儿童期代谢指标异常及其聚集性与颈动脉内中膜厚度的关联研究

Association of abnormal metabolic indices and its clustering with carotid intima-media thickness in childhood

目的探讨儿童期代谢指标异常与颈动脉内中膜厚度(cIMT)的关系。方法采用方便整群抽样的方法,以山东省淄博市桓台县某小学为调查点,于2017年11月至2018年1月进行调查,选取了该学校年龄为6~11岁的所有儿童,所有体测指标、问卷调查和血生化指标变量均完整者共计1 240名。采用协方差分析比较不同代谢指标异常组以及其不同聚集性组之间的cIMT的水平,采用多元线性回归模型分析代谢指标聚集性与cIMT的关系。结果 1 240名调查对象年龄为(8.9±1.5)岁,其中男生657名(53.0%)。异常代谢指标中,腹型肥胖检出率最高,男生和女生中检出率分别为30.9%(203/657)和29.7%(173/583);男、女生cIMT分别为(0.49±0.08)和(0.45±0.07)mm。调整性别、年龄、蔬菜水果、碳酸饮料、睡眠时间、视屏时间和体力活动等因素后,腹型肥胖、血压、甘油三酯和空腹血糖偏高等代谢指标异常与cIMT相关(P值均<0.001)。携带0、1、2和≥3个代谢指标异常儿童的cIMT分别为(0.45±0.07)、(0.48±0.08)、(0.50±0.09)和(0.53±0.08)mm,即cIMT随着代谢指标异常项数的增加而升高(P趋势<0.001)。结论腹型肥胖、血压偏高、甘油三酯偏高和空腹血糖偏高及其聚集性与cIMT相关。

Objective To examine the association of abnormal metabolic indexes and its clustering with carotid intima-media thickness (cIMT) in childhood. Methods A convenient sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 240 children who had complete data of questionnaires, physical examinations, and blood biochemical tests were included for analysis. Covariance analysis was used to analyze the association of the single abnormal metabolic indices and its clustering with cIMT. The multivariable linear regression model was used to quantify the relationship between the number of abnormal metabolic indices and cIMT. Results The age of 1 240 children was (8.9±1.5) years, and 657 boys accounted for 53.0%. The highest detection rate of abnormal metabolic indicators was found in abdominal obesity, accounting for 30.9%(203/657) of boys and 29.7%(173/583) girls respectively.The cIMT of boys and girls were (0.49±0.08) and (0.45±0.07) mm, respectively. After adjusting for sex, age, consumption of fruits, vegetables and carbonated drinks, sleep duration, screen time and physical activity, abdominal obesity, elevated blood pressure, total triglyceride and fasting glucose were associated with cIMT (all P values <0.001). Children with 0, 1, 2 and ≥3 abnormal metabolic indicators had cIMT values of (0.45±0.07),(0.48±0.08),(0.50±0.09) and (0.53±0.08) mm, respectively. That was, cIMT values increased with the number of abnormal metabolic indexes (Ptrend<0.001). Conclusion Abdominal obesity, elevated blood pressure, total triglyceride, fasting glucose and clustering of the above factors are associated with cIMT.