上海市安亭地区7-12岁学龄儿童末梢血血脂水平及其影响因素的现况调查

Survey on peripheral blood lipid levels and the influencing factors among school-age children in Shanghai Anting District

目的分析上海市安亭地区7~12岁学龄儿童末梢血血脂4项水平及其相关影响因素,为学龄期儿童心血管疾病预防及相关部门制定血脂水平的正常参考值标准范围提供流行病学依据。方法采用分层整群抽样的方法,随机选取上海市安亭镇2所小学7~12岁的学生共1018名(男性519名,女性499名),采用指尖血测定三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin,LDL-C)和高密度脂蛋白胆固醇(high density lipoprotein cholesterin,HDL-C)水平,分析上海地区学龄儿童血脂水平及异常率,结合体格检查及调查问卷,进一步分析影响血脂异常的潜在危险因素。结果7~12岁学龄儿童正常参考临界点TG(95百分位数,P_(95))=2.40 mmol/L,TC(P_(95))=4.88 mmol/L,HDL-C(P 5)=1.13 mmol/L,LDL(P_(95))=2.91 mmol/L,男生和女生之间分布差异无统计学意义(P>0.05);HDL水平与年龄分布存在负相关(P<0.05)。根据本研究得出的血脂异常增高切点,研究人群血脂异常增高发生率为16.8%,95%CI:14.6%~19.0%);Logistic回归分析结果显示体质量指数超重[OR:1.92,95%CI:1.19~3.09)、过期产儿(OR:2.578,95%CI:1.151~5.773)、肥胖家族史(OR:1.545,95%CI:1.033~2.310)和被动吸烟(OR:2.310,95%CI:1.348~3.957)是儿童脂代谢紊乱的独立危险因素,午休(OR:0.571,95%CI:0.341~0.958)是儿童脂代谢紊乱的独立保护因素。结论本研究初步探讨了上海市安亭地区7~12岁学龄儿童血脂水平正常参考值及相关危险因素,后续工作中应加强肥胖干预,密切关注有肥胖家族史儿童,适时户外运动,合理规避血脂异常危险因素,以便早期预防,早期干预。

Objective To survey the peripheral blood lipid levels and the influencing factors among school-age children in Anting District of Shanghai.Methods A total of 1018 students(519 males and 499 females)aged 712 years from 2 primary schools in Anting town of Shanghai were selected with stratified cluster sampling method.The fingertip blood samples were collected,the blood levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were measured.The physical examination was performed and questionnaires were used to collected baseline data.Logistic regression was used to analyze the independent risk factors of high level of blood lipids.Results The cut-off values of TG,TC,HDL-C and LDL(the 95 percentile,P 95)were 2.40 mmol/L,4.88 mmol/L,1.13 mmol/L and 2.91 mmol/L,respectively;and there was no significant difference between males and females(P>0.05).HDL was negatively correlated with age distribution(P<0.05).According to the cut-off point of this study,the overall detection rate of dyslipidemia was 16.8%(95%CI:14.6%19.0%).Logistic regression analysis showed that overweight(OR=1.558,95%CI:1.0822.242),overdue birth(OR=2.578,95%CI:1.1515.773),family history of obesity(OR=1.545,95%CI:1.0332.310),and passive smoking(OR=2.310,95%CI:1.3483.957)were independent risk factors;while napping(OR=0.571,95%CI:0.3410.958)was the protective factor for dyslipidemia in school children.Conclusion This study shows risk factors of dyslipidemia in school-age children in Shanghai Anting Town,indicating that the intervention measures should be strengthened to reduce risk factors of dyslipidemia in school children.