目的 探讨维吾尔族超重/肥胖儿童青少年的血尿酸(SUA)水平与代谢综合征(MS)之间的关系。方法 研究对象为维吾尔族儿童青少年超重/肥胖患者(n=173)和体重正常者(n=200)。测量其身高、体重、腰围及总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、空腹血糖及 SUA。结果 超重组和肥胖组的 SUA 水平分别为 235±42、285±42 μmol/L,均明显高于对照组(199±32 μmol/L),差异有统计学意义(P<0.01)。SUA 300~349 μmol/L 组和≥ 350 μmol/L 组超重/肥胖、MS、高血压、血脂异常的检出率均高于 SUA <250 μmol/L 组和 250~299 μmol/L 组(P<0.01)。不同 MS 组分的人群之间 SUA 水平差异有统计学意义,MS 组份增多,SUA 水平增高(P<0.01)。多元回归分析显示:体重指数增加 1 kg/m2,SUA 水平增加 5.74 μmol/L。结论 维吾尔族超重/肥胖儿童青少年的 SUA 水平明显升高;SUA水平升高,MS 及其组分发生率增加;SUA 与体重指数呈正相关。
Abstract
Objective To study the relationship between serum uric acid(SUA) level and metabolic syndrome(MS) in Uygur children and adolescents with overweight or obesity.Methods A total of 173 Uygur children or adolescents who were either overweight or obese and 200 controls with normal body weight were included in the study. Body weight, height, waist circumference, fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, lowdensity lipoprotein cholesterol, triglycerides, and SUA were measured. Results The overweight and obesity groups had significantly higher SUA levels(235±42 and 285±42 μmol/L respectively) than the control group(199±32 μmol/L; P<0.01). The subjects with SUA levels of 300-349 μmol/L and ≥350 μmol/L had significantly higher incidence of MS, overweight/obesity, hypertension and dyslipidemia than those with SUA levels of <250 μmol/L and 250-299 μmol/L(P<0.01). There were significant differences in SUA levels between groups with different MS components. SUA level was significantly increased in groups with more MS components(P<0.01). Every 1 kg/m2 increment in body mass index(BMI) was associated with 5.74 μmol/L increase in SUA level, according to a multivariate regression analysis.Conclusion Uygur children and adolescents who are either overweight or obese have higher SUA levels than those with normal body weight. The incidence of MS and its components rises with increasing SUA level. BMI has a positive relationship with SUA.
关键词
肥胖 /
血尿酸 /
代谢综合征 /
青少年 /
儿童
Key words
Obesity /
Serum uric acid /
Metabolic syndrome /
Adolescent /
Child
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参考文献
[1] Schwandt P, Bertsch T, Liepold E, et al.Age- and Gender-Specific Components of the Metabolic Syndrome in 2228 First Graders: The PEP Family Heart Study[J].Scientifica(Cairo),2013, 2013: 394807.
[2] Qin L, Yang Z, Gu H, et al.Association between serum uric acid levels and cardiovascular disease in middle-aged and elderly Chinese individuals[J].BMC Cardiovasc Disord, 2014, 14(1):26.
[3] 中国肥胖问题工作组.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准 [J].中华流行病学杂志, 2004, 25(2): 97-102.
[4] 中华医学会儿科学分会内分泌遗传代谢学组, 中华医学会儿科学分会心血管学组, 中华医学会儿科学分会儿童保健学组, 等.中国儿童青少年代谢综合征定义和防治建议 [J].中华儿科杂志, 2012, 50(6): 420-422.
[5] 中国医师协会心血管内科医师分会.无症状高尿酸血症合并心血管疾病诊治建议中国专家共识 [J].中国临床医生,2011,39(2): 73-77.
[6] 陈联辉, 朱伟芬, 梁黎, 等.非高密度脂蛋白胆固醇对肥胖儿童非脂性心血管疾病危险因素的预测作用 [J].中国当代儿科杂志, 2013, 15(5): 356-360.
[7] Kim SJ, Lee J, Nam CM, et al.Impact of obesity on metabolic syndrome among adolescents as compared with adults in Korea[J].Yonsei Med J, 2011, 52(5): 746-752.
[8] 儿童代谢综合征中国工作组.中国六城市学龄儿童代谢综合征流行现状研究 [J].中华儿科杂志, 2013, 51(6): 409-413.
[9] 尹雪瑶.尿酸与腹型肥胖及代谢综合征相关性研究 [J].中华内科杂志, 2014, 53(1): 13-18.
[10] Weiss R, Bremer AA, Lustig RH.What is metabolic syndrome,and why are children getting it? [J].Ann N Y Acad Sci, 2013,1281: 123-140.
[11] Fitzpatrick SL, Lai BS, Brancati FL, et al.Metabolic syndrome risk profiles among African American adolescents: national health and nutrition examination survey, 2003-2010[J].Diabetes Care, 2013, 36(2): 436-442.
[12] Civantos MS, Guijarro DAM, Monereo MS, et al.Hyperuricemia and metabolic syndrome in children with overweight and obesity[J].Endocrinol Nutr, 2012, 59(9): 533-538.
[13] Sinaiko AR, Caprio S.Insulin resistance[J].J Pediatr, 2012,161(1): 11-15.
[14] Johnson RJ, Nakagawa T, Sanchez-Lozada LG, et al.Sugar, uric acid, and the etiology of diabetes and obesity[J].Diabetes, 2013,62(10): 3307-3315.
[15] Johnson RJ, Sanchez-Lozada LG, Nakagawa T.The effect of fructose on renal biology and disease[J].J Am Soc Nephrol,2010, 21(12): 2036-2039.
基金
新疆自治区自然科学基金项目(2012211A067)。