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目的探讨肥胖儿童发生早期心血管病变的可能机制及高危因素。方法筛选100例肥胖儿童作为研究对象,并根据BMI(体重指数)将其分为轻度肥胖组、中重度肥胖组。选择同期体检合格的健康儿童60例进行对照。观察肥胖儿童的人体形态学参数指标(血压、身高、BMI、腰围),糖脂类代谢指标(血糖、血脂),血管内皮生长因子(VEGF)、血小板衍生因子(PDGF-BB)及其受体(PDGFR-2α)的表达水平,动脉内膜中层厚度(IMT)。经Logistic回归法分析肥胖儿童发生早期心血管病变的高危因素。结果中重度肥胖组儿童的年龄、颈内动脉IMT均值较轻度肥胖组更高(P<0.05)。经方差分析发现,观察组与对照组在血压、BMI、腰围、FPG、TC、TG、VEGF、PDGF-BB、PDGFR-2α表达水平等方面的差异均有统计学意义(P<0.05)。经Logistic回归分析发现,血压、BMI、腰围、FPG、TG、VEGF、PDGF-BB及PDGFR-2α均与肥胖儿童的IMT有相关性(P<0.05),为其发生早期血管病变的危险因素。结论中重度肥胖儿童更易发生高血压、血脂和血糖代谢异常、VEGF、PDGF-BB及PDGFR-2α等异常表达,是发生早期血管病变的危险因素。
Objective To explore the possible mechanism and risk factors of early cardiovascular disease in obese children. Methods 100 obese children were screened as subjects and divided into mild obesity group and moderate to severe obesity group according to body mass index (BMI). Select the same period the health check-up of 60 healthy children for comparison. Obesity children’s morphological parameters (blood pressure, height, BMI, waist circumference), indicators of glucose and lipid metabolism (blood glucose, blood lipid), vascular endothelial growth factor (VEGF), platelet derived factor (PDGF-BB) (PDGFR-2α) expression, intima-media thickness (IMT). Logistic regression analysis of risk factors for early cardiovascular disease in obese children. Results The mean age of IMT and the mean IMT of carotid artery in moderate-severe obesity group were higher than those in mild obesity group (P <0.05). Analysis of variance showed that the differences of blood pressure, BMI, waist circumference, FPG, TC, TG, VEGF, PDGF-BB and PDGFR-2α between the observation group and the control group were statistically significant (P <0.05). Logistic regression analysis showed that blood pressure, BMI, waist circumference, FPG, TG, VEGF, PDGF-BB and PDGFR-2α were all associated with IMT in obese children (P <0.05), which were risk factors for early vascular disease. Conclusions Hypertension, dyslipidemia and hyperglycemia, dysregulation of VEGF, PDGF-BB and PDGFR-2α are more likely to occur in children with moderate-severe obesity, which are risk factors for early vascular disease.