天津地区儿童空腹与非空腹血脂水平比较

摘要

Objective To compare the difference between fasting blood lipids and non－fasting blood lipids in children in Tianjin,and to explore the feasibility of non－fasting blood lipids detection in children.Methods A total of 223 child patients were enrolled in Department of Pediatrics,the Second Hospital of Tianjin Medical University from January 2017 to February 2018,fasting and 1－6 h post－dining blood samples were collected from each patient.Total cholesterol (TC),triglyceride (TG),high－density lipoprotein cholesterol (HDL－C)and low－density lipoprotein cholesterol (LDL－C)were measured.Self－control methods were used.Wilcoxon signed rank test was used for statisti-cal analysis.Results Compared with fasting lipids,non－fasting TC increased with 0.02 mmol/L,TG increased with 0.01 mmol/L,HDL－C increased with 0.03 mmol/L,while LDL－C decreased with 0.01 mmol/L,but non－high－density lipoprotein cholesterol did not change.Among them,only the difference in HDL －C between the fasting and non－fasting was statistically significant (Z＝ －2.870,P＜0.05).The difference in the change rate of all indicators was ＜3%.According to the dyslipidemia group comparison,the differences in hypercholesterolemia (0.72 mmol/L, Z＝ －2.551,P＝0.011),hypertriglyceridemia (0.73 mmol/L,Z＝ －3. 846,P＜0.001),low high－density lipopro-tein cholesterolemia (－0.04 mmol/L,Z ＝ －8.625,P ＜0.001)and normal level HDL －C (0.1 mmol/L,Z ＝－5.040,P＜0.001)between non －fasting lipids and fasting blood lipids were statistically significant.Conclusions The change of children's blood lipid profile in fasting and non－fasting conditions is little.Lipid testing in children does not require fasting.Blood tests can be performed at any appropriate time point in the normal diet.%目的 比较天津地区儿童空腹血脂与非空腹血脂的差异,探讨在儿童人群中进行非空腹血脂检测的可行性.方法 选取2017年1月至2018年2月天津医科大学第二医院儿科住院患儿223例,分别采集空腹和餐后1～6 h血液样本,进行总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)检测,采用自身对照的方法进行比较,统计分析采用非参数检验Wilcoxon符号秩检验.结果 与空腹血脂比较,非空腹TC升高0.02 mmol/L,TG升高0.01 mmol/L,HDL-C升高0.03 mmol/L,LDL-C降低0.01 mmol/L,非高密度脂蛋白胆固醇无变化.其中仅HDL-C非空腹检测与空腹检测差异有统计学意义(Z＝－2.870,P＜0.05),所有指标的差异变化率＜3%.按照血脂异常分组比较结果显示,高 TC血症(0.72 mmol/L, Z＝ －2.551,P＝0.011)、高TG血症(0. 73 mmol/L,Z＝ －3.846,P＜0.001)、低HDL-C血症(－0.04 mmol/L, Z＝ －8.625,P＜0.001)和正常水平HDL-C(0.1 mmol/L,Z＝ －5.402,P＜0.001),非空腹血脂与空腹血脂差异有统计学意义.结论 天津地区儿童血脂谱在空腹与非空腹状态下检测改变较小,在儿童中进行血脂检测不必禁食,可在正常饮食情况下任何合适时间点进行取血检测.