儿童青少年体成分与肺通气功能的相关性研究

Association Between Body Composition and Ventilatory Function Among Children and Adolescents

目的 探讨体脂、瘦体重等体成分指标以及脂肪分布模式与肺通气功能的相关性,为儿童青少年生长发育研究提供依据。方法 对525名6-18岁儿童青少年测定身高、体重、腰围、臀围,运用生物电阻抗（BIA）测定体脂百分含量、瘦体重含量等体成分指标,同时测试肺通气功能指标。采用协方差分析男女儿童不同的体脂、BMI和腰臀比水平时通气功能指标的变化情况,逐步回归分析年龄、身高、体成分及其分布指标等对肺通气功能的影响。结果 控制年龄后,男女儿童青少年随体脂百分含量、BMI和腰臀比的上升,肺活量指数和单位面积最大通气量（MVV）均呈下降趋势。男生肺活量指数与BMI、腰围和体脂百分含量呈负相关,用力肺活量（FVC）、第1秒用力呼出量（FEV1）和最大通气量（MVV）与身高和瘦体重呈正相关,MVV与腹部皮脂厚度负相关,单位面积MVV与体脂百分含量和腹部皮脂厚度负相关;女生肺活量指数与BMI、上臂皮脂厚度负相关;FVC,FEV1,MVV和单位面积MVV、年龄及身高正相关,单位面积MVV还与上臂皮脂厚度呈负相关。结论 体脂含量增加会对通气功能产生负性作用,中心性体脂分布对通气功能会产生一定影响,尤其是男生。

Objective To explore the effects of body composition and distributed patterns of body fat on ventilatory function among children and adolescents and to provide evidence for related research. Methods Ventilatory function tests such as forced vital capacity（FVC）, vital capacity index（ FVC/ weight）, forced expiratory volume in Is（FEV1）, FEV1%, maximal voluntary ventilation（MVV）, MVV per body area（MVV/BSA） were performed in 525 children and adolescents. Percentages of body fat and lean body weight were measured by BIA. Covariance analysis was conducted to examine the change of pulmonary variables under different levels of body fat, BMI and waist-to-hip ratio（WHR）. Stepwise multiple regression models were constructed to examine the effect of age, height and body composition on ventilatory function. Results After controlling for age, FVC/weight and MVV/BSA both declined with the increasing PBF, BMI and WHR. In boys, FVC/weight negatively associated with BMI, waist circumference and PBF, FVC, FEVz and MW positively associated with height and LBW; MVV showed negative associations with abdominal SFs, and MVV/BSA showed negative associations with abdominal SFs and PBF. In girls, FVC/weight negatively associated with BMI and triceps SFs, FVC, FEV1, MW and MVV/BSA positively associated with age and height, MVV/BSA negatively associated with triceps SFs. Conclusion The increasing fat mass negatively affects ventilatory function, for the ventilatory function decline with the increasing fat mass and showed negative association with BMI and PBF, especially in boys. The negative association between WHR and ventilatory function in boys illuminated that central fat distribution may affect their ventilatory function.