4~7岁儿童代谢综合征有关指标之间相关模式研究

The correlation patterns between the metabolic syndrome related indexes in children aged 4-7 years old

目的探究4~7岁儿童代谢综合征有关指标之间的相关模式。方法依托前期开展的孕期增补复合微量营养素预防母婴不良结局项目,在河北满城、元氏2县选取参加项目孕妇所生儿童1454名,于儿童4~7岁时测量身高、体重、腰围、血压并检测血脂和血糖。采用Pearson相关分析检验体质指数(BMI)、腰围、总胆固醇(CHO)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、空腹血糖(FPG)、收缩压和舒张压共9个指标之间的线性相关关系。参照美国心脏学会标准判定儿童中心性肥胖、高血压、高TG血症、低HDL-C血症和高血糖发生情况,采用关联分析的φ系数描述5个代谢综合征组分间的相关关系。结果儿童CHO与LDL-C相关关系强(r=0.82,P<0.001),腰围与BMI、收缩压与舒张压、CHO与HDL-C相关关系较强(r依次为0.63、0.60和0.74,P均<0.001),CHO与TG、TG与LDL-C、HDL-C与LDL-C中等强度相关(r依次为0.34、0.30和0.43,P均<0.001),其他指标之间为弱相关或无相关。儿童中心性肥胖与高血压、高TG血症、低HDL-C血症三者均呈弱相关关系(φ系数依次为0.06、0.08和0.07,P均<0.05),高血压和高TG血症呈弱相关关系(φ=0.05,P<0.05),其他代谢综合征组分间的φ系数无统计学意义。结论儿童收缩压与舒张压之间、腰围与BMI之间以及几个血脂指标彼此之间相关关系较强,包括HDL-C与CHO、LDL-C均为中等强度正相关关系,而血压、肥胖与血脂三类指标之间无明显相关,血糖与所有指标均无明显相关;儿童代谢综合征各组分间相关较弱或无相关,提示儿童代谢指标间相关模式与成人不完全相同,代谢综合征这一概念应用于儿童宜审慎。

Objective To explore the correlation patterns between metabolic syndrome related indexes in children aged 4 to 7 years old.Methods A total of 1454 children aged 4 to 7 years born to mothers who participated in the previous micronutrient supplementation and pregnancy outcomes were recruited in Mancheng and Yuanshi counties,Hebei province.Data on height,weight,waist circumference and blood pressure for all children were collected.Fasting blood samples were also collected to measure the blood lipids and fasting plasma glucose(FPG).Pearson correlation analysis was performed to determine the linear correlations among a total of 9 indexes of children including body mass index(BMI),waist circumference,total cholesterol(CHO),triglyceride(TG),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C),FPG and systolic/diastolic blood pressure.All five metabolic syndrome components including central obesity,hypertension,hypertriglyceridemia,low HDL-C and high fasting glucose were defined according to the criteria proposed by the American Heart Association.Phi coefficients(φ)were used to describe the correlations among the five components of metabolic syndrome.Results The correlation between CHO and LDL-C was strong in children(r=0.82,P<0.001).The correlations between waist circumference and BMI,systolic and diastolic blood pressure,CHO and HDL-C were moderate in children(r=0.63,P<0.001;r=0.60,P<0.001;r=0.74,P<0.001).The correlations between CHO and TG,TG and LDL-C,as well as HDL-C and LDL-C were fair in children(r=0.34,0.30 and 0.43,all P<0.001).The correlations between other indexes were poor.Children′s central obesity was weakly correlated with hypertension,hypertriglyceridemia,and low HDL-C(φ=0.06,0.08,and 0.07,all P<0.05).Hypertension were weakly correlated with hypertriglyceridemia(φ=0.05,P<0.05).There were no correlations between other metabolic syndrome components.Conclusion The systolic and diastolic blood pressure,waist circumference and BMI,as well as blood lipids indexes including HDL-C,CHO,and LDL-C in children were strongly or moderately correlated with each other.However,the correlations among blood lipids indexes,obesity indexes,blood pressure indexes and FPG were poor.There were weak or no correlations among the metabolic syndrome components in children,suggesting that the correlation patterns of metabolic syndrome related indexes in children were different from those in adults.The concept of metabolic syndrome should be used with caution during childhood.