肥胖儿童胰岛素抵抗与血管内皮功能损伤关系的研究

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1、理4．论著．肥胖儿童胰岛素抵抗与血管内皮功能损伤关系的研究刘蕴玲刘好田李淑英孙胜英周叶英程慧玲周聊生【摘要】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、IM

2、T(R=一0．201，P=0．010)、可溶性细胞间黏附分子1(R=一0．197，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冈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。【关键词】肥胖；胰岛素；动脉粥样硬化Insulinresistanceandimpairedendothelialfunctioninob

3、esechildrenL／UYun—ling，LIUHao—tian．LIShu—yingsU?、Sheng—yingZHOUYe—yingCHENGHui—ling，ZHOULiao—sheng．DepartmentofHeahhcare，QianfoshanHospital，SharutongUniversity，Jinan250014，ChinaCorrespondingauthor：LIUYun—ling，Email：liuyunling@medmaiLcoMcn【Abstract】ObjectiveTost

4、udytherelationshipbetweeninsulinresistanceandvascularendothelialdysfunetioninobesechildren．MethodsAtotalof176obesechildren．58over—weightchildrenand45healthychildrenwererecruited．Alltheparticipantsunderwenthematologictests．Homeostasismodelofassessnlentofinsulinr

5、esistancefH0MA—IR、andinsulinsensitivityindexwerecalculated．Ultrasoundnleasurenlentwasusedtoinvestigatecarotidintima—mediathicknessfIMT)andcarotidarterycompliance(CAC)．ResultsThereweresignificantdifiereneeamongthethreegroupsinriskfactorsofatheroselerosis，subclin

6、iea1inflammation．TMT(F=3．209，P=0．046)，andCAC(F=6．576，P=0．002)．Insulinsefisitvityndexwascorrelatedwithadiponectin(R=0．419，P=0．000)，riskfactorsofatherosclerosis，solubleintercellularadhesionmolecule1(R=一0．2O1．P=0．010)，andIMT(R：一0．201，P=0．010)．Theriskfaetorsofather

7、oselerosisandvasculardamagewereinereasedasinsulinsensitvityindexdecreased．MultiplestepwiseregressionanalysisrevealedstrongrelationshipbetweenIMTandabdominalobesity．meanbloodpressure．HOMA—IRandhigh—densitylipoproteincholestero1．ConclusionEarlyatheroselerosismayd

8、evelopinobesechildren．Preventionofchildhoodobesityshouldbeimportantinthepreventionofadultcardiovascularandeerebrovasculardiseases．【Keywords】Obesity；Insulin；Atheroselerosis随着