济南市儿童青少年不同肥胖类型与代谢异常的关系

Association between obesity types and metabolic abnormality in children and adolescents in Jinan

目的探讨儿童青少年不同肥胖类型与代谢异常的关系,为儿童青少年心血管病危险因素的防制提供科学依据。方法选取济南市城区1 170名7~17岁儿童青少年,测量身高、体重、腰围(WC)和血压,同时测定空腹血糖、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等血生化指标,分析不同肥胖类型与代谢异常的关系。结果儿童青少年各类生化指标平均水平(血糖、总胆固醇除外)和代谢异常检出率(高血糖除外)在不同肥胖类型组的差异均有统计学意义(P值均<0.05),且表现为复合型肥胖组>全身性肥胖或中心性肥胖组>体质量指数(BMI)和WC均正常组。以BMI与WC均正常为对照组,任意肥胖类型组以及复合型肥胖组罹患各类代谢异常的风险均较高。以预测代谢异常≥2个为例,任意肥胖类型的风险OR值为1.50(95%CI=0.78~2.90),复合型肥胖的风险OR值为7.84(95%CI=5.00~12.30)。结论在学生体检工作中,应联合使用BMI和WC来判定儿童肥胖,从而更有效地防控儿童青少年心血管病危险因素。

Objective To examine the relationship between obesity types and metabolic abnormality,and to provide scientific evidence for prevention and control of cardiovascular diseases in children and adolescents.Methods A total of 1 170 children and adolescents aged 7-17 years from urban area of Jinan were included in this study.Height,weight,waist circumference（WC）and blood pressure were measured,and the fasting plasma glucose（FPG）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,and low-density lipoprotein cholesterol（LDL-C） were also measured to analyze the relationship between different obesity types and metabolic disorders.Results There were statistical differences in various kinds of biochemical indicators（except for FPG and TC） and the prevalence of metabolism disorders（except for abnormal glucose metabolism） between three groups based on status of body mass index（BMI） and WC（P〈0.05）,significantly highest in the composite obesity group,moderate increased in general obesity or central obesity group,and lowest in normal BMI and WC group.Compared with normal BMI and WC group,the other two groups had higher risk of metabolic disorders.In predicting at least two metabolic disorders,for example,the odds ratio（OR） of general or central obesity was only 1.50（95% CI=0.78-2.90）,the OR of composite obesity was 7.84（95% CI=5.00-12.30）.Conclusion BMI and WC should be combined to determine obesity status in child and adolescent physical examination,more effectively prevent and control cardiovascular risk factors in this population.