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【目的】研究肥胖儿童血脂水平的影响因素,为高危儿童早期干预提供临床依据。【方法】本实验为病例对照研究,对两组分别进行体格测量、家族相关病史、饮食及生活方式情况问询,并抽取空腹静脉血作甘油三酯(triglyc-eride,TG)、胆固醇(total cholesterol,TC)、高密度脂蛋白(high-density lipoprotein,HDL)、低密度脂蛋白(low-density lipo-protein,LDL)、载脂蛋白A(apolipoprotein A,apoA)、载脂蛋白B(apolipoprotein B,apoB)检测,另外对两组儿童进行载脂蛋白E(apolipoprotein E,apoE)基因多态性等位基因测定,从环境和基因两方面分析影响肥胖儿童血脂的因素。【结果】与对照组比较,肥胖儿童有较高的血脂异常率;父母高血脂、心血管家族史、高脂肪饮食和运动等对血脂异常的影响差异有统计学意义(P<0.05);不同等位基因对血脂的影响不同,apoE3型等位基因有较高的TG、TC、LDL水平和较低HDL、apoA水平,apoE4型有较高的血TG、apoB水平和较低的HDL、apoA水平(P<0.05)。肥胖儿童组内比较,以apoE3为参照,apoE2等位基因呈现出较低水平的TC、LDL和apoB(P>0.05),而apoE4则具有较高的TG、apoB水平和较低的HDL水平(P<0.01);【结论】父母高脂血症、心血管家族史、父母肥胖史、高脂肪饮食、运动及aopE基因多态性是肥胖儿童血脂异常的影响因素,其中apoE4等位基因是血脂异常的风险基因之一,与肥胖儿童的血脂异常存在显著相关性。
【Objective】 To study the influencing factors of blood lipid levels in obese children and provide a clinical basis for the early intervention of high-risk children. 【Methods】 This study was a case-control study. The physical measurement, family history, diet and lifestyle were inquired into the two groups. Fasting venous blood was collected for triglyceride (TG), total cholesterol cholesterol, TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein A (apoA), apolipoprotein B and apoB). In addition, the alleles of apolipoprotein E (apoE) gene polymorphism were measured in two groups of children, and the factors influencing the blood lipids in obese children were analyzed from the aspects of environment and gene. 【Results】 Compared with the control group, obese children had higher rates of dyslipidemia; the effects of hyperlipidemia, family history of cardiovascular disease, high fat diet and exercise on dyslipidemia were statistically significant (P <0.05); different Alleles have different effects on blood lipids. The apoE3 allele has higher levels of TG, TC, LDL and lower HDL, apoA, apoE4 has higher blood TG, apoB levels and lower HDL, apoA Level (P <0.05). Compared with obese children, the apoE3 allele showed lower levels of TC, LDL and apoB (P> 0.05), while apoE4 had higher levels of TG, apoB and lower HDL P <0.01). 【Conclusion】 Parents with hyperlipidemia, family history of cardiovascular disease, history of obesity, high fat diet, exercise and aopE gene polymorphism are the influencing factors of dyslipidemia in obese children. The apoE4 allele is a lipid One of the abnormal risk genes is significantly associated with dyslipidemia in obese children.