Abstract: Objective To explore the clinical features of glucose and lipid metabolism in obese children and analyse the effects of dietary fiber and exercise intervention. Methods 110 obese children visiting our hospital from June 2013 to November 2014 were enrolled as obesity and 90 lean children were selected as normal control.Height,weight,waist circumference and hip circumference of all chilgren were measured,and the BMI was calculated.Differences in anthropometric data were compared between the two groups.At the same time,the obese children were randomly classified into two groups:clinical trial group (55 children) and control group (55 children).The clinical trial group were given dietary fiber food and exercise intervention for five weeks,while the control group were just given general direction.The biochemical paramaters including glucose metabolism,lipid metabolism,protein metabolism and the blood pressure in all the children were measured. Results The waist circumference,hip circumference,weight and BMI in the obese group were significantly higher compared to the normal lean group (P＜0.05).After intervention,the weight,BMI,waist circumference,plasma glucose,postprandial glucose,total cholesterol,triglyceride,high density lipoprotein and blood pressure in the clinical trial group were declined compared to the control group.Whereas there was no differences in low density lipoprotein cholesterol between between the two groups(P＞0.05). Conclusions Obese children have disturbances in clinical characteristics.Dietary fiber toghther with exercise intervention may be benefit for improving the disorders in glucose and lipid metabolism and blood pressure.

Key words: obesity, metabolic syndrome, dietary fiber, exercise, intervention, children

摘要： 目的 分析肥胖儿童糖脂代谢的临床特征并分析膳食纤维联合运动干预对患儿的临床效果,为进一步了解学龄期肥胖儿童体内糖脂代谢紊乱情况,及早给予干涉,降低成年及老年慢性疾病的风险。方法 选取2013年6月-2014年11月在青海省儿童医院园诊断为肥胖的110例儿童为肥胖组,同期通过自愿原则在当地筛选出90名体检正常的儿童为正常组,收集两组身高、体重、腰围、臀围数据,并计算体质指数(BMI),比较这些简单人体测量数据的差异。同时将肥胖组儿童随机分为两组:试验组(55例)和对照组(55例),试验组采用膳食纤维饮食联合运动干预,对照组不采取特殊的干预措施,比较两组患儿治疗5周前后反映糖代谢、脂代谢血液中生化指标、血压的变化情况。结果 与正常组比较,肥胖组的腰围、臀围、体重、BMI更大,差异有统计学意义(P＜0.05)。膳食纤维联合运动干预后,试验组较对照组儿童的体重、BMI、腰围明显下降,空腹血糖、餐后2 h血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、血压亦均明显下降(P＜0.05);而两组低密度脂蛋白胆固醇差异无统计学意义(P＞0.05)。结论 肥胖儿童在临床上有显著糖脂代谢紊乱的特征。膳食纤维联合运动干预后患儿糖代谢、脂质代谢紊乱得到较好调节,血压变化较对照组明显降低。

关键词: 肥胖, 代谢综合征, 膳食纤维, 运动, 干预, 儿童