以罗斯托夫地区儿童为例,肥胖症中心脏代谢紊乱的特征

O. Bocharova, E. Teplyakova, T. Shkurat, G. V. Karantysh, Alaa Hashim Abd Ali
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摘要

目的:研究肥胖儿童和青少年胰岛素抵抗、内皮功能障碍和左心室最小舒张功能障碍的血脂特征。材料与方法:研究纳入体重指数BMI > 30的7 ~ 17岁肥胖儿童青少年370例(主要组),对照组123例同龄非肥胖儿童。方法:临床、临床旁(血液生化检查、血压测量、内皮功能障碍的功能诊断、最小舒张功能障碍评估)。结果:儿童和青少年肥胖的心脏代谢紊乱首先伴随着高甘油三酯血症,这进一步破坏了脂质谱。在肥胖和内皮功能障碍的儿童和青少年中,以及在HOMA IR 3.2和内皮功能障碍和轻度功能障碍合并的患者中,胰岛素和甘油三酯水平的变化也存在正相关。结论:基于对肥胖儿童和青少年脂质谱紊乱的性质以及内皮功能障碍和/或轻微左心室功能障碍迹象的研究,得出结论:该年龄段的肥胖更常伴有轻微左心室舒张功能障碍或内皮功能障碍和左心室功能障碍的合并。胰岛素抵抗的发展导致合并病理(ED和MDLj)的增加。高甘油三酯血症与高胰岛素水平相关,可能决定了胰岛素抵抗的发展,在儿童和青少年肥胖的心脏代谢障碍的发展中起着重要作用。
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Features of cardiometabolic disorders in obesity on the example of the children’s population of the Rostov region
Objective: to study the features of the blood lipid profile in obese children and adolescents, depending on the presence of insulin resistance, endothelial dysfunction and minimal diastolic dysfunction of the left ventricle. Materials and methods: the study involved 370 obese children and adolescents from 7 to 17 years of age (the main group) with a body mass index BMI > 30, the control group consisted of 123 children of the same age without obesity. Methods: clinical, paraclinical (biochemical blood test, blood pressure measurement, functional diagnosis of endothelial dysfunction, assessment of minimal diastolic dysfunction). Results: cardiometabolic disorders in obesity in childhood and adolescence are accompanied, first of all, by hypertriglyceridemia, which entails further violations of the lipid profile. There was also a positive correlation between changes in insulin and triglyceride levels in children and adolescents with obesity and endothelial dysfunction, as well as in patients with HOMA IR 3.2 and a combination of endothelial dysfunction and minimal dysfunction. Conclusions: based on the study of the nature of lipid spectrum disorders in obese children and adolescents and the presence of signs of endothelial dysfunction and/or minimal left ventricular dysfunction, it was concluded that obesity at this age is more often accompanied by minimal left ventricular diastolic dysfunction or a combination of endothelial dysfunction and left ventricular dysfunction. The development of insulin resistance leads to an increase in the combined pathology (ED and MDLj). Hypertriglyceridemia, which is associated with high levels of insulin and presumably determines the development of insulin resistance, plays an important role in the development of cardiometabolic disorders in obesity in childhood and adolescence.
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