南宁地区儿童青少年肥胖与代谢综合征相关性的流行病学研究

Epidemiological study on the association between obesity with metabolic syndrome in obesechildren and adolescents of Nanning city, Guangxi

目的分析儿童青少年肥胖与代谢综合征（MS）相关性及危险因素。方法采用分层整群随机抽样方法从南宁市396所中小学抽取14所学校6—18岁中小学生7893人，进行体格检查及空腹血糖（FBG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、丙氨酸氨基转移酶（hLT）、天门冬氨酸氨基转移酶（AST）、空腹胰岛素（FINS）的血液生化检测，并计算胰岛素抵抗指数（HOMA-IR）。结果（1）MS患病率为正常组0．57％、超重组4．53％、肥胖组26．80％。（2）除HDL-C均值随肥胖增加而降低外，其余各指标均值、异常率比较均为肥胖组〉超重组〉正常组，3组间差异有统计学意义（P〈0．05）。（3）对MS有影响的指标为腰围（OR=1．087，95％CI：1．033～1．143）、SBP（OR=1．073，95％CI：1．032～1．116）、FBG（OR=1．394，95％CI：1．568～3．423）、TG（OR=3．213，95％CI：1．410-7．319）、HDL．C（OR=0．001，95％CI：O．000-0．012）。结论儿童青少年MS与肥胖密切相关，其患病率和危险因素随着肥胖程度的加重而增加。

Objective To investigate the association between obesity and prevalence ofmetabolic syndrome （MS） with its associated risk factors, in children and adolescents. Methods A stratified random sampling method was used to select 7893 students from 6 to 18 years of age from 14 out of 396 primary and secondary schools in Nanning city. All the students had undergone physical examination and blood tests including the following risk factors related to metabolic syndrome： fasting blood glucose （FBG） , total cholesterol （TC） , triglycerides （TG） , high-density lipoprotein cholesterol （HDL-C） , low density lipoprotein cholesterol （LDL-C） , alanine amino shift enzyme （ALT）, aspartic acid amine shift enzyme （AST） and fasting insulin （FINS）. The homeostasis model assessment insulin resistance index （HOMA-IR） was also measured. Results （1） The prevalence rate of MS in normal group was 0.57%. In both the overweight and obesity groups, the prevalence rates of MS were 4.53% and 26.80%, respectively. （2）These indices in obesity group were higher than other two groups （P〈0.05）. The result of overweight group was higher than normal group （P〈0.05）. （3） Waist circumference （OR= 1.087,95%CI： 1.033-1.143）, SBP （OR= 1.073,95%CI： 1.032-1.116）, FBG（OR=l.394, 95%CI： 1.568-3.423）, TG（OR=3.213,95%CI： 1.410-7.319） and HDL-C （OR= 0.001,95%CI： 0.000-0.012）were detecting indices which had statistically significant with MS in binary logistic regression analysis. Conclusion Metabolic syndrome and obesity were closely related in children and adolescents while its prevalence and risk factors increased with the severity of obesity.