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青少年肥胖的代谢并发症,尤其是关于尿酸水平升高的情况

[Metabolic complications of obesity during adolescence, particularly regarding elevated uric acid levels].

作者信息

Ságodi László, Fehér Viktória, Kiss-Tóth Emőke, Almási Andrea, Barkai László

机构信息

Preventív Egészségtudományi Tanszék, Miskolci Egyetem, Egészségügyi Kar Miskolc.

出版信息

Orv Hetil. 2015 May 31;156(22):888-95. doi: 10.1556/650.2015.30140.

Abstract

INTRODUCTION

Obesity is a social problem worldwide that leads to several diseases, including metabolic syndrome, hypertension and cardiovascular diseases. It is known that hyperuricemia in adults may be associated with these disorders.

AIM

The aim of the authors was to investigate the frequency of metabolic syndrome and hyperuricemia and their relationship among obese adolescents.

METHOD

This was a cross-sectional study. The authors analysed the data of 162 overweight or obese adolescents (100 boys and 62 girls) who were previously investigated in a paediatric endocrinology consultation. Anthropometric and metabolic parameters were evaluated in all subjects. Healthy, age-matched, non obese girls (n = 20) and boys (n = 26) were used as controls. The age of overweight or obese boys was: 12 ± 2.1 and overweight or obese girls was 11 ± 2.5 years. In the control group the age of boys was 12.9 ± 2.5 years and the age of girls was 13.2 ± 1.6 years. Linear regression was used to evaluate associations between uric acid and clinical and laboratory findings associated with metabolic syndrome.

RESULTS

Obese or overweight subjects had greater BMI SDS (boys, 3.4 ± 1.3 vs 0.05 ± 0.4 in controls, p<0.0001; girls, 3.75 ± 1.4 vs 0.72 ± 0.9 in controls, p = 0.0001), waist circumference (boys, 90.1 ± 9.2 vs 82.3 ± 6.4 cm in controls; girls, 90.2 ± 8.6 vs 78.1 ± 7.2 cm in controls, p<0.001), higher systolic blood pressure (boys, 125 ± 14.3 vs 118.2 ± 10.8 mmHg in controls, p = 0.02; girls, 125.8 ± 11.8 vs 119.8 ± 8.8 mmHg in controls, p<0.01), diastolic blood pressure (boys, 78.4 ± 9.1 vs 71.2 ± 8.0 mmHg in controls, p = 0.0003; girls, 76.45 ± 7.2 vs 73.2 ± 6.3 mmHg in controls, p = 0.0453). The prevalence of metabolic syndrome was 45/162 (27.8%) and the prevalence of hyperuricemia was 62/162 (38.3%). Of the 45 subjects with metabolic syndrome, 30 (66.7%) had hyperuricemia.

CONCLUSIONS

It can be concluded that hyperuricemia is strongly associated with metabolic syndrome. The high concentration of uric acid predicts cardiovascular risk in adulthood. It is important for paediatricians to determine and assess uric acid levels in overweight or obese adolescents.

摘要

引言

肥胖是一个全球性的社会问题,会引发多种疾病,包括代谢综合征、高血压和心血管疾病。已知成人高尿酸血症可能与这些疾病有关。

目的

作者旨在调查肥胖青少年中代谢综合征和高尿酸血症的发生率及其关系。

方法

这是一项横断面研究。作者分析了162名超重或肥胖青少年(100名男孩和62名女孩)的数据,这些青少年之前在儿科内分泌门诊接受过检查。对所有受试者进行了人体测量和代谢参数评估。选取健康、年龄匹配的非肥胖女孩(n = 20)和男孩(n = 26)作为对照组。超重或肥胖男孩的年龄为:12±2.1岁,超重或肥胖女孩的年龄为11±2.5岁。对照组中男孩的年龄为12.9±2.5岁,女孩的年龄为13.2±1.6岁。采用线性回归评估尿酸与代谢综合征相关的临床和实验室检查结果之间的关联。

结果

肥胖或超重受试者的BMI SDS更高(男孩,3.4±1.3,对照组为0.05±0.4,p<0.0001;女孩,3.75±1.4,对照组为0.72±0.9,p = 0.0001),腰围更大(男孩,90.1±9.2cm,对照组为82.3±6.4cm;女孩,90.2±8.6cm,对照组为78.1±7.2cm,p<0.001),收缩压更高(男孩,125±14.3mmHg,对照组为118.2±10.8mmHg,p = 0.02;女孩,125.8±11.8mmHg,对照组为119.8±8.8mmHg,p<0.01),舒张压更高(男孩,78.4±9.1mmHg,对照组为71.2±8.0mmHg,p = 0.0003;女孩,76.45±7.2mmHg,对照组为73.2±6.3mmHg,p = 0.0453)。代谢综合征的患病率为45/162(27.8%),高尿酸血症的患病率为62/162(38.3%)。在45名患有代谢综合征的受试者中,30名(66.7%)患有高尿酸血症。

结论

可以得出结论,高尿酸血症与代谢综合征密切相关。高尿酸水平预示着成年期的心血管风险。儿科医生确定和评估超重或肥胖青少年的尿酸水平非常重要。

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