青少年骨骼肌质量指数与肥胖代谢表型的关系

Relationship between skeletal muscle mass index and metabolic phenotypes of obesity in adolescents

目的 探讨青少年骨骼肌质量指数(skeletal mass index,SMI)与肥胖代谢表型的关系,为青少年肥胖及相关代谢性疾病的防控提供依据。方法 于2017年10月—2020年9月以分层整群随机抽样的方法抽取银川市1 352例12~18岁青少年作为研究对象,并对其进行问卷调查、体格测量、体成分测定和实验室检查。根据代谢异常诊断标准及体重指数定义的肥胖将研究对象分为4种代谢表型:代谢正常体重正常、代谢正常肥胖、代谢异常体重正常、代谢异常肥胖。采用多因素logistic回归法分析SMI与不同代谢表型的关联强度。结果 代谢异常体重正常组、代谢正常肥胖组和代谢异常肥胖组SMI水平均低于代谢正常体重正常组,差异均具有统计学意义(P<0.001)。多因素logistic回归分析结果显示,调整性别、年龄后,SMI水平升高是青少年发生代谢异常体重正常、代谢正常肥胖和代谢异常肥胖表型的保护因素(分别OR=0.74、0.60、0.54,均P<0.001)。结论 SMI升高可降低青少年发生代谢异常/肥胖的风险。

Objective To study the relationship between skeletal muscle mass index(SMI)and metabolic phenotypes of obesity in adolescents,and to provide a basis for the prevention and control of adolescent obesity and related metabolic diseases.Methods A total of 1352 adolescents aged 12 to 18 years were randomly selected by stratified cluster sampling in Yinchuan City from October 2017 to September 2020,and they were surveyed using questionnaires,physical measurements,body composition measurements,and laboratory tests.According to the diagnostic criteria for metabolic abnormalities and the definition of obesity based on the body mass index,the subjects were divided into four metabolic phenotypes:metabolically healthy normal weight,metabolically healthy obesity,metabolically unhealthy normal weight,and metabolically unhealthy obesity.The association between SMI and the metabolic phenotypes was analyzed using multivariate logistic regression.Results The SMI level in the metabolically unhealthy normal weight,metabolically healthy obesity,and metabolically unhealthy obesity groups was lower than that in the metabolically healthy normal weight group(P<0.001).Multivariate logistic regression analysis showed that after adjusting for gender and age,a higher SMI level was a protective factors for adolescents to develop metabolic unhealthy normal weight,metabolically healthy obesity,and metabolically unhealthy obesity phenotypes(OR=0.74,0.60,and 0.54,respectively;P<0.001).Conclusions Increasing SMI can reduce the risk of the development of metabolic unhealthy/obesity.