CAJ | 학술논문

目的判断肥胖儿童胰岛素抵抗与血管内皮功能损伤的关系.方法肥胖176例、超重58例、正常45例三组儿童,B超检测颈动脉内中膜层厚度(IMT)和舒张功能;化验生化指标和血管慢性炎症指标,计算胰岛素抵抗指数和敏感指数.结果三组间比较,动脉粥样硬化危险因素、部分慢性炎症指标、IMT(F=3.209,P=0.046)、颈动脉血管弹性(F=6.576,P=0.002)有显著性差别.胰岛素敏感指数与动脉粥样硬化危险因素、IMT(R=-0.201,P=0.010)、可溶性细胞间黏附分子1(R=-0.197,P=0.010)、脂联素(R=0.419,P=0.000)密切相关;随着胰岛素敏感指数的降低,动脉粥样硬化的危险因素和血管损伤逐渐增加.多元回归分析IMT与腹型肥胖程度、平均血压,胰岛素抵抗指数、高密度脂蛋白胆固醇有关.结论肥胖儿童早期动脉粥样硬化已经启动,预防成人心脑血管疾病应该从预防儿童肥胖做起.
목적 판단비반인동이도소저항여혈관내피공능손상적관계.방법 비반176례、초중58례、정상45례삼조인동,B초검측경동맥내중막층후도(IMT)화서장공능;화험생화지표화혈관만성염증지표,계산이도소저항지수화민감지수.결과 삼조간비교,동맥죽양경화위험인소、부분만성염증지표、IMT(F=3.209,P=0.046)、경동맥혈관탄성(F=6.576,P=0.002)유현저성차별.이도소민감지수여동맥죽양경화위험인소、IMT(R=-0.201,P=0.010)、가용성세포간점부분자1(R=-0.197,P=0.010)、지련소(R=0.419,P=0.000)밀절상관;수착이도소민감지수적강저,동맥죽양경화적위험인소화혈관손상축점증가.다원회귀분석IMT여복형비반정도、평균혈압,이도소저항지수、고밀도지단백담고순유관.결론 비반인동조기동맥죽양경화이경계동,예방성인심뇌혈관질병응해종예방인동비반주기.
Objective To study the relationship between insulin resistance and vascular endothelial dysfunction in obese children. Methods A total of 176 obese children, 58 over-weight children and 45 healthy children were recruited. All the participants underwent hematologjc tests. Homeostasis model of assessment of insulin resistance ( HOMA-IR) and insulin sensitivity index were calculated. Ultrasound measurement was used to investigate carotid intima-media thickness ( IMT) and carotid artery compliance (CAC). Results There were significant difference among the three groups in risk factors of atherosclerosis, subclinical inflammation, IMT ( F = 3. 209, P = 0. 046 ), and CAC ( F = 6. 576, P = 0. 002 ) . In sulin sensitvity index was correlated with adiponectin (R = 0. 419, P = 0. 000) , risk factors of atherosclerosis, soluble intercellular adhesion molecule 1 (R= -0. 201 ,P = 0. 010) ,and IMT (R= -0. 201 ,P = 0. 010). The risk factors of atherosclerosis and vascular damage were increased as in sulin sensitvity index decreased. Multiple stepwise regression analysis revealed strong relationship between IMT and abdominal obesity, mean blood pressure, HOMA-IR and high-density lipoprotein cholesterol. Conclusion Early atherosclerosis may develop in obese children. Prevention of childhood obesity should be important in the prevention of adult cardiovascular and cerebrovascular diseases.