学龄儿童内脏脂肪面积与尿酸的相关性研究

Correlation between visceral fat area and uric acid in school-age children

目的探讨学龄儿童内脏脂肪面积与尿酸水平的关联,为预防儿童高尿酸血症(HUA)提供依据。方法研究对象来自"儿童青少年心血管与骨健康促进项目"于2019年11月—2020年1月进行的随访调查,最终纳入8~18岁儿童青少年10 609人进行分析。内脏脂肪面积(VFA)与各心血管代谢指标间的关联采用Spearman相关性分析。根据BMI和VFA诊断的肥胖与否将体型划分为4组,多因素Logistic回归分析不同肥胖类型与HUA的关联,并调整年龄、血压、血糖、血脂等潜在混杂因素。结果 VFA在生长发育进程中逐渐增加,并存在性别差异。男女童VFA与尿酸水平均呈正相关关系(r=0.399、0.375,P<0.001),BMI评价的非超重、超重、肥胖组HUA患病率依次升高(男童依次为28.9%、43.5%和52.1%,女童依次为6.0%、15.9%和32.4%),VFA评价的肥胖组HUA患病率显著高于非肥胖组(男童:57.5%vs. 33.7%;女童:31.6%vs. 7.7%;P<0.001)。在调整了年龄、血压、血糖、血脂等混杂因素后,男童单纯腹型肥胖组HUA风险较非肥胖组增加1.70倍(OR=2.70, 95%CI:1.36~5.35),女童混合型肥胖组的HUA风险较非肥胖组增加3.74倍(OR=4.74, 95%CI:3.77~5.95)。结论儿童VFA与血尿酸水平密切相关,在健康体检中加入体成分分析可以早期发现儿童肥胖,对防控儿童HUA也具有重要意义。

Objective To explore the correlation between visceral fat area(VFA) and uric acid level in school-age children, so as to provide reference for preventing hyperuricemia(HUA) of children. Methods Data were from school-based cardiovascular and bone health promotion program(SCVBH), and 10 609 children and adolescents aged 8 to 18 years were finally included for analysis. The correlation between VFA and cardiovascular metabolic parameters was analyzed by Spearman correlation analysis. The body type was divided into four groups according to obesity diagnosed by body mass index(BMI) and VFA. The association between different obesity types and HUA was analyzed by multivariate Logistic regression, and the potential confounding factors such as age, blood pressure, blood glucose and blood lipids were adjusted. Results VFA increased gradually with growth and development of children, and the gender difference was significant. VFA was positively correlated with uric acid level in boys and girls(r=0.399, 0.375, P<0.001). The prevalence of HUA increased successively among the non-overweight, overweight and obesity group divided by BMI(28.9%, 43.5% and 52.1% for boys, 6.0%, 15.9% and 32.4% for girls, respectively). The prevalence of HUA in the obesity group evaluated by VFA was significantly higher than that in the non-overweight group(57.5% vs. 33.7% for boys, 31.6 % vs. 7.7 % for girls, P <0.001). After adjusting the confounding factors such as age, blood pressure, blood glucose and blood lipid, the ORs and 95%CIs of risk for HUA were 2.70(95%CI: 1.36-5.35) in boys with simple abdominal obesity.and 4.74(95%CI:3.77-5.95) in girls with mixed obesity. Conclusions VFA is closely related to uric acid levels in children. Body composition analysis in health examination can early detect obesity in children, which is also of great significance for prevention and control of HUA in children.