体质量指数和腰围与肥胖儿童心血管危险因素关系的研究

The relationship between body mass index,waist circumference and cardiovascular risk factors in obese children

目的探讨体质量指数(BMI)、腰围与肥胖儿童心血管危险因素的关系。方法回顾性分析2001年1月至2005年12月在上海交通大学医学院附属仁济医院肥胖病专科门诊就诊的6~18(11.8±3.0)岁患儿283例,其中男179例(11.4±3.0)岁,女104例(12.3±3.0)岁,测体重、身高、腰围、臀围、血压、血清总三酰甘油(甘油三酯,TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C),并计算BMI和腰臀比。结果283例患儿血脂水平异常147例(51.9%),其中1项指标异常100例,2项异常34例,3项异常和4项全部异常为11例和2例。131例患儿TG升高,42例TC升高,HDL-C降低和LDL-C升高分别为20例和17例。283例患儿中高血压131例(46.3%),收缩压(SP)增高112例,舒张压(DP)增高88例,69例两者均增高。校正年龄和性别后,BMI与血清TG水平正相关(r=0.13,P<0.05)。腰围不仅与血清TG水平呈正相关(r=0.21,P<0.01),还与血清HDL-C负相关(r=-0.14,P<0.05)。腰围与血脂紊乱程度也呈正相关,而BMI则无类似关系。BMI和腰围均与SP、DP呈正相关。腰围异常患儿SP、DP和血清TG明显增高,而HDL-C明显降低。高血压组儿童腰围、血清TC、LDL-C水平明显高于血压正常组儿童。结论肥胖儿童易并发脂质代谢紊乱和高血压等心血管危险因素。BMI和腰围与肥胖儿童心血管危险因素关系密切。不同年龄、性别,腰围第95百分位值可作为腰围正常与否的临界点。

Objective To evaluate the relationship between body mass index （BMI）, waist circumference and cardiovascular risk factors in obese children. Methods A total of 283 children aged 6 - 18 years were recruited from our obesity ore-patient service from January 2001 to December 2005,179 [ （ 11.4 ± 3.0 ） years ] of whom were boys and the others were girls [ （12. 3 ± 3.0）years]. Body weight, height, waist circumference and hip circumference were recorded for each child. Serum TG,TC,HDL-C and LDL-C were measured after 12h fasting. R^ults Totally 147 of 283 children were diagnosed as with dyslipidemia （51.9% ）. Children with one, two, three or four abnormal lipid indexes were 100,34,11 and 2 respectively;131 children were observed with elevation of TG and elevation of TC was appeared in 42 children. Increase of LDL-C was found in 17 children,while decrease of HDL-C was found in 20 children;131 of 283 children was diagnosed as with hypertension, among whom 112 and 88 children were found with increase of systolic pressure and diastolic pressure. The increase of beth systolic and diastolic pressure was found in 69 children. Controlled for age and gender, there was a positive relationship between BMI and serum TG （ r = 0. 13, P 〈 0. 05 ）. Waist circumference showed not only a positive relationship with serum TG, but also a negative relationship with serum HDL-C （ r = -0. 14, P 〈 0. 05 ）. Waist circumference showed a positive relationship with the degree of dyslipidemia,while BMI had no similar relationship. BMI and waist circumference showed positive relationship with systolic and diastolic pressure. Waist circumference, SP,DP, and serum TG were higher while HDL-C was lower in children with abnormal waist circumference. Waist circumference, serum TC, and LDL-C were higher in children with high blood pressure than those in normal blood pressure chil -dren. Conclusion Dyslipidemia and high blood pressure are common in obese children. Both BMI and waist circumfer- ence show a positive correlation with cardiovascular risk factors. The probable cutoff point for abnormal waist circumference is 95th percentile by age and gender.