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中华肥胖与代谢病电子杂志 ›› 2022, Vol. 08 ›› Issue (03) : 164 -168. doi: 10.3877/cma.j.issn.2095-9605.2022.03.004

论著

肥胖儿童阻塞性睡眠呼吸暂停低通气综合征对生长发育和代谢指标的影响
骆辉珍1,(), 叶伟雄2, 蔡绪伟1, 杜宝文1   
  1. 1. 516000 惠州,惠州市中心人民医院耳鼻咽喉头颈外科
    2. 510403 广州,中国南方航空航空卫生中心
  • 收稿日期:2021-12-15 出版日期:2022-08-30
  • 通信作者: 骆辉珍

The effect of obese children with obstructive sleep apnea-hypopnea syndrome on growth and development and metabolic indexes

Huizhen Luo1,(), Weixiong Ye2, Xuwei Cai1, Baowen Du1   

  1. 1. Department of Otorhinolaryngology, Head and Neck Surgery, Huizhou Central People's Hospital, Huizhou 516000, Guangdong
    2. China Southern Airlines Aviation Health Center Guangzhou, Guangzhou 510403, China
  • Received:2021-12-15 Published:2022-08-30
  • Corresponding author: Huizhen Luo
引用本文:

骆辉珍, 叶伟雄, 蔡绪伟, 杜宝文. 肥胖儿童阻塞性睡眠呼吸暂停低通气综合征对生长发育和代谢指标的影响[J/OL]. 中华肥胖与代谢病电子杂志, 2022, 08(03): 164-168.

Huizhen Luo, Weixiong Ye, Xuwei Cai, Baowen Du. The effect of obese children with obstructive sleep apnea-hypopnea syndrome on growth and development and metabolic indexes[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(03): 164-168.

目的

探讨肥胖儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对生长发育和代谢指标的影响。

方法

回顾性分析2016年6月至2021年9月于惠州市中心人民医院诊断为OSAHS的肥胖儿童共93例,并根据OSAHS严重程度分级标准分为轻度组(n=29),中度组(n=33),重度组(n=31),另外选择未合并OSAHS的肥胖儿童作为对照组(n=30)。对比各组儿童的体重、身高、血脂、血糖相关代谢指标的水平,并分析呼吸暂停低通气指数(AHI)、最低血吸氧饱和度(LSaO2)、LSaO2持续时间占监测睡眠时间百分比(DLSaO2%)和≥4%氧减指数(≥4% ODI)与生长发育、糖脂代谢指标的相关性。

结果

OSAHS轻度组、中度组和重度组的体质量均显著低于对照组,且重度组显著低于轻度组和重度组(P<0.05);而OSAHS中度组和重度组的身高显著低于轻度组和对照组,BMI显著高于轻度组和对照组,差异具有统计学意义(P<0.05)。OSAHS重度组和中度组儿童的空腹血糖(FBG)、血清胆固醇(TC)、甘油三酯(TG)、和低密度脂蛋白胆固醇(LDL-C)水平显著高于轻度组和对照组,高密度脂蛋白胆固醇(HDL-C)水平显著低于轻度组和对照组,差异具有统计学意义(P<0.05)。LSaO2水平与身高、体质量、HDL-C呈显著的正相关,而与FBG、TC、TG、LDL-C水平呈显著的负相关(P<0.05)。

结论

肥胖儿童合并OSAHS可影响其生长发育和糖脂代谢,且肥胖儿童OSAHS严重程度与生长发育差及糖脂代谢异常程度相关。

Objective

To explore the effects of obstructive sleep apnea-hypopnea syndrome (OSAHS) on growth and metabolism in obese children.

Methods

A total of 93 obese children diagnosed with obstructive sleep apnea-hypopnea syndrome in Huizhou Central People's Hospital from June 2016 to September 2021 were retrospectively analyzed, and they were divided into mild group (n=29), moderate group (n=33) and severe group (n=31) according to the grading standard of OSAHS severity. In addition, obese children without OSAHS were selected as the control group (n=30). The levels of weight, height, blood lipid and blood glucose related metabolic indexes of children in each group were compared, and the correlation between apnea-hypopnea index (AHI), the lowest blood oxygen saturation (LSaO2), the percentage of LSaO2 duration in the monitored sleep time (DLSaO2%) and ≥4% oxygen reduction index (≥4% ODI) and growth and development, glucose and lipid metabolism indexes were analyzed.

Results

The body weight of mild, moderate and severe OSAHS groups was significantly lower than that of the control group, and that of severe OSAHS group was significantly lower than that of mild and severe groups (P<0.05). However, the height of moderate and severe OSAHS group was significantly lower than that of mild group and control group, and BMI was significantly higher than that of mild group and control group (P<0.05). The levels of fasting blood glucose (FBG), serum cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in children with severe and moderate OSAHS were significantly higher than those in mild and control groups, while the level of high-density lipoprotein cholesterol (HDL-C) was significantly lower than those in mild and control groups, with statistical significance (P<0.05). LSaO2 level was positively correlated with height, weight and HDL-C, but negatively correlated with FBG, TC, TG and LDL-C (P<0.05).

Conclusions

Obese children with OSAHS can affect their growth and development and glucose and lipid metabolism, and the severity of OSAHS in obese children is related to poor growth and development and abnormal glucose and lipid metabolism.

表1 肥胖儿童资料及OSAHS分组依据
表2 不同分组肥胖儿童的生长发育情况比较
表3 不同分组肥胖儿童的OSAHS呼吸指标比较
表4 不同分组肥胖儿童的代谢指标比较
表5 肥胖儿童OSAHS呼吸指标与生长发育、代谢指标的相关性分析(rPn=300)
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