中国六省学龄儿童体重指数、体脂百分比评价肥胖与心血管代谢危险因素的相关性

刘军廷, 么鸿雁, 于石成, 刘剑君, 朱广瑾, 韩少梅, 徐涛

中国儿童保健杂志 ›› 2022, Vol. 30 ›› Issue (5) : 469-474.

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中国儿童保健杂志 ›› 2022, Vol. 30 ›› Issue (5) : 469-474. DOI: 10.11852/zgetbjzz2021-1752
科研论著

中国六省学龄儿童体重指数、体脂百分比评价肥胖与心血管代谢危险因素的相关性

  • 刘军廷1,2, 么鸿雁1, 于石成1, 刘剑君1, 朱广瑾3, 韩少梅4, 徐涛4
作者信息 +

Association of obesity classified by body mass index and fat mass percentage with cardiometabolic risk factors among school-age children in 6 provinces, China

  • LIU Jun-ting*, YAO Hong-yan, YU Shi-cheng, LIU Jian-jun, ZHU Guang-jin, HAN Shao-mei, XU Tao
Author information +
文章历史 +

摘要

目的 探讨单纯体重指数(BMI)、体脂百分比(FMP)分类肥胖及二者交叉分组与心血管代谢危险因素的关联,为儿童肥胖及相关代谢异常的防控提供依据。方法 基于在6省(黑龙江、内蒙古、宁夏、四川、云南和湖南)完成的横断面调查,选取10~18岁的学龄儿童11 542人为研究对象。分别以[BMI(+-)]和[FMP(+-)]单独或交叉分类肥胖状况分组,采用Logistic回归模型分析比较心血管代谢危险因素异常的风险。结果 不调整腰围(WC)的影响,[BMI(-)+FMP(+)]组低高密度脂蛋白胆固醇(HDL-C)和血糖升高风险较低,其余各组与肥胖相关代谢异常的关联较高。调整WC后,男生中 [BMI(+)+FMP(+)]组高三酰甘油(TG)[OR(95%CI):2.55(1.29~5.02)]、合并血脂异常[OR(95%CI):2.07(1.19~3.61)]和血压升高[OR(95%CI):2.20(1.29~3.77)]的风险较高。女生中[BMI(+)+FMP(+)]组合并血脂异常[OR(95%CI):2.02(1.09~3.74)]的风险较高。结论 结合FMP对儿童肥胖评价可提高对血脂异常和血压升高的筛查效果。

Abstract

Objective To explore the association of obesity classified by body mass index (BMI), body fat mass percentage (FMP) and the cross-grouping of BMI and FMP with cardiometabolic risk factors, so as to provide basis for the prevention and control of childhood obesity and related metabolic abnormalities. Methods Based on the cross-sectional data of the survey in China completed in 6 provinces (Heilongjiang, Inner Mongolia, Ningxia, Sichuan, Yunnan and Hunan), 11 542 school-age children aged 10 to 18 were selected as the research subjects. The obesity status was classified separately or cross-classified by BMI and FMP, and the Logistic regression model was used to analyze and compare the risks of cardiometabolic risk factors. Results Without adjusting for the waist circumference (WC), the group [BMI(-)+FMP(+)] had a lower risk of elevated low high-density lipoprotein cholesterol (HDL-C) and elevated blood glucose, however, the other groups had a higher risk of obesity-related metabolic abnormalities. After adjusting for WC, the [BMI(+)+FMP(+)] group had a higher risk of high triglycerides(TG) [OR(95%CI):2.55 (1.29 - 5.02)], dyslipidemia [OR(95%CI):2.07 (1.19 - 3.61)] and elevatedfasting blood pressure [OR(95%CI):2.20 (1.29 - 3.77)] among boys. Among girls, the [BMI(+)] and [FMP(+)] group had a higher risk of dyslipidemia [OR(95%CI):2.02(1.09 - 3.74)]. Conclusion It is necessary to add FMP when assessing child obesity to screen for the risk of dyslipidemia and elevated blood pressure.

关键词

肥胖 / 体脂百分比 / 心血管代谢危险因素 / 学龄儿童

Key words

obesity / fat mass percentage / cardiometabolic risk factors / school-age children

引用本文

导出引用
刘军廷, 么鸿雁, 于石成, 刘剑君, 朱广瑾, 韩少梅, 徐涛. 中国六省学龄儿童体重指数、体脂百分比评价肥胖与心血管代谢危险因素的相关性[J]. 中国儿童保健杂志. 2022, 30(5): 469-474 https://doi.org/10.11852/zgetbjzz2021-1752
LIU Jun-ting, YAO Hong-yan, YU Shi-cheng, LIU Jian-jun, ZHU Guang-jin, HAN Shao-mei, XU Tao. Association of obesity classified by body mass index and fat mass percentage with cardiometabolic risk factors among school-age children in 6 provinces, China[J]. Chinese Journal of Child Health Care. 2022, 30(5): 469-474 https://doi.org/10.11852/zgetbjzz2021-1752
中图分类号: R179   

参考文献

[1] Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013:A systematic analysis for the Global Burden of Disease Study 2013[J]. Lancet (London, England), 2014, 384(9945):766-781.
[2] Ittermann T, Werner N, Lieb W, et al. Changes in fat mass and fat-free-mass are associated with incident hypertension in four population-based studies from Germany[J]. Int J of Cardiology, 2019, 274:372-377.
[3] Han TS, Al-gindan YY, Govan L, et al. Associations of body fat and skeletal muscle with hypertension[J]. J of Clin Hypertens, 2019, 21(2):230-238.
[4] Lee HT, Shin J, Min SY, et al. The relationship between bone mineral density and blood pressure in the Korean elderly population:the Korea National Health and Nutrition Examination Survey, 2008-2011[J]. Clin Exp Hypertens, 2015, 37(3):212-217.
[5] Hu G, Bouchard C, Bray GA, et al. Trunk versus extremity adiposity and cardiometabolic risk factors in white and African American adults[J]. Diabetes Care, 2011, 34(6):1415-1418.
[6] Kobo O, Leiba R, Avizohar O, et al. Relative fat mass is a better predictor of dyslipidemia and metabolic syndrome than body mass index[J]. Cardiovasc Endocrinol & Metab, 2019, 8(3):77-81.
[7] Liao YY, Chu C, Wang Y, et al. Association of body mass index changes from childhood to adulthood with dyslipidemia in adults:Hanzhong adolescent cohort study[J]. J Public Health, 2021,43(4):780-788.
[8] Mizuno TM. Fat Mass and Obesity Associated (FTO) gene and hepatic glucose and lipid metabolism[J]. Nutrients, 2018, 10(11):1600.
[9] Ramos RB, Casanova GK, Maturana MA, et al. Variations in the fat mass and obesity-associated (FTO) gene are related to glucose levels and higher lipid accumulation product in postmenopausal women from southern Brazil[J]. Fertil Steril, 2011, 96(4):974-979.
[10] Ghachem A, Lagacé JC, Brochu M, et al. Fat-free mass and glucose homeostasis:is greater fat-free mass an independent predictor of insulin resistance?[J]. Aging Clin Exp Res, 2019, 31(4):447-454.
[11] Moon SS. Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population:the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010[J]. Endocr J, 2014, 61(1):61-70.
[12] Lurbe E, Torro MI, Alvarez-pitti J, et al. Uric acid is linked to cardiometabolic risk factors in overweight and obese youths[J]. J Hypertens, 2018, 36(9):1840-1846.
[13] Kuwabara M, Kuwabara R, Niwa K, et al. Different risk for hypertension, diabetes, dyslipidemia, and hyperuricemia according to level of body mass index in japanese and American subjects[J]. Nutrients, 2018, 10(8):1011.
[14] Mechanick JI, Hurley DL, Garvey WT.Adiposity-based chronic disease as a new diagnostic term:the american association of clinical endocrinologists and american college of endocrinology position statement[J]. Endocr Pract,2017, 23(3):372-378.
[15] 中国肥胖问题工作组. 中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J]. 中华流行病学杂志,2004,25(2):97-102.
[16] 中华儿科杂志编辑委员会,中华医学会儿科学分会儿童保健学组,中华医学会儿科学分会心血管学组,等. 儿童青少年血脂异常防治专家共识[J]. 中华儿科杂志,2009,47(6):426-428.
[17] 中华医学会儿科学分会内分泌遗传代谢学组,中华医学会儿科学分会心血管学组,中华医学会儿科学分会儿童保健学组,等. 中国儿童青少年代谢综合征定义和防治建议[J]. 中华儿科杂志,2012,50(6):420-422.
[18] 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.
[19] Alberti KGMM, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome:A joint interim statement of the international diabetes federation task force on epidemiology and prevention; National heart, lung, and blood institute; American heart association; World heart federation; International atherosclerosis society; and International association for the study of obesity[J]. Circulation, 2009, 120(16):1640-1645.
[20] 米杰,王天有,孟玲慧,等. 中国儿童青少年血压参照标准的研究制定[J]. 中国循证儿科杂志,2010,5(1):4-14.
[21] Chen Y, Liang X, Zheng S, et al. Association of body fat mass and fat distribution with the incidence of hypertension in a population-based chinese cohort:A 22-year follow-up[J]. J Am Heart Assoc, 2018, 7(6):e007153.
[22] Afshin A, Forouzanfar MH, Reitsma MB, et al. Health effects of overweight and obesity in 195 countries over 25 years[J].NEJM, 2017, 377(1):13-27.
[23] Wang Y, Zhao L, Gao L, et al. Health policy and public health implications of obesity in China[J].Lancet Diabetes Endo, 2021, 9(7):446-461.
[24] Romero-corral A, Somers VK, Sierra-johnson J, et al. Normal weight obesity:a risk factor for cardiometabolic dysregulation and cardiovascular mortality[J]. Eur Heart J, 2010, 31(6):737-746.
[25] 肖培. 中国七城市儿童青少年血脂异常的流行特征与适宜诊断切点研究[D]. 北京:北京协和医学院(清华大学医学部)&中国医学科学院,2020.
[26] 张敏陆. 血脂异常与代谢综合征[J]. 中华心血管病杂志, 2003, 31(12):958-960.
[27] 肖培,程红,郁兆仓,等. 基于体脂肪的肥胖评估指标在学龄儿童持续性血脂异常筛查中的应用[J]. 中华流行病学杂志,2020,41(12):2066-2071.
[28] 徐仁应,周一泉,张晓敏,等. 体脂肪含量与儿童青少年高血压关系[J]. 临床儿科杂志,2018,36(7):481-485.
[29] 谌丁艳,王赟,吴宇,等. 深圳市中小学生血压与体质量指数的关系[J]. 中国学校卫生,2017,38(12):1853-1855.
[30] 陶瑞文,万宇辉,张辉,等. 安徽省儿童青少年高血压与体脂百分比关联性研究[J]. 中华流行病学杂志,2016,37(2):178-182.
[31] Drozdz D, Kwinta P, Korohoda P, et al. Correlation between fat mass and blood pressure in healthy children[J]. Pediatr Nephrol, 2009, 24(9):1735-1740.
[32] Kang S, Kyung C, Park JS, et al. Subclinical vascular inflammation in subjects with normal weight obesity and its association with body fat:An 18 F-FDG-PET/CT study[J]. Cardiovasc Diabetol, 2014, 13:70.
[33] 孙嘉鸿,马传伟,梁亚军,等. 体质指数正常的儿童青少年中腰围对血压偏高的预测作用[J]. 中国儿童保健杂志,2017,25(6):544-547.

基金

北京市医管局青苗人才计划项目 (QML20191302);公共卫生应急反应机制运行(131031001000200001)

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