银川中小学生不同肥胖评价指标与心血管危险因素的关系

Different classification of obesity and its relation with cardiovascular risk among children and adolescents

目的分析银川市学龄儿童青少年不同肥胖定义指标与心血管危险因素的关系,为儿童青少年肥胖及相关心血管疾病的防治提供科学依据。方法采用横断面研究设计,以分层方便整群抽样的方法于2015年抽取银川市6～18岁中小学生1 939名,进行问卷调查、体格检查、体成分检测及实验室检测。结果不同指标体质量指数(BMI)、体脂百分比(FMP)、腰围身高比(WHtR)、腰围(WC)肥胖组的心血管危险因素检出率均高于正常组,差异均有统计学意义(P值均<0.01)。BMI,FMP,WHtR,WC均可预测心血管危险因素的风险(OR值均>1,P值均<0.01),其中BMI和WC预测心血管危险因素的风险分别是正常组的1.46～1.86,1.51～1.91倍,预测效果优于FMP和WHtR。随着心血管危险因素聚集数的增加,BMI与WC肥胖组心血管危险因素≥1项或≥2项的检出风险预测分别是正常组的3.12(2.2～4.3)倍和5.36(3.8～7.5)倍,优于其他不同定义肥胖指标分组组合对心血管危险因素的风险预测。结论不同指标定义肥胖对心血管危险因素的影响存在差异,BMI和WC定义肥胖的心血管危险因素检出高于FMP和WHtR,BIM与WC定义肥胖相结合对心血管危险因素的预测风险较高。

Objective To explore the associations of obesity classified by body mass index（ BMI）,percentage of body fat（ FMP）,waist-to-height ratio（ WHtR）,waist circumference（ WC） with cardiovascular risk among children and adolescents in Yinchuan City. Methods A cross-sectional P〈0pulation-based study was conducted among stratified cluster sampled children and adolescents aged 6-18 years in 2015. A total of 1 939 children and adolescents completed the questionnaire,anthroP〈0metry,body comP〈0sition and laboratory examinations. Results Cardiovascular risk was significantly higher among children with obesity classified through BMI,FMP,and WC,compared with normal weight group（ P〈0.01）. Cardiovascular risk significantly associated with BMI,FMP,WHtR,and WC（ OR 1,P〈0.01）,with BMI and WC showed highest association（ OR = 1.46-1.86 and 1.51-1.91） than FMP and WHtR. Cardiovascular risk factor clustering（ risk factor number ≥1 or ≥2） was about 3.12（ 2.2-4.3） and 5.36（ 3.8-7.5） times higher in BMI and WC obese groups than that of the normal group. Conclusion Different classification of obesity varies in the predictive value of cardiovascular risk. Our results indicate that obesity defined through combination of BMI and waist circumference shows optimal value in prediction of cardiovascular risk,compared with percentage of body fat and waist-to-height ratio in Ningxia children and adolescents.