肥胖儿童代谢紊乱以及饮食运动行为危险因素分析

Analysis of Metabolic Disorders and Risk Factors of Diet and Exercise Behavior in Obese Children

摘要: 目的：分析肥胖儿童发生代谢异常状况，以及饮食行为和运动行为的危险因素，为儿童肥胖防治重点提供依据。方法：70例单纯性肥胖儿童体格测量，检测血糖、血脂、血尿酸和胰岛素。以1:1病例健康对照配对，问卷调查肥胖儿童的饮食行为和运动行为。结果：肥胖组BMI、腰臀比和血压均高于对照组，差异有显著性意义(P < 0.01)。肥胖代谢异常组腰围和收缩压高于肥胖代谢正常组，差异有显著性意义(P < 0.05)。本组70例肥胖儿童中，伴有一种及以上代谢异常的总人数46例，检出率为65.71%；各项代谢指标异常检出率：高血压18.57% (13/70)、高血糖21.43% (15/70)，高甘油三酯高21.43% (15/70)，高低密度脂蛋白胆固醇10.00% (7/70)，高尿酸24.29% (17/70)，高胰岛素20.00% (14/70)。条件多因素Logistic回归模型分析显示，喜吃零食、肉食为主和进食速度快是肥胖发生的危险因素。室内静坐时间长是肥胖的危险因素，户外活动时间长和运动量大是保护因素。结论：儿童期肥胖的代谢异常发生率较高，是心血管疾病、糖尿病发病高危因素。早期发现、及时纠正极为重要。改变喜吃零食、高脂食物等不良饮食习惯和静坐少动的生活方式是控制肥胖，预防相关代谢性疾病的基石。

Abstract: Objective: To study the metabolic abnormalities and the risk factors of dietary behavior and exer-cise behavior in obese children, so as to provide basis for the prevention and treatment of obesity in children. Methods: The Anthropometry and the blood glucose, blood lipid, blood uric acid and insu-lin were measured; Abnormal blood glucose, abnormal blood lipid, abnormal blood pressure, hy-perinsulinemia and abnormal blood uric acid were defined according to the diagnostic boundary value. 1:1 case-control matched questionnaire was used to investigate the dietary behavior and ex-ercise behavior of obese children. Results: BMI, waist hip ratio and blood pressure in obese group were significantly higher than those in control group (P < 0.01). Waist circumference and systolic blood pressure in obese metabolic abnormal group were significantly higher than those in obese metabolic normal group (P < 0.05). Among the 70 obese children, 46 cases were accompanied by one or more metabolic abnormalities (65.71%), hypertension 18.57% (13/70), hyperglycemia 21.43% (15/70), high triglyceride 21.43% (15/70), high LDL-c 10.00% (7/70), high uric acid 24.29% (17/70), high insulin 20.00% (14/70). Conditional multivariate logistic regression analysis showed that liking snacks, meat and fast eating speed were the risk factors of obesity. Long indoor sitting time is a risk factor for obesity, while long outdoor activities and large amount of exercise are pro-tective factors. Conclusion: The incidence of metabolic abnormalities in childhood obesity is high, and it is a high risk factor for cardiovascular disease and diabetes. Early detection and timely cor-rection are extremely important. Changing bad eating habits such as snacks and high fat and sed-entary lifestyle is the cornerstone of controlling obesity and preventing related metabolic diseases.