中国六省学龄儿童体重指数、体脂百分比评价肥胖与心血管代谢危险因素的相关性

Association of obesity classified by body mass index and fat mass percentage with cardiometabolic risk factors among school-age children in 6 provinces,China

目的探讨单纯体重指数(BMI)、体脂百分比(FMP)分类肥胖及二者交叉分组与心血管代谢危险因素的关联,为儿童肥胖及相关代谢异常的防控提供依据。方法基于在6省(黑龙江、内蒙古、宁夏、四川、云南和湖南)完成的横断面调查,选取10~18岁的学龄儿童11542人为研究对象。分别以[BMI(+-)]和[FMP(+-)]单独或交叉分类肥胖状况分组,采用Logistic回归模型分析比较心血管代谢危险因素异常的风险。结果不调整腰围(WC)的影响,[BMI(-)+FMP(+)]组低高密度脂蛋白胆固醇(HDL-C)和血糖升高风险较低,其余各组与肥胖相关代谢异常的关联较高。调整WC后,男生中[BMI(+)+FMP(+)]组高三酰甘油(TG)[OR(95%CI):2.55(1.29~5.02)]、合并血脂异常[OR(95%CI):2.07(1.19~3.61)]和血压升高[OR(95%CI):2.20(1.29~3.77)]的风险较高。女生中[BMI(+)+FMP(+)]组合并血脂异常[OR(95%CI):2.02(1.09~3.74)]的风险较高。结论结合FMP对儿童肥胖评价可提高对血脂异常和血压升高的筛查效果。

Objective To explore the association of obesity classified by body mass index(BMI),body fat mass percentage(FMP)and the cross-grouping of BMI and FMP with cardiometabolic risk factors,so as to provide basis for the prevention and control of childhood obesity and related metabolic abnormalities.Methods Based on the cross-sectional data of the survey in China completed in 6 provinces(Heilongjiang,Inner Mongolia,Ningxia,Sichuan,Yunnan and Hunan),11542 school-age children aged 10 to 18 were selected as the research subjects.The obesity status was classified separately or cross-classified by BMI and FMP,and the Logistic regression model was used to analyze and compare the risks of cardiometabolic risk factors.Results Without adjusting for the waist circumference(WC),the group[BMI(-)+FMP(+)]had a lower risk of elevated low high-density lipoprotein cholesterol(HDL-C)and elevated blood glucose,however,the other groups had a higher risk of obesity-related metabolic abnormalities.After adjusting for WC,the[BMI(+)+FMP(+)]group had a higher risk of high triglycerides(TG)[OR(95%CI):2.55(1.29-5.02)],dyslipidemia[OR(95%CI):2.07(1.19-3.61)]and elevated fasting blood pressure[OR(95%CI):2.20(1.29-3.77)]among boys.Among girls,the[BMI(+)]and[FMP(+)]group had a higher risk of dyslipidemia[OR(95%CI):2.02(1.09-3.74)].Conclusion It is necessary to add FMP when assessing child obesity to screen for the risk of dyslipidemia and elevated blood pressure.