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6、3 4962 收稿日期2022 10 27 本文编辑余军吕文娟本文引用格式曾琼戎，刘泽峰，王文娟，等 耐索拉非尼肝癌细胞株的构建及耐药机制研究J 中国临床新医学，2023，16(2):135 140论著单纯性肥胖儿童综合减重干预后维生素 D水平变化及作用探讨李世寒，李瑞珍，贺珮玲，王源源，常雪凝，曹中强，梅红基金项目:湖北省中央引导地方科技发展专项(编号:2019ZYYD051)作者单位:430056湖北，江汉大学医学院(李世寒);430016湖北，武汉儿童医院儿童保健科(李瑞珍，贺珮玲，王源源，常雪凝，李世寒)，妇女儿童健康研究所(曹中强，梅红)作者简介:李世寒，在读硕士研究生，研究方向:儿
7、科疾病的诊治。E-mail:1269437703 qq com通信作者:李瑞珍，医学博士，教授，硕士研究生导师，主任医师，研究方向:小儿内分泌与儿童保健。E-mail:dr_lrz163 com 摘要 目的探讨单纯性肥胖儿童综合减重干预后维生素 D 水平变化及作用。方法选择 2020 年10 月至2021 年3 月武汉市某小学的体检儿童作为研究对象，年龄7 14 岁，其中单纯性肥胖儿童43 例(肥胖组)，体重(Wt)正常儿童 50 名(对照组)。对肥胖组进行3 个月的综合减重干预，内容包括饮食、运动指导和健康宣教等。检测正常组及肥胖组干预前后血清 25 羟基维生素 D 25-(OH)D 水平，
8、以及人体学指标和代谢相关指标。结果与对照组相比，干预前肥胖组 Wt、腰围(WC)、体质量指数(BMI)、BMI-Z、体脂率(PBF)、空腹血胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-I)、甘油三酯(TG)更高，空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)水平更低，差异有统计学意义(P 0.05)。经干预后，肥胖组的 WC 减小，BMI-Z、25-(OH)D水平降低，总胆固醇(TC)水平升高，与干预前比较差异有统计学意义(P 0.05)。Pearson 相关分析结果显示25-(OH)D 与 Wt、WC、BMI、BMI-Z、FINS、HOMA-I 呈负相关(P 0.05)，与
9、HDL-C 呈正相关(P 0.05)。多重线性回归分析结果显示，25-(OH)D 与WC(P 0.01)、FBG(P 0.05)呈负关联，提示 25-(OH)D 水平下降水平越大，WC、FBG 降低越小。结论维生素 D 与单纯性肥胖儿童机体代谢指标水平密切相关，维生素 D 水平下降会影响单纯性肥胖儿童的减重效果。关键词 儿童;单纯性肥胖;维生素 D;减重干预 中图分类号 725.8 文献标识码 A 文章编号 1674 3806(2023)02 0140 06doi:10 3969/j issn 1674 3806 2023 02 08041Chinese Journal of New Clin
10、ical Medicine，February 2023，Volume 16，Number 2An exploration on the changes and effects of vitamin D levels in children with simple obesity after comprehen-sive weight loss interventionLI Shi-han，LI ui-zhen，HE Pei-ling，et al School of Medicine of Jianghan Univer-sity，Hubei 430056，China;Department of
11、 Child Healthcare，Wuhan Childrens Hospital，Hubei 430016，China Abstract ObjectiveTo explore the changes and effects of vitamin D levels in children with simple obesityafter comprehensive weight loss intervention MethodsThe children were selected as the research subjects from a pri-mary school in Wuha
12、n during October 2020 and March 2021，aged from 7 to 14 years，among whom 43 cases were simpleobese children(the obese group)and 50 cases were normal weight(Wt)children(the control group)In the obese group，comprehensive weight loss intervention was carried out for 3 months，including diet，exercise guid
13、ance and health educa-tion The levels of serum 25-hydroxyvitamin D 25-(OH)D，anthropological and metabolic indicators in the normal groupand the obese group were detected before and after intervention esultsCompared with the control group，the obesegroup had higher Wt，waist circumference(WC)，body mass
14、 index(BMI)，BMI-Z，percentage body fat(PBF)，fastinginsulin(FINS)，homeostasis model assessment of insulin resistance index(HOMA-I)and triglyceride(TG)，and lowerfasting blood glucose(FBG)and high-density lipoprotein cholesterol(HDL-C)level before intervention，and the differ-ences were statistically sig
15、nificant(P 0.05)Compared with those before intervention，WC decreased，and the levelsof BMI-Z and 25-(OH)D decreased，and the total cholesterol(TC)level increased after intervention，and the differ-ences were statistically significant(P 0.05)The results of Pearson correlation analysis showed that 25-(OH
16、)D wasnegatively correlated with Wt，WC，BMI，BMI-Z，FINS and HOMA-I(P 0.05)，and positively correlated withHDL-C(P 0.05)The results of multiple linear regression analysis showed that 25-(OH)D was negatively correlatedwith WC(P 0.01)and FBG(P 0.05)，that is，the greater the decrease of 25-(OH)D，the smaller the decrease ofWC and FBG ConclusionVitamin D is closely related to the level of metabolic indexes in children with simple obe-sity The decrease of vitamin D level affects the effect of weight loss i
