhibited dyslipidemia defined as increased concentrations of total cholesterol (>200 mg/dL), LDL (>130 mg/dL), or TGs (>150 mg/dL), or decreased HDL concentration (<35 mg/dL). Dyslipidemia improved with weight loss; the odds ratio (OR) was 0.37 per BMI SDS (p = 0.014) after adjusting for age, sex, and baseline BMI SDS. Baseline TG concentration correlated positively and HDL concentration correlated negatively with baseline BMI SDS. Weight loss was associated with a decrease in the concentrations of total cholesterol (p = 0.0005), LDL (p < 0.0001), non-HDL (p < 0.0001), and TGs (p < 0.0001), and with an increase in HDL concentration (p < 0.0001).

CONCLUSION

High lipid concentrations were associated with childhood obesity. The lipid profile improved during weight loss independently of the baseline BMI SDS and baseline lipid concentration.

摘要

背景

儿童肥胖症及其相关合并症日益增多。本干预研究评估了肥胖儿童和青少年体重变化与血脂异常之间的关系。

方法

共纳入 240 名肥胖儿童和青少年(中位数年龄为 11.3 岁;范围为 3.9-20.9 岁),参加最佳实践多学科慢性护理治疗方案。在基线和最长 39 个月的连续治疗后,收集总胆固醇、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)和甘油三酯(TGs)浓度以及身高和体重等人体测量数据。

结果

在治疗期间,51%的患者 BMI 标准差评分(SDS)下降,32%的患者保持不变。基线时,65 名(27.1%)患者存在血脂异常,定义为总胆固醇(>200mg/dL)、LDL(>130mg/dL)或 TGs(>150mg/dL)浓度升高,或 HDL 浓度(<35mg/dL)降低。体重减轻改善了血脂异常;调整年龄、性别和基线 BMI SDS 后,BMI SDS 每降低 0.37 个单位,比值比(OR)为 0.37(p=0.014)。基线 TG 浓度与基线 BMI SDS 呈正相关,HDL 浓度与基线 BMI SDS 呈负相关。体重减轻与总胆固醇(p=0.0005)、LDL(p<0.0001)、非-HDL(p<0.0001)和 TGs(p<0.0001)浓度降低以及 HDL 浓度升高(p<0.0001)相关。

结论

高脂质浓度与儿童肥胖有关。体重减轻时,血脂谱改善与基线 BMI SDS 和基线血脂浓度无关。

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