儿童期慢性病相关指标与超重肥胖关系

Correlations between relevant indexes of chronic diseases and overweight and obesity in childhood

目的探讨儿童期慢性病相关指标与超重肥胖关系,为预防和减少成年后慢性病的发生提供科学依据。方法采用分层整群随机抽样法,随机抽取江苏省无锡市3个地区的10-14岁儿童共2 870人,测量身高、体重和血压,并从中抽取300名儿童采血,检测相关生化指标。结果儿童超重和肥胖检出率分别为11.39%和2.23%,男生超重和肥胖检出率为14.77%和2.41%,高于女生的4.24%和1.85%,差异有统计学意义（P〈0.01）;超重和肥胖组收缩压为（102.64±10.36）和（104.05±12.80）mmHg,均高于正常组的（99.72±10.18）mmHg,差异有统计学意义（P〈0.05）;肥胖组高密度脂蛋白为（1.30±0.20）mmol/L,低于正常组的（1.57±0.33）mmol/L,肥胖组甘油三酯、载脂蛋白B、胰岛素、C肽、胰岛素抵抗指数分别为（1.25±0.60）mmol/L（0.83±0.22）mmol/L、（17.97±8.44）mU/L、（0.75±0.43）pmol/mL、（3.96±2.22）,均高于正常组的（0.80±0.31）mmol/L、（0.68±0.11）mmol/L、（11.19±6.04）mU/L、（0.35±0.20）pmol/mL和（2.36±1.33）,差异均有统计学意义（均P〈0.05）;肥胖引起胰岛素抵抗的OR值为5.77（95%CI=1.41-23.69）,而超重OR值为1.03（95%CI=0.36-2.97）,肥胖更容易引起胰岛素抵抗。结论无锡市10-14岁儿童超重和肥胖流行情况处于中国富裕乡村和中小城市之间,肥胖是引起儿童血压偏高、影响糖代谢和脂质代谢的一个重要危险因素。

Objective To evaluate associations of relevant indexes of chronic diseases with overw eight and obesity in childhood and to provide scientific evidences for the prevention of chronic diseases in adulthood. Methods With stratified cluster random sampling,2 870 children aged 10 to 14 years in three districts of Wuxi,Jiangsu province were selected and their height,weight,and blood pressure were measured. And 300 blood samples were collected from some of the children and the relevant biochemical indexes were detected. Results The prevalence rates of overw eight and obesity in the children were 11. 39% and 2. 23%,respectively. The prevalence rates of overw eight and obesity of the boys were14. 77% and 2. 41% and significantly higher than those of the girls（4. 24% and 1. 85%,P 〈0. 01）. The average systolic blood pressures of overw eight and obese children were 102. 64 ± 10. 36 and 104. 05 ± 12. 80 mmHg,respectively,and were significantly higher than that of the children with normal body weight（99. 72 ± 10. 18 mmHg,P〈0. 05）. The concentration of high density lipoprotein-cholesterol（HDL-C） in the obese children was 1. 30 ± 0. 20 mmol/L,which was significantly low er than that of normal children（1. 57 ± 0. 33 mmol/L）. Compared to the children with normal body weight,the obese children had higher concentrations of triglyceride（TG）（1. 25 ± 0. 60 vs. 0. 80 ± 0. 31 mmol/L）,apolipoprotein B（Apo B）（0. 83 ± 0. 22 vs. 0. 68 ± 0. 11 mmol/L）,insulin（17. 97 ± 8. 44 vs. 11. 19 ± 6. 04 mU/L）,c-peptide（C-P）（0. 75 ± 0. 43 vs. 0. 35 ± 0. 20 pmol/mL）,and insulin resistance index（3. 96 ± 2. 22 vs. 2. 36 ± 1. 33）（all P〈0. 05）. In addition,the overw eight children had an increased risk（odds ratio [OR]= 1. 03,95% confidence interval[95% CI]：0. 36-2. 97） and the obese children had a significantly increased risk（OR = 5. 77,95% CI：1. 41-23. 69） of insulin resistance. Conclusion The prevalence level of overw eight and obesity in the children aged 10 to 14 years in Wuxi city was betw een those in the children living in rich rural areas and in small or middle-sized cities in China. Obesity is an important influencing factor for high blood pressure and glucose and lipid metabolism among the children.