Study On The Relationship Between Childhood Obesity,Cardiometabolic Risk Factors And Bone Metabolism

Objective By detecting the indexes of cardiovascular metabolism and bone metabolism in simple obese children,and further exploring the relationship between body mass index(BMI)and cardiometabolic risk factors,bone metabolic indexes,in order to find the early high risk factors of cardiovascular disease and abnormal bone metabolism in obese children,and to strengthen the society,medical institutions and families to pay more attention to the prevention and treatment of childhood obesity and other related complications.Method We selected 75 children with simple obesity who were diagnosed in the General Hospital of Ningxia Medical University from October 2019 to December 2020 as the obesity group,and selected 75 healthy children who underwent physical examination in the same period as the control group.We should record the following information of both groups,including age,sex,height,weight,systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate,we should also detect the level of serum total cholesterol(TC),triglyceride(TG),lowdensity lipoprotein(LDL)and high-density lipoprotein(HDL),and use the echocardiography to measure left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),interventricular septal end diastolic thickness(IVST),left ventricular posterior wall end diastolic thickness(LVPWT),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),and then,calculate relative wall thickness(RWT)and left ventricular mass(LVM).At the same time,collect the indexes of bone metabolism,including 25-hydroxy vitamin D(25(OH)D),parathyroid hormone(PTH),Calcium(Ca),phosphorus(P)and alkaline phosphatase(ALP).Compare the differences of the indexes that mentioned above between the two groups,and further explore the relationship between BMI and cardiometabolic risk factors,bone metabolic indexes in obese children.All data are analyzed by SPSS 22.0,the methods of analysis include student t-test,chi-square test and Pearson correlation analysis.The differences are statistically significant when P<0.05.Results1.Comparison of BMI,blood pressure and heart rate between the two groups.The average BMI of the obese group is 25.8±3.1,and the control group is 18.7±1.8,the BMI of the obese group is higher than that of the control group(P<0.05);the SBP and DBP of the obese group are significantly higher than those of the control group(P<0.05),the heart rate between the two groups has no significant difference(P>0.05).2.Comparison of lipid metabolism indexes between the two groups.The serum level of TC,TG,LDL,HDL in the obese group are 4.18±0.71 mg/dl,1.39±0.52mg/dl,2.44±0.51mg/dl,1.11±0.25mg/dl respectively;and the serum level of TC,TG,LDL,HDL in the control group are 3.85 ±0.68mg/dl,1.14±0.40mg/dl,2.23±0.53mg/dl,1.21±0.22mg/dl respectively.The level of TC,TG,LDL in the obese group are higher than those of the control group,while the serum level of HDL in the obese group is lower(P<0.05).3.Comparison of the parameters of ultrasonic cardiogram between the two groups.The IVST,LVPWT,RWT and LVM of the obese group are 6.98±1.29 mm,6.92±1.21 mm,0.33±0.48 mm,87.16±29.78 g respectively,while in the control group are 6.34±0.98 mm,6.30±0.95 mm,0.31±0.41,72.79±21.64 g respectively.The differences of the indexes that mentioned above between the two groups are significant(P<0.05).The LVEDD,LVESD,LVEDV,LVESV and LVEF between the two groups have no significant differences.4.Based on there are statistical significances of some cardiometabolic indexes between the two groups,the Pearson correlation analysis shows that BMI of obese children is positively correlated with TG(r=0.353,P=0.012),IVST(r=0.301,P=0.034),LVM(r=0.382,P=0.006),and negatively correlated with HDL(r=-0.349,P=0.013).5.The distribution of Vit D level in the two groups.69.3% of the children in the obese group have Vit D deficiency,24.0% are insufficient,and only 6.7% of the children have sufficient Vit D level;28.0% of the children in the control group have Vit D deficiency,30.7% are insufficient,and 41.3% are sufficient.6.Comparison of bone metabolism indexes between the two groups.The average level of serum 25(OH)D in the obese group is 12.63±5.36 ng/ml,while in the control group is 18.21±7.46 ng/ml.The level of serum 25(OH)D in obese children is lower than that in the control group,and there is a negative correlation between BMI and serum25(OH)D in obese children(r=-0.384,P=0.001).There are no significant differences in PTH,Ca,P and ALP between the two groups.Conclusions1.Compared with healthy children,blood pressure has increased in obese children,and lipid metabolism has become abnormal.2.The ventricular structure of obese children has changed.3.The phenomenon that Vit D deficiency in obese children is very common,we should encourage them to do more outdoor exercises and take vitamin D supplement reasonably.