Prevalence of Dyslipidemia and Associated Factors in Obese Children and Adolescents.
Prevalence of Dyslipidemia and Associated Factors in Obese Children and Adolescents.
复制标题
DOI：
10.4274/jcrpe.1867
复制
发表时间：
2015-09
影响因子：
1.9
通讯作者：
Demirel F
中科院分区：
文献类型：
--
作者：
Elmaoğulları S;Tepe D;Uçaktürk SA;Karaca Kara F;Demirel F
儿童期肥胖与成年期心血管疾病（CVD）相关的死亡率和发病率增加有关。血脂异常在心血管疾病的发病机制中起着重要作用。本研究旨在探讨肥胖儿童青少年血脂异常的发生率及其相关因素。年龄在2至18岁之间的肥胖患者被纳入研究。回顾性评价血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、空腹血糖水平、胰岛素、促甲状腺激素（TSH）、游离甲状腺素（fT 4）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）和肝脏超声检查结果。在823例肥胖患者中，353例（42.9%）符合血脂异常标准：21.7%有高胆固醇血症，19.7%有低水平HDL-C，18.6%有高胆固醇血症，13.7%有高水平LDL-C。年龄较大和/或高体重指数（BMI）与血脂异常患病率增加有关。脂肪肝在血脂异常患者中更常见。高脂血症患者还可出现胰岛素抵抗（IR）、ALT和TSH升高。血脂异常和2-3级脂肪肝患者ALT、AST和TSH水平较高，fT 4水平较低。肥胖儿童中血脂异常的患病率很高，高血脂症是最有可能发生的。在血脂异常和脂肪肝共存的背景下，观察到更高水平的IR和更明显的肝功能检查结果异常。与甲状腺功能相关的代谢和激素改变也可能与肥胖患者的血脂异常和脂肪肝有关。
Childhood-onset obesity is associated with increased mortality and morbidity related to cardiovascular diseases (CVD) during adulthood. Dyslipidemia has a fundamental role in the pathogenesis of CVD. This study aimed to evaluate the prevalence of dyslipidemia and related factors among obese children and adolescents. Obese patients aged between 2 and 18 years were included in the study. Serum concentrations of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), fasting glucose levels, insulin, thyroid-stimulating hormone (TSH), free thyroxine (fT4), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver ultrasound findings were evaluated retrospectively. Among 823 obese patients, 353 (42.9%) met the dyslipidemia criteria: 21.7% had hypertriglyceridemia, 19.7% had low levels of HDL-C, 18.6% had hypercholesterolemia, and 13.7% had high levels of LDL-C. Older age and/or high body mass index (BMI) were related to increased prevalence of dyslipidemia. Hepatosteatosis was more common among dyslipidemic patients. The frequency of insulin resistance (IR) and of higher levels of ALT and TSH were also detected in dyslipidemic patients. Patients with both dyslipidemia and grade 2-3 hepatosteatosis had higher levels of ALT, AST and TSH and lower levels of fT4. Prevalence of dyslipidemia is high in obese children, and hypertriglyceridemia is in the foreground. Higher levels of IR and more apparent abnormal liver function test results are observed in the context of dyslipidemia and hepatosteatosis coexistence. Metabolic and hormonal alterations related with thyroid functions may also be associated with dyslipidemia and hepatosteatosis in obese patients.