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目的研究肥胖儿童血浆载脂蛋白B(Apo B)/载脂蛋白A1(Apo A1)与颈总动脉内膜中层厚度(CCA IMT)的相关性。方法选择在诸暨市人民医院就诊的53例肥胖儿童和59名正常体检儿童,分别检测空腹血糖(FG)、血浆胰岛素(FI)、总胆固醇(TC)和三酰甘油(TG)等生化指标水平;同时采用高分辨B超监测仪测量肥胖儿童CCA IMT。比较两组儿童各项检测指标水平差异,采用多元回归模型分析肥胖组儿童CCA IMT与各项生化检测指标的相关性。结果肥胖组儿童谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿酸(UA)、TG、TC、低密度脂蛋白胆固醇(LDL-C)、Apo B和Apo B/Apo A1水平以及胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)均高于对照组(P<0.05);高密度脂蛋白胆固醇(HDL-C)和Apo A1水平均低于对照组(P<0.01);直线相关性分析显示,CCA IMT与Apo A1水平呈负相关,与Apo B/Apo A1、ALT和AST水平呈正相关(P<0.05);多元逐步回归分析结果显示,肥胖儿童Apo B/Apo A1与CCA IMT呈正相关(P<0.05)。结论 Apo B/Apo A1是肥胖儿童CCA IMT的独立影响因素,可能是早期动脉粥样硬化的危险因素。
Objective To investigate the correlation between plasma apolipoprotein B (Apo B) and apolipoprotein A1 (Apo A1) and carotid artery intima-media thickness (CCA IMT) in obese children. Methods Fifty-three obese children and 59 normal children were enrolled in Zhuji People’s Hospital. The levels of fasting blood glucose (FB), plasma insulin (FI), total cholesterol (TC) and triglyceride (TG) At the same time, high-resolution B-monitor was used to measure CCA IMT in obese children. The differences between the two groups were compared, and the correlation between CCA IMT and various biochemical parameters in obese children was analyzed by multivariate regression model. Results The levels of ALT, AST, UA, TG, TC, LDL-C, Apo B and Apo B / Apo A1 in obese children and the levels of pancreatic β-cells The levels of HOMA-β and HOMA-IR were higher than those of the control group (P <0.05). The levels of HDL-C and Apo A1 were lower than those of the control group (P <0.01) ). The linear correlation analysis showed that CCA IMT was negatively correlated with Apo A1 level and positively correlated with Apo B / Apo A1, ALT and AST (P <0.05). Multiple stepwise regression analysis showed that obese children Apo B / Apo A1 was positively correlated with CCA IMT (P <0.05). Conclusion Apo B / Apo A1 is an independent risk factor for CCA IMT in obese children and may be a risk factor for early atherosclerosis.