膳食支链氨基酸对儿童青少年血脂异常的影响

doi:10.11852/zgetbjzz2025-0236

中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (10): 1101-1107.DOI: 10.11852/zgetbjzz2025-0236

膳食支链氨基酸对儿童青少年血脂异常的影响

陈垚¹, 刘长青², 朱谦让³, 刘怡娅⁴, 田美娜², 王宏伟⁵, 于连龙⁶

1.日照市人民医院临床营养科,山东日照 276827;
2.河北省疾病预防控制中心营养与食品安全所;
3.江苏省疾病预防控制中心营养与食品安全所;
4.贵州省疾病预防控制中心公共卫生监测评价所;
5.日照市人民医院保健/老年医学科;
6.山东省疾病预防控制中心公共卫生监测评价所

收稿日期:2025-03-14 修回日期:2025-06-18 发布日期:2025-10-11
通讯作者: 于连龙,E-mail:lianlong00a@163.com
作者简介:陈垚(1989—),男,副主任医师,主要研究为营养与疾病。
基金资助:
齐鲁卫生与健康杰出青年人才项目(2021.01-2025.12);山东省医药卫生科技发展计划项目(2019WS436);山东省自然科学基金项目(ZR2023QH157);国家卫生健康委公共营养与健康重点实验室开放课题(WLKFZ202505);日照市自然科学基金(RZ2024ZR64)

Effect of dietary branched-chain amino acids on dyslipidemia in children and adolescents

CHEN Yao¹, LIU Changqing², ZHU Qianrang³, LIU Yiya⁴, TIAN Meina², WANG Hongwei⁵, YU Lianlong⁶

1. Clinical Nutrition Department, Rizhao People's Hospital,Rizhao, Shandong 276827,China;
2. Institute for Nutrition and Food Safety, Hebei Province Center for Disease Control and Prevention;
3. Institute of Nutrition and Food Safety, Jiangsu Provincial Center for Disease Control and Prevention;
4. Institute of Public Health Surveillance and Evaluation, Guizhou Center for Disease Control and Prevention;
5. Department of Health Care and Geriatrics, Rizhao People's Hospital;
6. Institute of Public Health Surveillance and Evaluation, Shandong Center for Disease Control and Prevention

Received:2025-03-14 Revised:2025-06-18 Published:2025-10-11
Contact: YU Lianlong, E-mail:lianlong00a@163.com

摘要/Abstract

摘要： 目的分析6~18岁儿童青少年群体中膳食支链氨基酸(BCAAs)摄入与血脂异常的关系,为血脂异常防治提供新的思路。方法选取“中国儿童与乳母营养健康监测”四省份11 019例6~18岁儿童青少年膳食调查与血生化数据。采用食物频率表法获得膳食调查数据,结合《中国食物成分表》计算儿童青少年人群膳食BCAAs 摄入量。比较不同BCAAs摄入水平组间各血脂异常亚组的患病差异,利用logistic回归模型评估BCAAs与血脂异常的关联并利用乘法模型来评估年龄、性别和体质量指数(BMI)分别与BCAAs的交互作用对血脂异常的影响。结果正常对照组9 389例,血脂异常组1 630例,其中高胆固醇(TC)血症470例。总BCAAs、BCAAs密度高水平组的高TC血症患病率显著高于低水平组(χ²=9.554、18.109,P＜0.01)。分层分析表明,与低水平组比较,正常体重组BCAAs高水平组(OR=1.781,95%CI:1.326~2.391)和BCAAs密度高水平组(OR=2.011,95%CI:1.493~2.708)高TC血症发病风险均升高(P＜0.05),女性中BCAAs高水平组(OR=1.721,95%CI:1.243~2.384)、BCAAs密度高水平组(OR=1.899,95%CI:1.361~2.651)高TC血症发病风险升高(P＜0.05),6~12岁组BCAAs高水平组高TC血症发病风险升高(OR=1.447,95%CI:1.100~1.905),各年龄组BCAAs密度高水平组高TC血症发病风险升高(6~12岁OR=1.636,95%CI:1.242~2.155;OR=1.881,95%CI:1.170~3.024)(P<0.05)。BCAAs密度与BMI对高TC血症的影响存在显著交互效应(P=0.027)。中介效应分析显示BMI在总BCAAs摄入量、BCAAs密度与高TC血症之间表现出异质性中介效应。结论 BCAAs摄入增加是高TC血症的独立危险因素,通过调整膳食结构,减少红肉及其制品的摄入来限制饮食中BCAAs可降低高TC血症发病风险。

关键词: 支链氨基酸, 血脂异常, 胆固醇, 高胆固醇血症, 代谢性疾病, 儿童青少年

Abstract: Objective To analyze the relationship between dietary branched-chain amino acids (BCAAs) intake and the risk of dyslipidemia in children and adolescents aged 6 - 18 years, in order to provide new insights for the prevention and treatment of dyslipidemia. Methods Dietary survey and blood biochemical data of 11 019 children and adolescents aged 6 - 18 years in four provinces of the China Children and Lactating Women Nutrition and Health Surveillance (CCLWNHS) project were analyzed.Dietary BCAAs intake was calculated using food frequency questionnaires combined with the China Food Composition Table.Differences in the prevalence of dyslipidemia subtypes across different BCAAs intake levels were compared.Logistic regression models were used to assess the association between BCAAs and dyslipidemia, and multiplicative interaction models were employed to evaluate the effects of interactions between BCAAs and age, sex, or body mass index (BMI) on dyslipidemia. Results Among the participants, 9,389 were in the normal control group, while 1 630 had dyslipidemia, including 470 cases of hypercholesterolemia.The hypercholesterolemia prevalence was significantly higher in the high total BCAAs and high BCAAs density groups compared to the low-intake groups (χ²=9.554, 18.109, P<0.01).Stratified analysis showed that, compared to the low-intake group, the high BCAAs intake group (OR=1.781, 95% CI: 1.326 - 2.391) and high BCAAs density group (OR=2.011, 95% CI: 1.493 - 2.708) had increased hypercholesterolemia risk in the normal-weight subgroup (P<0.05).Compared to the low-intake group, females in the high BCAAs intake group (OR=1.721, 95% CI: 1.243 - 2.384) and high BCAAs density group (OR=1.899, 95% CI: 1.361 - 2.651) also exhibited elevated hypercholesterolemia risk (P<0.05).In the 6 - 12 age group, high BCAAs intake was associated with increased hypercholesterolemia risk (OR=1.447, 95% CI: 1.100 - 1.905) compared to the low-intake group, while high BCAAs density elevated hypercholesterolemia risk across all age groups (6 - 12 years old OR=1.636, 95% CI: 1.242 - 2.155; 13-18 years old OR=1.881, 95% CI: 1.170 - 3.024) (P<0.05).A significant interaction effect was observed between BCAAs density and BMI on hypercholesterolemia risk (P=0.027).Mediation analysis revealed heterogeneous mediating effects of BMI on the relationship among total BCAAs intake, BCAAs density, and hypercholesterolemia risk. Conclusions Increased BCAAs intake is an independent risk factor for hypercholesterolemia.Adjusting dietary patterns by reducing red meat and processed meat consumption to limit BCAAs intake may lower the risk of hypercholesterolemia.

Key words: branched-chain amino acids, dyslipidemia, cholesterol, hypercholesterolemia, metabolic diseases, children and adolescents

中图分类号:

R179

陈垚, 刘长青, 朱谦让, 刘怡娅, 田美娜, 王宏伟, 于连龙. 膳食支链氨基酸对儿童青少年血脂异常的影响[J]. 中国儿童保健杂志, 2025, 33(10): 1101-1107.

CHEN Yao, LIU Changqing, ZHU Qianrang, LIU Yiya, TIAN Meina, WANG Hongwei, YU Lianlong. Effect of dietary branched-chain amino acids on dyslipidemia in children and adolescents[J]. Chinese Journal of Child Health Care, 2025, 33(10): 1101-1107.

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膳食支链氨基酸对儿童青少年血脂异常的影响

Effect of dietary branched-chain amino acids on dyslipidemia in children and adolescents

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