ULTRASONOGRAPHIC MARKERS OF CARDIOVASCULAR DISEASE RISK IN OBESE CHILDREN

ASTRACT Objective: To evaluate whether the obesity alters ultrasonographical markers of metabolic and cardiovascular disease risk in children. Methods: A cross-sectional study evaluated 80 children aged between 6 and 10 years, comparing 40 obese with 40 normal children. The following parameters were assessed: weight; height; body mass index; arterial blood pressure; body fat; basal metabolic rate; HDL-cholesterol, LDL-cholesterol and total cholesterol; fasting insulin and glucose; quantitative insulin sensitivity check index (QUICKI); homeostasis model of assessment - insulin resistance (HOMA-IR); basal diameter of the brachial artery; brachial artery flow mediated dilation (FMD) and of pulsatility index change (PI-C). Results: Significant differences were observed between obese vs. non-obese children: systolic blood pressure (97.7±8.4 vs. 89.0±5.8 mmHg; p<0.01), diastolic blood pressure (64.3±7.9 vs. 52.9±5.1 mmHg; p<0.01), proportion of body fat (45.1±5.9 vs. 21.3±6.0%; p<0.01), basal metabolic rate (1216.1±102.1 vs. 1072.9±66.4 Kcal; p<0.01), total cholesterol (164.7±25.2 vs. 153.4±15.8 mg/dL; p=0.03), fasting insulin (7.1±5.2 vs. 2.8±1.8 pIU/mL; p<0.01), HOMA-IR (1.5±1.1 vs. 0.6±0.4; p<0.01), basal diameter of the brachial artery (2.5±0.3 vs. 2.1±0.3 mm; p<0.01); PI-C (-15.5±27.2 vs. -31.9±15.5%; p<0.01), decreased QUICKI (0.4±0.05 vs. 0.4±0.03; p<0.01), and FMD (6.6±3.2 vs. 15.6±7.3%; p<0.01). Conclusions: Obesity worsens ultrasonographical and laboratorial markers of metabolic and cardiovascular disease risk in children.

摘要
研究目的：评估肥胖是否会改变儿童代谢与心血管疾病风险的超声学标志物（ultrasonographical markers）。
研究方法：本横断面研究纳入80名6~10岁儿童，将40名肥胖儿童与40名正常体重儿童进行对比评估。评估指标包括：体重、身高、体质量指数、动脉血压、体脂率、基础代谢率、高密度脂蛋白胆固醇（HDL-cholesterol）、低密度脂蛋白胆固醇（LDL-cholesterol）、总胆固醇、空腹胰岛素与空腹血糖、定量胰岛素敏感性检测指数（QUICKI）、胰岛素抵抗稳态模型评估（HOMA-IR）、肱动脉基础内径、肱动脉血流介导舒张功能（FMD）及搏动指数变化值（PI-C）。
研究结果：肥胖组与正常体重组儿童多项指标存在显著差异：收缩压（97.7±8.4 vs 89.0±5.8 mmHg；p<0.01）、舒张压（64.3±7.9 vs 52.9±5.1 mmHg；p<0.01）、体脂百分比（45.1±5.9 vs 21.3±6.0%；p<0.01）、基础代谢率（1216.1±102.1 vs 1072.9±66.4 kcal；p<0.01）、总胆固醇（164.7±25.2 vs 153.4±15.8 mg/dL；p=0.03）、空腹胰岛素（7.1±5.2 vs 2.8±1.8 pIU/mL；p<0.01）、胰岛素抵抗稳态模型评估值（1.5±1.1 vs 0.6±0.4；p<0.01）、肱动脉基础内径（2.5±0.3 vs 2.1±0.3 mm；p<0.01）、搏动指数变化值（-15.5±27.2 vs -31.9±15.5%；p<0.01）；同时定量胰岛素敏感性检测指数（0.4±0.05 vs 0.4±0.03；p<0.01）与肱动脉血流介导舒张功能（6.6±3.2 vs 15.6±7.3%；p<0.01）显著降低。
研究结论：儿童肥胖会加重其代谢与心血管疾病风险相关的超声学及实验室标志物异常。