初中生超敏C反应蛋白与体质量指数腰围变化间的关系

Association of high-sensitivity C-reactive protein with the increments of BMI and WC in junior high school students

目的观察哈尔滨市初中生体质量指数(body mass index,BMI)、腰围(waist circumference,WC)短期变化情况,探究其与同时期超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)变化的关联,进一步分析hs-CRP预测儿童青少年BMI,WC变化的价值。方法采用方便抽样方法,分层整群抽取哈尔滨市某校六、七年级学生408名,连续2年进行体格检查和血清hs-CRP测定。根据各指标2次测定结果将研究对象分为对照组(正常→正常)、病例组(异常→异常)、好转组(异常→正常)以及进展组(正常→异常)4组。利用无序多分类Logistic回归分析hs-CRP变化对BMI,WC变化的预测价值。结果初中生的超重肥胖率为30.6%。女生BMI增长较男生明显(U=17 358.0,P<0.05)。BMI和WC变化与hs-CRP的变化均呈正相关(P值均<0.05)。"BMI异常→异常"和"WC异常→异常"的发生风险在hs-CRP"正常→异常""异常→正常"和"异常→异常"中均依次增加,分别为"BMI正常→正常"的3.45,5.98和38.84倍;分别为"WC正常→正常"的3.45,4.26和28.50倍。"BMI异常→正常"的发生风险在hs-CRP"异常→正常"时是BMI"正常→正常"的7.70倍。结论哈尔滨市初中生超重肥胖发生率较高,初中女生BMI增长较快,BMI和WC的变化方向与hs-CRP变化方向一致。"hs-CRP变化"对BMI,WC发展有较好的预测价值。

Objective To observe the short-term changes of Body Mass Index(BMI) and Waist Circumference(WC) in junior high school students in Harbin, and to explore its association with the changes of high-sensitivity C-reactive protein(hs-CRP) in the same period. Furthermore, to analyze the value of hs-CRP to predict the BMI and WC changes in children and adolescents. Methods Convenient sampling method was used,and the students in grades 6 and 7 in junior high school in Harbin were selected by stratified clicstering. Physical examination and serum hs-CRP were performed for two consecutive years. According to the results of the two surveys, the subjects were divided into control group(normal → normal), case group(abnormal → abnormal), improved group(abnormal → normal) and progression group(normal → abnormal). The multinomial logistic regression was used to analyze the predictive value of hs-CRP changes for BMI and WC changes. Results The rate of overweight and obesity among samples from junior high school was 30.6%. The increment of BMI in female was more obvious than that in male(U=17 358.0,P<0.05). Both increments in BMI and WC were positively correlated with increments in hs-CRP(P<0.05). The risk of occurrence of "BMI always abnormal" and "WC always abnormal" increased sequentially in hs-CRP "normal → abnormal","abnormal → normal" and "abnormal → abnormal", were 3.45 times, 5.98 times and 38.84 times of "BMI is always normal", respectively;and were 3.45 times, 4.26 times and 28.50 times of "WC is always normal", respectively. The risk of "BMI improvement" was 7.70 times more than that of BMI "always normal" when hs-CRP "abnormal → normal". Conclusion The prevalence of overweight and obesity in junior high school students in Harbin is high. The BMI increases faster in female from junior high school. The trends of change of BMI and WC are consistent with the trend of change of hs-CRP. The "hs-CRP change" has a good predictive value for BMI and WC development.