目的：探讨超敏C反应蛋白（high-sensitivity C-reactive protein, hs-CRP）作为肥胖青少年心血管疾病发病风险的生物标志物的评估价值。方法6-18岁青少年，体重指数（body mass index, BMI）超过2 SDS。所有入组对象空腹12h采集静脉血，检测hs-CRP，肝脏功能检测，血脂检测，尿酸等检测；糖耐量试验。我们认为肥胖青少年存在代谢综合征症状，至少包括两个以下症状：高甘油三酯血症、低高密度脂蛋白胆固醇（high density lipoprotein cholesterol, HDL-C）、高血压及糖代谢障碍。结果115例青少年患者中，24%显示存在代谢综合症，存在代谢综合症的患者血清hs-CRP水平（M=3.8ml/L；95% CI：2.9-4.8）高与不存在代谢综合征症状的肥胖青少年（M=1.9ml/L；95% CI：1.5-2.5），经多变量分析，影响hs-CRP水平的是BMI、甘油三酯、HDL-C水平。讨论血清hs-CRP是判断肥胖青少年是否存在早期心血管疾病发生风险的有价值的生物标志物。
hs-CRP level was associated to diagnosis of cardiovascular risk in obese teenagers
Objective To assess the utility of the high -sensitivity C-reactive protein (hs-CRP) as a marker of cardiovascular risk in obese teenagers. Methods The study included teenagers between 6 and 18 years of age with a body mass index (BMI) higher than 2 SDS. Al the patients had their blood pressure taken and hs-CRP, hepatic function, lipid and uric acid were determined after 12 h of fasting, likewise , an oral glucose tolerance test was performed, determining basal glucose and insulin levels, and after stimulus. Results Out of the 115 obese teenagers 24% showed signs of metabolic syndrome. Those with metabolic syndrome presented higher levels of hs-CRP (M=3.8ml/L; 95% CI: 2.9-4.8) in comparison with the obese patients who did not show signs of metabolic syndrome(M=1.9ml/L; 95% CI: 1.5-2.5). After a multivariate analysis, the variables that appear to influence the changes in hs-CRP were BMI, triglycerides and HDL-C levels. Conclusions The hs-CRP is a useful tool for early diagnosis of cardiovascular risk in obese teenagers.
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