| 马传伟,羊柳,赵敏,席波.儿童腹型肥胖及其肥胖类型与颈动脉内中膜厚度的关系[J].中华流行病学杂志,2020,41(9):1450-1454 |
| 儿童腹型肥胖及其肥胖类型与颈动脉内中膜厚度的关系 |
| Association of abdominal obesity and obesity types with carotid intima-media thickness in children in China |
| 收稿日期:2020-02-25 出版日期:2020-09-18 |
| DOI：10.3760/cma.j.cn112338-20200225-00171 |
| 中文关键词: 腹型肥胖 颈动脉内中膜厚度 儿童 |
| 英文关键词: Abdominal obesity Carotid intima-media thickness Children |
| 基金项目:国家自然科学基金（81673195） |
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| 摘要点击次数: 2871 |
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| 中文摘要: |
| 目的 探讨儿童腹型肥胖及其肥胖类型与颈动脉内中膜厚度（cIMT）的关系，为儿童心血管结构异常的防治提供科学依据。方法 数据来源于2017年11月至2018年1月在山东省淄博市桓台县开展的“儿童心血管健康队列”基线调查数据。本研究纳入性别、年龄、体测指标、血生化指标和问卷调查变量等信息完整的儿童1 240名（男生657人，占53.0%）。采用协方差分析比较正常腰围组、腹型肥胖前期组和腹型肥胖组儿童的cIMT水平，采用logistic回归模型分析腹型肥胖前期、腹型肥胖与cIMT增厚（以性别、年龄别的P95为界值点）及外周型超重/肥胖与腹型肥胖或前期的联合作用与cIMT增厚的关系。结果 腹型肥胖前期组、腹型肥胖组cIMT水平高于正常腰围组（0.47±0.03、0.50±0.04 vs.0.45±0.05）mm，差异有统计学意义（P<0.001）。腹型肥胖前期组、腹型肥胖组cIMT增厚检出率高于正常腰围组（20.8%、49.5% vs.8.8%，P<0.001）。调整各种潜在协变量后，与正常腰围相比，腹型肥胖前期、腹型肥胖与cIMT增厚存在关联（腹型肥胖前期：OR=2.53，95% CI：1.67~3.84；腹型肥胖：OR=8.56，95% CI：5.97~12.29）。与BMI和腰围均正常者相比，仅腹型肥胖或前期和混合型超重/肥胖均与cIMT增厚存在关联（仅腹型肥胖或前期：OR=2.24，95% CI：1.36~3.69；混合型超重/肥胖：OR=6.94，95% CI：4.87~9.90）。结论 儿童腹型肥胖与cIMT增厚存在较强关联，混合型超重/肥胖与cIMT增厚的关联性更强。提示儿童心血管结构异常的防治，应当考虑混合型超重/肥胖的重要性。 |
| 英文摘要: |
| Objective To evaluate the association of abdominal obesity and obesity types with carotid intima-media thickness (cIMT) in children and provide scientific evidence for the prevention of abnormal vascular structure. Methods Based on the “Children's Cardiovascular Health Cohort” conducted in Huantai county of Zibo, Shandong province from November 2017 to January 2018, a total of 1 240 children, including 657 boys (53.0%), who had completed data of sex, age, physical examinations, blood biochemical indices and lifestyle variables (collected by questionnaires) were included for the analysis. Covariance analysis was used to compare the levels of cIMT in groups with normal waist circumference, pre-abdominal obesity and abdominal obesity. Logistic regression analysis was used to evaluate the association of pre-abdominal obesity and abdominal obesity with high cIMT, and the association of combined effect of general overweight or obesity and abdominal obesity or pre-abdominal obesity with high cIMT. Results The levels of cIMT in children with pre-abdominal obesity (0.47±0.03) mm and abdominal obesity (0.50±0.04) mm were higher than that in children with normal waist circumference (0.45±0.05) mm, the difference was significant (P<0.001). The detection rates of high cIMT in children with pre-abdominal obesity (20.8%) and abdominal obesity (49.5%) were higher than that in children with normal waist circumference (8.8%), the difference was significant (P<0.001). Compared with normal waist circumference, pre-abdominal obesity and abdominal obesity were significantly associated with high cIMT (pre-abdominal obesity: OR=2.53, 95% CI: 1.67-3.84; abdominal obesity: OR=8.56, 95% CI: 5.97-12.29) after adjustment for potential covariates. Compared with normal body mass index and normal waist circumference, abdominal obesity or pre-abdominal obesity alone (OR=2.24, 95% CI: 1.36-3.69), and mixed overweight and obesity (OR=6.94, 95% CI: 4.87-9.90) were significantly associated with high cIMT. Conclusions The association between abdominal obesity and high cIMT was significant in children, and the association was stronger between mixed overweight or obesity and high cIMT, suggesting that we should consider mixed overweight and obesity in the prevention of abnormal vascular structure. |
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