学龄期肥胖儿童胰岛素抵抗的发生情况及其与自主神经功能的相关性研究

许君

doi:10.16766/j.cnki.issn.1674-4152.002372

学龄期肥胖儿童胰岛素抵抗的发生情况及其与自主神经功能的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.002372

许君

杭州市儿童医院内科，浙江杭州 310000

基金项目:

浙江省医药卫生科技计划项目 2017KY556

详细信息

作者简介:
许君：E-mail：to181604121@126.com

中图分类号: R179 R587
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出版历程
- 收稿日期: 2021-04-12
- 网络出版日期: 2022-08-13

Incidence of insulin resistance in obese school-age children and its correlation with autonomic nerve function

XU Jun

Department of Internal Medicine, Hangzhou Children's Hospital, Hangzhou, Zhejiang 310000, China

摘要

摘要: 目的探讨学龄期肥胖儿童胰岛素抵抗(IR)的发生情况及其与心率减速力(DC)、心率加速力(AC)、心率变异性(HRV)的相关性。方法选取2018年5月—2019年5月杭州市儿童医院收治的122例学龄期肥胖儿童作为研究对象，根据胰岛素抵抗指数(IRI)结果将其分为IR组(69例)和非IR组(53例)。收集2组一般情况，比较2组DC、AC和HRV各指标结果，并采用Pearson相关系数分析IRI指标与DC、AC和HRV各指标结果的相关性。结果 IR组DC、正常RR间期标准差(SDNN)、5分钟均值标准差(SDANN)及高频功率(HF)均低于非IR组(均P < 0.05)，而AC高于非IR组(P < 0.05)。2组IRI与DC、SDNN、SDANN、相邻RR间期差值的均方根(RMSSD)、低频功率(LF)及HF呈负相关关系(r=-0.390、-0.451、-0.290、-0.215、-0.259、-0.324，均P < 0.05)，而与AC呈正相关关系(r=0.584，P < 0.05)；在IR组中，IRI指标与SDNN、RMSSD及LF呈负相关关系(r=-0.517、-0.370、-0.355，均P < 0.05)，而与AC呈正相关关系(r=0.519，P < 0.05)；在非IR组中，IRI指标与RMSSD、HF呈负相关关系(r=-0.343、-0.344，均P < 0.05)。结论 IR学龄期肥胖儿童心脏自主神经功能受损较严重，主要表现为DC及HRV相关指标水平降低，AC水平升高，且患儿IR程度越高，自主神经功能受损越严重。
- 肥胖 /
- 胰岛素抵抗 /
- 心率减速力 /
- 心率加速力 /
- 心率变异性 /
- 学龄期儿童
Abstract: Objective To investigate the incidence of insulin resistance (IR) in obese school-age children and its correlation with heart rate deceleration capacity (DC), heart rate acceleration capacity (AC) and heart rate variability (HRV). Methods A total of 122 obese school-age children were admitted to our hospital between May 2018 and May 2019 as the research objects, and they were divided into the IR group (69 cases) and non-IR group (53 cases) on the basis of the IR index (IRI) calculation results. The general conditions of both groups were recorded. The results of DC, AC and HRV in both groups were compared, and the Pearson correlation coefficient was analysed to determine the correlation between IRI indicators and results of DC, AC and HRV. Results The IR group had lower DC, SDNN, SDANN and HF (P < 0.05) and higher AC than the non-IR group (P < 0.05). The two groups were negatively correlated with DC, SDNN, SDANN, RMSSD, LF and HF (r=-0.390, -0.451, -0.290, -0.215, -0.259, -0.324, all P < 0.05) and positively correlated with AC (r=0.584, P < 0.05). In the IR group, IRI indicators were negatively correlated with SDNN, RMSSD and LF (r=-0.517, -0.370, -0.355, all P < 0.05) and positively correlated with AC (r=0.519, P < 0.05). In the non-IR group, IRI indicators were negatively correlated with RMSSD and HF (r=-0.343, -0.344, all P < 0.05). Conclusion The heart autonomic nerve function of obese school-age children with IR is severely damaged, as evidenced by a decrease in DC-and HRV-related indicators and an increase in AC level. Moreover, the higher the degree of IR in the child, the more severe the damage of autonomic nerve function.
- Obesity /
- Insulin resistance /
- Heart rate deceleration /
- Heart rate acceleration /
- Heart rate variability /
- School-age children

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表 1 2组肥胖儿童一般情况比较

Table 1. Comparison of general situation of obese children in the two groups

组别	例数	性别 (男/女，例)	年龄 (x±s, 岁)	BMI (x±s)	腰围 (x±s, cm)	臀围 (x±s, cm)
IR组	69	32/37	8.17±1.14	29.56±0.50	79.25±7.85	83.17±5.50
非IR组	53	20/33	8.26±1.06	29.55±0.52	79.28±7.81	83.19±5.51
统计量		0.915^a	0.446^b	0.108^b	0.021^b	0.020^b
P值		0.339	0.657	0.914	0.983	0.984
注：^a为χ²值，^b为t值。

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表 2 2组肥胖儿童DC、AC和HRV各指标结果比较(x±s)

Table 2. Comparison of DC, AC and HRV of obese children in the two groups (x±s)

组别	例数	DC(ms)	AC(ms)	SDNN(ms)	SDANN(ms)	RMSSD(ms)	LF(ms²)	HF(ms²)
IR组	69	6.76±1.69	-6.58±1.15	122.28±37.78	107.09±25.43	41.58±16.87	793.80±439.16	479.02±257.74
非IR组	53	7.50±1.66	-8.32±1.61	152.67±49.96	122.03±29.01	43.12±18.64	907.52±410.38	645.50±312.34
t值		4.519	-6.642	3.691	2.973	0.471	1.471	3.144
P值		< 0.001	< 0.001	< 0.001	0.004	0.639	0.144	0.002

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表 3 2组IRI与DC、AC及HRV各指标的相关性分析

Table 3. Correlation analysis between IRI and DC, AC and HRV indexes in the two groups

项目	IR组		非IR组		合计
项目	r值	P值	r值	P值	r值	P值
DC	-0.160	0.188	-0.098	0.486	-0.390	< 0.001
AC	0.519	< 0.001	-0.059	0.677	0.584	< 0.001
SDNN	-0.517	< 0.001	-0.082	0.561	-0.451	< 0.001
SDANN	-0.169	0.166	-0.062	0.661	-0.290	0.001
RMSSD	-0.370	0.002	-0.343	0.012	-0.215	0.017
LF	-0.355	0.003	-0.084	0.551	-0.259	0.004
HF	-0.129	0.290	-0.344	0.012	-0.324	< 0.001

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