Aypak Cenk, Türedi Ozlem, Bircan Mustafa A, Yüce Adnan
Department of Family Medicine and.
Platelets. 2014;25(6):393-8. doi: 10.3109/09537104.2013.827783. Epub 2013 Aug 23.
Interest in childhood metabolic syndrome (MetS) has increased substantially due to the increasing prevalence of childhood obesity on a global scale. Early recognition of MetS is critical in order to delay the development of cardiovascular disease (CVD). In this study, we evaluated the relationship between complete blood count (CBC) parameters and MetS among pre-pubertal children which may provide evidence in support of using low cost, readily available clinical haematological parameters for the detection of MetS. A retrospective analysis was carried out on 330 (125 lean vs. 205 overweight) Turkish pre-pubertal children who attend to a paediatric outpatient clinic. Age, gender, puberty, body mass index, CBC parameters, cardiometabolic risk factors including lipid profiles, high sensitive serum reactive protein (hsCRP) and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated and compared among lean, overweight children and children with MetS. The mean age of the study population was 7.4 ± 1.9 years. In both gender, the mean values of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were significantly lower and red blood cell (RBC), platelet (PLT) counts were significantly higher in overweight children. Overall, 8.4% (n = 28) of patients met the criteria of MetS. Children with MetS had higher levels of PLT and lower levels of mean platelet volume (MPV). Of all the haematological parameters analysed, PLT was positively, whereas MPV was negatively correlated with MetS in girls. In addition, MPV was inversely correlated with fasting blood glucose, HOMA-IR, low density lipoprotein-cholesterol (LDL-C) and low density lipoprotein-cholesterol/high density lipoprotein-cholesterol (LDL-C/HDL-C) ratio in girls after adjusting for confounding factors. The risk analyses of MetS in terms of MPV quartiles showed that the adjusted OR (95% CI) for the lowest vs. the highest quartile was 7.71 (1.45-40.89) in girls. These data might suggest that MPV could be another feature of MetS in pre-pubertal girls and might be used as a surrogate marker for MetS in clinical settings.
由于全球范围内儿童肥胖患病率的上升，对儿童代谢综合征（MetS）的关注大幅增加。早期识别MetS对于延缓心血管疾病（CVD）的发展至关重要。在本研究中，我们评估了青春期前儿童全血细胞计数（CBC）参数与MetS之间的关系，这可能为支持使用低成本、易于获得的临床血液学参数来检测MetS提供证据。对330名（125名瘦儿童与205名超重儿童）到儿科门诊就诊的土耳其青春期前儿童进行了回顾性分析。评估并比较了瘦儿童、超重儿童和患有MetS的儿童的年龄、性别、青春期、体重指数、CBC参数、包括血脂谱在内的心脏代谢危险因素、高敏血清反应蛋白（hsCRP）以及通过稳态模型评估（HOMA-IR）计算的胰岛素抵抗指数。研究人群的平均年龄为7.4±1.9岁。在两个性别中，超重儿童的平均红细胞体积（MCV）、平均红细胞血红蛋白（MCH）和平均红细胞血红蛋白浓度（MCHC）的平均值显著较低，而红细胞（RBC）、血小板（PLT）计数显著较高。总体而言，8.4%（n = 28）的患者符合MetS标准。患有MetS的儿童血小板水平较高，平均血小板体积（MPV）水平较低。在所有分析的血液学参数中，女孩的PLT与MetS呈正相关，而MPV与MetS呈负相关。此外，在调整混杂因素后，女孩的MPV与空腹血糖、HOMA-IR、低密度脂蛋白胆固醇（LDL-C）以及低密度脂蛋白胆固醇/高密度脂蛋白胆固醇（LDL-C/HDL-C）比值呈负相关。根据MPV四分位数对MetS进行的风险分析表明，女孩中最低四分位数与最高四分位数相比的调整后OR（95%CI）为7.71（1.45 - 40.89）。这些数据可能表明，MPV可能是青春期前女孩MetS的另一个特征，并且在临床环境中可能用作MetS的替代标志物。
