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肥胖儿童和青少年的心血管危险因素

Cardiovascular Risk Factors in Obese Children and Adolescents.

作者信息

Rumińska Małgorzata, Majcher Anna, Pyrzak Beata, Czerwonogrodzka-Senczyna Aneta, Brzewski Michał, Demkow Urszula

出版信息

Adv Exp Med Biol. 2016;878:39-47. doi: 10.1007/5584_2015_168.

Abstract

The aim of the study was to analyze cardiometabolic risk factors andcarotid intima-media thickness (IMT) in obese children. We studied 122 obese children fulfilling the criteria of the International Obesity Task Force and 58 non-obese children. Anthropometric parameters, blood pressure, lipid profile, C-reactive protein, and adiponectin were assessed in all children. Glucose and insulin during the oral glucose tolerance test were assessed in obese children. The IMT was determined using ultrasound B-mode imaging in 81 obese and 32 non-obese children. We found that obese children had significantly higher levels of lipid andother non-lipid atherogenic indicators, but lower levels of adiponectin compared with non-obese children. The difference in the mean carotid IMT was insignificant in the two groups. Taking the combined groups, the level of adiponectin correlated negatively with body mass index and lipid atherogenic indicators. The IMT strongly correlated with systolic blood pressure in obese children. In the children fulfilling the criteria of metabolic syndrome, 17 out of the 84 obese children older than 10 years of age, IMT was greater than in those who did not fulfil these criteria. We conclude that the coexistence of abdominal obesity with abnormal lipid profile and hypertension leads to the early development of atherosclerosis accompanied by increased carotid intima-media thickness. Obesity initiates the atherosclerotic processes in early childhood.

摘要

本研究的目的是分析肥胖儿童的心脏代谢危险因素和颈动脉内膜中层厚度(IMT)。我们研究了122名符合国际肥胖特别工作组标准的肥胖儿童和58名非肥胖儿童。对所有儿童评估人体测量参数、血压、血脂谱、C反应蛋白和脂联素。对肥胖儿童评估口服葡萄糖耐量试验期间的血糖和胰岛素。使用超声B型成像对81名肥胖儿童和32名非肥胖儿童测定IMT。我们发现,与非肥胖儿童相比,肥胖儿童的脂质和其他非脂质致动脉粥样硬化指标水平显著更高,但脂联素水平更低。两组的平均颈动脉IMT差异不显著。综合两组来看,脂联素水平与体重指数和脂质致动脉粥样硬化指标呈负相关。肥胖儿童的IMT与收缩压密切相关。在符合代谢综合征标准的儿童中,84名10岁以上肥胖儿童中有17名的IMT大于不符合这些标准的儿童。我们得出结论,腹型肥胖与脂质异常和高血压并存会导致动脉粥样硬化早期发展,并伴有颈动脉内膜中层厚度增加。肥胖在儿童早期就启动了动脉粥样硬化进程。

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