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目的探讨单纯性肥胖儿童尿酸(UA)水平与糖尿病及心血管疾病危险因素之间的关系,为在相关人群中开展健康教育提供参考。方法选择2014年7—8月参加上海市某体重管理中心组织的暑期减肥夏令营全国范围的79例肥胖儿童青少年为研究对象。按照尿酸水平将其分为正常组(35名)和高尿酸组(44名),分别检测2组儿童的身高、体重、体质量指数(BMI)、体脂率、脂肪体重(FM)、去脂体重(FFM)、腰围、臀围、腰臀比(WHR)、腰围身高比(WHtR)、收缩压、舒张压、空腹血糖(FBG)、空腹胰岛素(FINS)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及UA,计算胰岛素分泌功能指数(HOMA-β)、稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(IAI)及空腹胰岛素/空腹血糖比值,并对UA与各指标进行相关性分析。结果高尿酸组体脂率,腰围,WHR,WHtR,FINS,HOMA-β,HOMA-IR,IAI,FNIS/FBG,LDL-C,HDL-C,TG,收缩压和舒张压与正常组差异均无统计学意义(P值均>0.05)。高尿酸组体重,BMI,FM,FFM,臀围,FBG和TC均高于正常组,差异均有统计学意义(P值均<0.05)。UA水平与体重,BMI,FM,FFM,臀围,TC,TG,LDL-C,收缩压均呈正相关(P值均<0.05)。多元向后回归分析显示,腰围,WHtR,FBG,HOMA-β,TC及收缩压对尿酸水平有影响(P值均<0.05)。结论肥胖儿童高尿酸血症与糖尿病及心血管疾病危险因子密切相关;肥胖儿童应定期监测血尿酸水平。
Objective To investigate the relationship between the level of uric acid (UA) and the risk factors of diabetes mellitus and cardiovascular diseases in simple obesity children, and provide a reference for developing health education in related population. METHODS: A total of 79 obese children and adolescents nationwide who participated in the Summer Weight Loss Summer Camp organized by a weight management center in Shanghai from July to August 2014 were selected as the research subjects. According to the level of uric acid, they were divided into normal group (35 cases) and high uric acid group (44 cases). The height, weight, body mass index (BMI), body fat percentage and body fat mass Body mass index (FFM), waist circumference, hip circumference, WHR, WHt, SBP, DBP, FINS, TG, (HOMA-β), homeostasis model insulin resistance index (HOMA-β), insulin sensitivity index (HOMA-β) IR), insulin sensitivity index (IAI) and fasting insulin / fasting blood glucose (FBG), and the correlation between UA and each index was analyzed. Results The percentages of body fat, waist circumference, WHR, WHtR, FINS, HOMA-β, HOMA-IR, IAI, FNIS / FBG, LDL-C, HDL- No statistical significance (P> 0.05). Body weight, BMI, FM, FFM, hip circumference, FBG and TC in hyperuricemia group were significantly higher than those in normal group (all P <0.05). There was a positive correlation between UA level and body weight, BMI, FM, FFM, hip circumference, TC, TG, LDL-C and systolic blood pressure (all P <0.05). Multivariate backward regression analysis showed that waist circumference, WHtR, FBG, HOMA-β, TC and systolic blood pressure affected uric acid levels (all P <0.05). Conclusion The hyperuricemia in obese children is closely related to the risk factors of diabetes mellitus and cardiovascular disease. Obese children should be monitored regularly for serum uric acid.