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肥胖中学生体脂分布与胰岛素抵抗的相关性研究
http://www.100md.com 2007年12月1日 于雪梅 冯 萍 金慧英 黄一鑫 赵桃月
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     【摘要】 目的 研究肥胖中学生的体脂分布及其与胰岛素抵抗的相关性,为预防肥胖中学生代谢综合征的发生提供参考。方法 对某中学13~14岁940名中学生的身高、体重进行测量,计算人体质量指数(body mass index,BMI)。选择BMI在同年龄、同性别第95百分位数或以上者47名为肥胖组;对照组为年龄、性别相匹配的同期健康体检青少年,BMI在同年龄、同性别第25~75百分位数以内者,共50名。检查血压、空腹血糖、血脂、空腹胰岛素等指标,计算胰岛素抵抗指数(HOMA-IR),并采用双能X线吸收法检查体脂百分比及分布。结果肥胖组中学生血压、BMI、三酰甘油、空腹胰岛素水平、HOMA-IR、体脂和躯干部体脂百分比均显著高于对照组。多元逐步回归分析显示,躯干部体脂百分比是胰岛素抵抗的独立相关因素。结论 躯干部体脂量能够很好地反映中学生肥胖状况,并与胰岛素抵抗相关。

    【关键词】 肥胖症;体脂分布;胰岛素;统计学,医学;学生

    【中图分类号】 R 179 Q 591.5 R 589.2 【文献标识码】 A 【文章编号】 1000-9817(2007)12-1085-02

    The Relationship Between Body Fat Composition and Insulin Resistance in Obese Middle School Students/YU Xue-mei,FENG Ping,JIN Hui-ying,et al. Department of Endocrinology,Taizhou Central Hospital,Taizhou(318000),Zhejiang Province,China

    【Abstract】 Objective To study the relationship between body fat composition and insulin resistance in obese middle school students,and to provide evidence for middle school students' obesity prevention. Methods Height,body weight were examined in 940 students aged 13-14 year. Forty-seven students were selected as the obese group,whose BMI were≥95th percentile for age-and sex,and 50 health ones were taken as control group,whose BMI were 25th to 75th percentile for age-and sex. Blood pressure,fasting blood glucose and insulin,serum lipid were determined,and HOMA-IR was calculated. Assessment of body composition was measured by dual energy X-ray absorption(DEXA). Results In obese children,the levels of blood pressure,BMI,triglyceride,fasting insulin,HOMA-IR,total fat and trunk fat were all higher than the control. Multivariate regression analysis indicated that trunk fat was an independent determinant for HOMA-IR. Conclusion Trunk fat is a useful index for determination of obese students in middle schools and positively correlated to insulin resistance.

    【Key words】 Obesity;Body fat distribution;Insulin;Statistics,medical;Students

    肥胖是我国面临的一个严重公共健康问题,已经成为现代社会的流行病,其中青少年肥胖或超重尤其令人担忧。研究发现,北京市7~15岁青少年肥胖检出率为10.7%,肥胖人群以每年近1%的速度增加[1]。青少年期超重或肥胖很容易移行到成年[2],从而导致一系列健康问题,其中,中心性肥胖是最重要的危险因素。笔者采用双能X线吸收法对肥胖中学生进行体脂分布检查,并与胰岛素抵抗进行相关性分析,探讨中学生肥胖与胰岛素抵抗的关系。

    1 对象与方法

    1.1 对象 选择某中学初中二年级(13~14岁)全部学生940名(男生453名,女生487名)进行健康体检,检测身高和体重。以人体质量指数(body mass index,BMI)在同年龄、同性别第95百分位数或以上者47名为肥胖组;对照组为年龄、性别相匹配的同期健康体检青少年,BMI在同年龄、同性别第25~75百分位数以内者 ......

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