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目的:探究不同程度肥胖儿童血清25羟维生素D［25（OH）D］、人去乙酰化酶4（SIRT4）水平与糖脂代谢的关系。方法:选取2016年2月至2021年2月绍兴市妇女儿童保健院收治的肥胖儿童124例为研究对象，参照体质量指数（BMI）分为轻/中度肥胖组（76例）以及重度肥胖组（48例），并选取同期在该院体检健康儿童62例为对照组。收集各组儿童一般资料，分析儿童肥胖影响因素及血清25（OH）D、SIRT4水平与糖脂代谢的关系。结果:三组儿童体质量［（26.68±4.98）kg、（33.24±5.48）kg、（37.18±5.88）kg］、腰围［（56.12±4.62）cm、（68.45±5.20）cm、（79.34±5.65）cm］、臀围［（68.42±5.08）cm、（72.45±6.45）cm、（80.56±6.95）cm］、BMI［（15.90±2.04）kg/mn 2、（23.58±2.45）kg/mn 2、（25.89±2.35）kg/mn 2］、胰岛素（FINS）［（26.65±3.68）pmol/L、（34.82±4.15）pmol/L、（48.56±5.49）pmol/L］、胰岛素抵抗指数（HOMA-IR）［（1.06±0.24）、（2.12±0.35）、（3.84±0.52）］、总胆固醇（TC）［（2.21±0.45）mmol/L、（4.14±0.58）mmol/L、（5.96±0.64）mmol/L］、三酰甘油（TG）［（0.68±0.16）mmol/L、（1.12±0.24）mmol/L、（1.56±0.35）mmol/L］、低密度脂蛋白胆固醇（LDL-C）［（2.68±0.42）mmol/L、（2.10±0.32）mmol/L、（1.41±0.25）mmol/L］、高密度脂蛋白胆固醇（HDL-C）［（1.98±0.42）mmol/L、（3.12±0.51）mmol/L、（4.10±0.56）mmol/L］差异均有统计学意义（n F=53.62、280.42、53.33、303.44、338.48、755.71、618.75、165.81、186.89、251.42，均n P < 0.001）；各组体质量、腰围、臀围、BMI、FINS、HOMA-IR、TC、TG、HDL、LDL两两比较：对照组 < 轻/中度组（ n t=-7.28、-14.56、-4.00、-19.72、-6.49、-21.45、-12.36、9.20、-14.12，均n P < 0.05）、轻/中度组 < 重度组（ n t=-3.79、-10.98、-6.61、-5.19、-15.81、-22.02、-16.34、-8.30、12.68、-10.03，均n P 轻/中度组［（60.52±8.95）nmol/L比（49.88±8.12）nmol/L］、［（1.98±0.38）mmol/L比（1.06±0.30）mmol/L］（ n t=7.31、15.89，均n P 重度组［（49.88±8.12）nmol/L比（41.62±7.50）nmol/L］、［（1.06±0.30）mmol/L比（0.52±0.15）mmol/L］（ n t=5.68、11.57，均n P < 0.05）。多元线性回归分析显示，体质量、腰围、臀围、FINS、HOMA-IR、TC、TG、LDL是儿童肥胖的正向影响因素（n B=0.170、0.310、0.403、1.000、3.464、2.080、2.656、4.324）；HDL、血清25（OH）D及SIRT4是儿童肥胖的负向影响因素（n B=-2.096、-0.156、-6.615）。Pearson相关性分析显示，血清25（OH）D与FINS、HOMA-IR、TC、TG、LDL均呈显著负相关（n r=-0.20、-0.46、-0.30、-0.36，均n P < 0.01），与FPG、HDL呈显著正相关（ n r=0.43、0.77，均n P < 0.01）；血清SIRT4与FINS、TC、TG、LDL均呈显著负相关（ n r=-0.48、-0.74、-0.61、-0.64，均n P < 0.01），与FPG、HDL呈显著正相关（ n r=0.21、0.84，均n P < 0.01）。n 结论:血清25（OH）D、SIRT4水平随儿童肥胖程度的加重而降低，且与糖脂代谢关系密切，因此早期检测可反映儿童肥胖程度及糖脂代谢情况。“,”Objective:To investigate the relationship between serum 25(OH)D and SIRT4 levels and glycolipid metabolism in children with different levels of obesity.Methods:A total of 124 children with different levels of obesity who received treatment in Shaoxing Women\'s and Children\'s Health Care Hospital from February 2016 to February 2021 were included in this study. These children were divided into mild/moderate obesity group (n n = 76) and severe obesity group (n n = 48) according to body mass index. An additional 62 healthy children who concurrently received a physical examination were selected for controls. The general data of all children were collected. The relationship between the factors that affect obesity in children and serum 25(OH)D and SIRT4 levels and glycolipid metabolism was analyzed.n Results:In the control, mild/moderate obesity, and severe obesity groups, body mass was (26.68 ± 4.98) kg, (33.24 ± 5.48) kg, (37.18 ± 5.88) kg, respectively; waist circumference was (56.12 ± 4.62) cm, (68.45 ± 5.20) cm, (79.34 ± 5.65) cm, respectively; hip circumference was (68.42 ± 5.08) cm, (72.45 ± 6.45) cm, (80.56 ± 6.95) cm, respectively; body mass index (BMI) was (15.90 ± 2.04) kg/mn 2, (23.58 ± 2.45) kg/mn 2, (25.89 ± 2.35) kg/mn 2], respectively; fasting insulin (FINS) level was (26.65 ± 3.68) pmol/L, (34.82 ± 4.15) pmol/L, (48.56 ± 5.49) pmol/l, respectively; homeostasis model assessment of insulin resistance (HOMA-IR) was (1.06 ± 0.24), (2.12 ± 0.35), (3.84 ± 0.52), respectively; total cholesterol (TC) level was (2.21 ± 0.45) mmol/L, (4.14 ± 0.58) mmol/L, (5.96 ± 0.64) mmol/L, respectively; triacylglycerol (TG) level was (0.68 ± 0.16) mmol/L, (1.12 ± 0.24) mmol/L, (1.56 ± 0.35) mmol/L, respectively; low density lipoprotein cholesterol (LDL-C) was (2.68 ± 0.42) mmol/L, (2.10 ± 0.32) mmol/L, (1.41 ± 0.25) mmol/L, respectively; high density lipoprotein cholesterol (HDL-C) was (1.98 ± 0.42) mmol/L, (3.12 ± 0.51) mmol/L, (4.10 ± 0.56) mmol/L, respectively. There were significant differences in body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC, TG, HDL-C, and LDL-C among the three groups (n F = 53.62, 280.42, 53.33, 303.44, 338.48, 755.71, 618.75, 165.81, 186.89, 251.42, all n P < 0.001). Body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC level, TG level, HDL-C level, and LDL-C level were lower in the control group than in the mild/moderate obesity group ( n t = -7.28, -14.56, -4.00, -19.72, -6.49, -21.45, -12.36, 9.20, -14.12, all n P < 0.05). Body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC, TG, HDL-C and LDL-C were lower in the mild/moderate obesity group than in the severe obesity group ( n t = -3.79, -10.98, -6.61, -5.19, -15.81, -22.02, -16.34, -8.30, 12.68, -10.03, all n P < 0.05). Serum 25(OH)D [(60.52 ± 8.95) nmol/L n vs. (49.88 ± 8.12) nmol /L, n t = 7.31, n P < 0.05] and SIRT4 [(1.98 ± 0.38) mmol/L n vs. (1.06 ± 0.30) mmol/L,n t = 15.89, n P < 0.05] levels were significantly greater in the control group than in the mild/moderate obesity group. Serum 25(OH)D [(49.88 ± 8.12) nmol/L n vs. (41.62 ± 7.50) nmol /L, n t = 5.68, n P < 0.05] and SIRT4 [(1.06 ± 0.30) mmol/L n vs. (0.52 ± 0.15) mmol/L, n t = 11.57, n P < 0.05] levels were significantly greater in the mild/moderate obesity group than in the severe obesity group. Multiple linear regression analysis showed that body mass, waist circumference, hip circumference, FINS, HOMA-IR, TC, TG, and LDL were the positive influential factors of childhood obesity ( n B = 0.170, 0.310, 0.403, 1.000, 3.464, 2.080, 2.656, 4.324); HDL, serum 25(OH)D and SIRT4 were the negative influential factors of childhood obesity (n B = -2.096, -0.156, -6.615). Pearson correlation analysis showed that serum 25(OH)D was significantly negatively correlated with FINS, HOMA-IR, TC, TG and LDL (n r = -0.20, -0.46, -0.30, -0.36, all n P < 0.01), and significantly positively correlated with FPG and HDL ( n r = 0.43, 0.77, both n P < 0.01). Serum SIRT4 was negatively correlated with FINS, TC, TG, and LDL ( n r = -0.48, -0.74, -0.61, -0.64, all n P < 0.01), and positively correlated with FPG and HDL ( n r = 0.21, 0.84, both n P < 0.01).n Conclusion:Serum 25(OH)D and SIRT4 levels decrease with the aggravation of obesity in children and are closely related to glycolipid metabolism. Therefore, early detection of obesity can reflect the degree of obesity and glycolipid metabolism in children.