目的 探讨儿童期腹型肥胖及其腹型肥胖前期与高尿酸血症的关系,为儿童高尿酸血症的防治提供科学依据。方法 数据来源于2017年11月—2018年1月在山东省淄博市桓台县开展的“桓台儿童心血管健康队列”的基线调查。本研究共纳入信息完整的儿童1 202名,采用协方差分析比较儿童期腹型肥胖状态(正常腰围、腹型肥胖前期、腹型肥胖)儿童的尿酸水平,采用多因素Logistic回归模型分析儿童期腹型肥胖及其腹型肥胖前期与高尿酸血症之间的关联。结果 调整潜在协变量后,腹型肥胖前期[(289.7±80.6)μmol/L]、腹型肥胖[(332.2±87.8)μmol/L]儿童的尿酸水平均显著高于正常腰围儿童[(268.6±71.3)μmol/L](F=88.51,P<0.05)。与腰围正常儿童相比,儿童腹型肥胖前期(OR=2.71,95%CI:1.38～5.31)、腹型肥胖(OR=7.97,95%CI:4.61～13.76)儿童罹患高尿酸血症的风险增加(P<0.01)。采用腰围身高比指标进行腹型肥胖评价,得到相似的结果。结论 儿童腹型肥胖及其腹型肥胖前期与高尿酸血症存在正向关联,提示今后应采取积极措施降低儿童腹型肥胖,从而预防儿童高尿酸血症的发生。
Abstract
Objective To examine the relationship of abdominal obesity and pre-abdominal obesity with hyperuricemia among children, in order to provide scientific basis for the prevention and treatment of hyperuricemia in children. Methods Data were from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study conducted in Huantai County, Zibo City, Shandong Province from November 2017 to January 2018. A total of 1 202 children with complete data were included in this study. Covariance analysis was used to compare the difference in uric acid levels between children with normal waist circumference (WC), pre-abdominal obesity and abdominal obesity, and multivariate Logistic regression model was used to analyze the relationship of abdominal obesity and pre-abdominal obesity with hyperuricemia among children, using normal WC as reference. Results After adjusting for all potential covariates, uric acid levels in children with pre-abdominal obesity [(289.7±80.6)μmol/L] and abdominal obesity [(332.2±87.8)μmol/L] were significantly higher than those with normal WC [(268.6±71.3)μmol/L] (F=88.51, P<0.05). Compared with children with normal WC, children with pre-abdominal obesity (OR=2.71, 95%CI:1.38-5.31) and abdominal obesity (OR=7.97, 95%CI:4.61-13.76) were at an increased risk of hyperuricemia(P<0.01). The results were similar when using waist-to-height ratio to determine abdominal obesity. Conclusion There is a positive relationship of abdominal obesity and pre-abdominal obesity with hyperuricemia in children, suggesting that more efforts should be made to reduce childhood abdominal obesity, in order to prevent the occurrence of childhood hyperuricemia.
关键词
腹型肥胖 /
腹型肥胖前期 /
高尿酸血症 /
儿童
Key words
abdominal obesity /
pre-abdominal obesity /
hyperuricemia /
children
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参考文献
[1] Li Y, Shen Z, Zhu B, et al. Demographic, regional and temporal trends of hyperuricemia epidemics in mainland China from 2000 to 2019:A systematic review and meta-analysis[J]. Glob Health Action, 2021, 14(1):1874652.
[2] Maloberti A, Giannattasio C, Bombelli M, et al. Hyperuricemia and risk of cardiovascular outcomes:The experience of the URRAH (uric acid right for heart health) project[J]. High Blood Press Cardiovasc Prev, 2020, 27(2):121-128.
[3] Lee JH. Prevalence of hyperuricemia and its association with metabolic syndrome and cardiometabolic risk factors in Korean children and adolescents:Analysis based on the 2016—2017 Korea national health and nutrition examination survey[J]. Korean J Pediatr, 2019, 62(8):317-323.
[4] 杨丽丽,张茜,张艳青,等.山东省淄博市桓台儿童心血管健康随访队列设计方案[J].中华预防医学杂志,2020,54(12):1461-1464.
Yang LL,Zhang Q,Zhang YQ,et al.Design of huantai childhood cardiovascular health cohort study[J].Chin J Prev Med,2020,54(12):1461-1464.(in Chinese)
[5] 孟玲慧,侯冬青,单馨影,等.OMRON HEM-7012电子血压计测量儿童青少年血压的准确性评[J].中华高血压杂志,2013,21(2):158-162.
Meng LH,Hou DQ,Shan XY,et al.Accuracy evaluation of Omron HEM-7012 electronic sphygmomanometers in measuring blood pressure of children and adolescents[J].Chin J Hypertens,2013,21(2):158-162.(in Chinese)
[6] 马冠生,季成叶,马军,等.中国7～18岁学龄儿童青少年腰围界值点研究[J].中华流行病学杂志,2010,31(6):609-615.
Ma GS,Ji CY,Ma J,et al.Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents aged 7-18 years[J].Chin J Epidemiol,2010,31(6):609-615.(in Chinese)
[7] 孟玲慧,罗纳,程红,等.北京与全国7～18岁儿童青少年腰围适宜界值对心血管危险因素筛查效度的对比分析[J].中华预防医学杂志,2011,45(8):717-722.
Meng LH,Luo N,Cheng H,et al.Waist circumference reference values in Beijing versus the national values in detecting cardiovascular risk factors in 7-18 years old children[J].Chin J Prev Med,2011,45(8):717-722.(in Chinese)
[8] Ashwell M, Gibson S. A proposal for a primary screening tool:′Keep your waist circumference to less than half your height′[J]. BMC Med, 2014 (12):207.
[9] Zhao M, López-Bermejo A, Caserta CA, et al. Metabolically healthy obesity and high carotid intima-media thickness in children and adolescents:International childhood vascular structure evaluation consortium[J]. Diabetes Care, 2019, 42(1):199-125.
[10] Cook S, Weitzman M, Auinger P, et al. Prevalence of a metabolic syndrome phenotype in adolescents:Findings from the third National Health and Nutrition Examination Survey, 1988—1994[J]. Arch Pediatr Adolesc Med, 2003, 157(8):821-827.
[11] 范晖,闫银坤,米杰.中国3～17岁儿童性别、年龄别和身高别血压参照标准[J].中华高血压杂志,2017,25(5):428-435.
Fan H,Yan YK,Mi J.Updating blood pressure references for Chinese children aged 3-17 years[J].Chin J Hypertens,2017,25(5):428-435.(in Chinese)
[12] 胡亚美,江载芳,申昆玲,等.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2015.
Hu YM,Jiang ZF,Shen KL,et al.Zhu Futang textbook of pediatrics[M].8th ed.Beijing:People′s Medical Publishing House,2015.(in Chinese)
[13] Holstein BE, Damsgaard MT, Due P, et al. Intake of sugar sweetened soft drinks among adolescents:Trends and social inequality in Denmark 2002—2018[J]. Nutr Health, 2020, 26(1):3-8.
[14] World Health Organization. Effectiveness of interventions and programmes promoting fruit and vegetableintake[EB/OL].[2022-03-01].https://www.who.int/dietphysicalactivity/publications/f&v_promotion_effectiveness.pdf?ua=1.
[15] World Health Organization. Global recommendations on physical activity for health[EB/OL].[2022-03-01].https://www.who.int/dietphysicalactivity/factsheet_recommendations/en/.
[16] Li N, Zhang S, Li W, et al. Prevalence of hyperuricemia and its related risk factors among preschool children from China[J]. Sci Rep, 2017, 7(1):9448.
[17] 陈新春,寇永妹,谷小娜,等.唐山地区儿童青少年血尿酸分布特征及相关危险因素分析[J].中国全科医学,2019,22(26):3227-3232.
Chen XC,Kou YS,Gu XN,et al.Distribution of serum uric acid and risk factors of hyperuricemia in children and adolescents in Tangshan[J].Chin Gen Pract,2019,22(26):3227-3232.(in Chinese)
[18] Numata T, Miyatake N, Wada J, et al. Comparison of serum uric acid levels between Japanese with and without metabolic syndrome[J]. Diabetes Res Clin Pract, 2007, 80(1):e1-e5.
[19] Yunkyung K, Jihun K, Geun-Tae K. Prevalence of hyperuricemia and its associated factors in the general Korean population:An analysis of a population-based nationally representative sample[J]. Clin Rheumatol, 2018, 37(9):2529-2538.
[20] 蔡蓉蓉,董洋洋,周金玉,等.银川市儿童青少年血清尿酸水平与心血管危险因素及其聚集的关系[J].卫生研究,2022,51(1):56-62,67.
Cai RR,Dong YY,Zhou JY,et al.Association of serum uric acid with cardiovascular risk factors and their clustering among children and adolescents in Yinchuan City[J].J Hyg Res,2022,51(1):56-62,67.(in Chinese)
[21] Moulin-Mares SRA, Oliosa PR, Faria ER, et al. Association of uric acid with cardiovascular risk in Brazilian children and adolescents[J]. Nutr Metab Cardiovasc Dis, 2021, 31(1):314-321.
[22] Yu T, Hitoshi N, Yoshihiro T, et al. Uric acid secretion from adipose tissue and its increase in obesity[J]. J Biol Chem, 2013, 288(38):27138-27149.
[23] Masaru D, Yuichi T, Hidetsugu S, et al. The increased protein level of URAT1 was observed in obesity/metabolic syndrome model mice[J]. Nucleosides Nucleotides Nucleic Acids, 2011, 30(12):1290-1294.
[24] Bajnok L, Seres I, Varga Z, et al. Relationship of serum resistin level to traits of metabolic syndrome and serum paraoxonase 1 activity in a population with a broad range of body mass index[J]. Exp Clin Endocrinol Diabetes, 2008, 116(10):592-599.
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