Karney Alicja, Brągoszewska Hanna, Soluch Leszek, Ołtarzewski Mariusz
Oddział Hospitalizacji Jednego Dnia, Instytut Matki i Dziecka, Warszawa, Polska.
Zakład Diagnostyki Obrazowej, Instytut Matki i Dziecka, Warszawa, Polska.
Dev Period Med. 2017;21(3):259-265. doi: 10.34763/devperiodmed.20172103.259265.
Obesity in children causes metabolic and structural changes in blood vessels which lead to the development of cardiovascular diseases and type 2 diabetes.
The aim of the study was to assess the risk factors for atherosclerosis in obese children studied in the One-Day Hospitalization Department of the Institute of Mother and Child.
The study included 75 children aged 6-12 years (36 boys, 39 girls) with aBMI>97th percentile. The control group consisted of 36 children aged 5-10 years (18 boys, 18 girls) with a BMI of 75-90. Analysis was conducted of family history regarding obesity, CVD, dyslipidemia. The children's examination consisted of: BMI, waist circumference, cholesterol, LDL, HDL, triglycerides, and insulin. Both groups had their IMT (left and right) examined with ultrasound.
In the study group 82.6% of the obese children had a positive family history of obesity and 72% of CVD and dyslipidemia. Regarding the children from the control group, 34.2% had a family history of obesity and 36.8 of CVD and dyslipidemia. The mean waist circumference in the obese children was 72.7 cm, while in the control group it was 59.9 (<0.001). The mean levels of lipids were higher in obese children (<0.001). The insulin level was almost twice as high as in the control group (±8.47 SD; <0.003). The mean IMT in obese patients was 0.36 mm; ±0.059 SD (right side) and 0.37 mm; ±0.033 SD (left side), while in the control group it was 0.32 mm; ±0.087 SD (right side) and 0.32 mm, ±0.082 SD (left side). The differences between the two groups were statistically significant. A positive correlation between waist circumference and insulin level was found (<0.003).
Obesity and dyslipidemia are more common among children with familial obesity and CVD. Dyslipidemia is statistically more widespread among obese children. IMT is significantly higher in obese children compared with the control group, suggesting that changes in the structure of carotid atherosclerosis may occur in obese children in early childhood. This can be diagnosed using the noninvasive IMT method measured with ultrasound. Children with obesity, especially visceral, have higher levels of insulin, which may contribute to insulin resistance. Parents lack sufficient knowledge about the effects of childhood obesity and its effects on atherosclerosis and cardiovascular diseases.
In the study group 82.6% of the obese children had a positive family history of obesity and 72% of CVD and dyslipidemia. Regarding the children from the control group, 34.2% had a family history of obesity and 36.8 of CVD and dyslipidemia. The mean waist circumference in the obese children was 72.7 cm, while in the control group it was 59.9 (<0.001). The mean levels of lipids were higher in obese children (<0.003).
Obesity and dyslipidemia are more common among children with familial obesity and CVD. Dyslipidemia is statistically more widespread among obese children. IMT is significantly higher in obese children compared with the control group, suggesting that changes in the structure of carotid atherosclerosis may occur in obese children in early childhood. This can be diagnosed using the noninvasive IMT method measured with ultrasound. Children with obesity, especially visceral, have higher levels of insulin, which may contribute to insulin resistance. Parents lack sufficient knowledge about the effects of childhood obesity and its effects on atherosclerosis and cardiovascular diseases.
儿童肥胖会导致血管发生代谢和结构变化，进而引发心血管疾病和2型糖尿病。
本研究旨在评估在母婴研究所一日住院部接受研究的肥胖儿童的动脉粥样硬化风险因素。
该研究纳入了75名6至12岁的儿童（36名男孩，39名女孩），其BMI>第97百分位。对照组由36名5至10岁的儿童（18名男孩，18名女孩）组成，BMI为75 - 90。分析了关于肥胖、心血管疾病、血脂异常的家族史。对儿童的检查包括：BMI、腰围、胆固醇、低密度脂蛋白、高密度脂蛋白、甘油三酯和胰岛素。两组均通过超声检查其双侧颈动脉内膜中层厚度（IMT）。
在研究组中，82.6%的肥胖儿童有肥胖家族史，72%有心血管疾病和血脂异常家族史。对照组中，34.2%有肥胖家族史，36.8%有心血管疾病和血脂异常家族史。肥胖儿童的平均腰围为72.7厘米，而对照组为59.9厘米（<0.001）。肥胖儿童的平均血脂水平更高（<0.001）。胰岛素水平几乎是对照组的两倍（±8.47标准差；<0.003）。肥胖患者的平均IMT右侧为0.36毫米；±0.059标准差，左侧为0.37毫米；±0.033标准差，而对照组右侧为0.32毫米；±0.087标准差，左侧为0.32毫米，±0.082标准差。两组之间的差异具有统计学意义。发现腰围与胰岛素水平呈正相关（<0.003）。
肥胖和血脂异常在有家族性肥胖和心血管疾病的儿童中更为常见。血脂异常在肥胖儿童中在统计学上更为普遍。与对照组相比，肥胖儿童的IMT明显更高，这表明肥胖儿童在幼儿期可能就会出现颈动脉粥样硬化结构变化。这可以通过超声测量的无创IMT方法进行诊断。肥胖儿童，尤其是内脏型肥胖儿童，胰岛素水平较高，这可能导致胰岛素抵抗。家长对儿童肥胖的影响及其对动脉粥样硬化和心血管疾病的影响缺乏足够的了解。
在研究组中，82.6%的肥胖儿童有肥胖家族史，72%有心血管疾病和血脂异常家族史。对照组中，34.2%有肥胖家族史，36.8%有心血管疾病和血脂异常家族史。肥胖儿童的平均腰围为72.7厘米，而对照组为59.9厘米（<0.001）。肥胖儿童的平均血脂水平更高（<0.003）。
肥胖和血脂异常在有家族性肥胖和心血管疾病的儿童中更为常见。血脂异常在肥胖儿童中在统计学上更为普遍。与对照组相比，肥胖儿童的IMT明显更高，这表明肥胖儿童在幼儿期可能就会出现颈动脉粥样硬化结构变化。这可以通过超声测量的无创IMT方法进行诊断。肥胖儿童，尤其是内脏型肥胖儿童，胰岛素水平较高，这可能导致胰岛素抵抗。家长对儿童肥胖的影响及其对动脉粥样硬化和心血管疾病的影响缺乏足够的了解。
