文章摘要
侯冬青,董虹孛,朱忠信,郁兆仓,王宏健,高爱钰,程红,赵小元,刘军廷,黄贵民,陈芳芳,米杰.学龄儿童肥胖持续状态与心血管代谢异常发病风险[J].中华流行病学杂志,2021,42(3):440-447
学龄儿童肥胖持续状态与心血管代谢异常发病风险
Change in obesity status and development of cardiometabolic disorders in school-age children
收稿日期:2020-08-12  出版日期:2021-03-29
DOI:10.3760/cma.j.cn112338-20200812-01060
中文关键词: 儿童青少年;肥胖;心血管代谢异常;队列研究
英文关键词: Children;Obesity;Cardiometabolic disorder;Cohort study
基金项目:国家重点研发计划(2016YFC0900600,2016YFC0900602);国家自然科学基金(81973110)
作者单位E-mail
侯冬青 首都儿科研究所流行病学研究室, 北京 100020  
董虹孛 国家儿童医学中心儿童慢病管理中心, 首都医科大学附属北京儿童医院, 北京 100045  
朱忠信 北京市密云区中小学卫生保健所 101500  
郁兆仓 北京市通州区中小学卫生保健所 101100  
王宏健 北京市房山区中小学卫生保健所 102400  
高爱钰 北京市东城区中小学卫生保健所 100009  
程红 首都儿科研究所流行病学研究室, 北京 100020  
赵小元 首都儿科研究所流行病学研究室, 北京 100020  
刘军廷 首都儿科研究所流行病学研究室, 北京 100020  
黄贵民 首都儿科研究所流行病学研究室, 北京 100020  
陈芳芳 首都儿科研究所流行病学研究室, 北京 100020  
米杰 国家儿童医学中心儿童慢病管理中心, 首都医科大学附属北京儿童医院, 北京 100045 jiemi12@vip.sina.com 
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中文摘要:
      目的 分析学龄儿童肥胖持续状态与心血管代谢异常罹患风险的关系。方法 研究对象为儿童青少年,根据基线和随访时状态将研究对象分为持续非肥胖、肥胖恢复、新发肥胖和持续肥胖组,并按照基线与随访时点是否为肥胖分析比较不同肥胖持续状态儿童的血压、血糖和血脂水平的变化。采用多元logistic回归方程,分析不同肥胖持续状态与心血管代谢异常发生风险的关系。结果 本研究最终纳入分析11 379人(男童占49.6%)。随访2年间,人群新发肥胖率为3.2%(95%CI:2.9%~3.5%),肥胖恢复率为4.4%(95%CI:4.0%~4.8%)。新发肥胖组和持续肥胖组的SBP、DBP、TG、LDL-C和非HDL-C的增加值高于持续非肥胖组,而肥胖恢复组的SBP、LDL-C和非HDL-C的增加值较低(均P<0.05)。此外,以持续非肥胖组为对照,持续肥胖组和新发肥胖组的高血压、高血糖、血脂各项异常及心血管危险因素聚集(异常个数≥2)的发生风险均显著增加,而肥胖恢复组在大部分心血管代谢异常发生风险与持续非肥胖组无统计学差异。结论 新发肥胖和持续肥胖均可增加心血管代谢异常的发生风险,而肥胖儿童恢复为非肥胖后上述风险则可有效降低。
英文摘要:
      Objective To analyze the influence of obesity status on the development of cardiometabolic disorders in school-age children. Methods Information about children's body weight, body height and cardiovascular risk factors were collected in baseline survey in 2017 and follow-up survey in 2019. The school-age children were divided into four groups based on their baseline and follow-up obesity status, i.e. sustained non-obesity group, restored obesity group, newly classified obesity group, and persistent obesity group. Analysis of covariance was used to compare the difference of change in levels of cardiometabolic factors among the four groups. The multivariate logistic regression model was used to analyze the relationship between obesity status and the incidence risk of cardiometabolic disorders. Results The present study included 11 379 school-age children (boys accounting for 49.6%). During the 2 years, the incidence of obesity was 3.2% (95%CI:2.9%-3.5%) with the restoration ratio of obesity of 4.4% (95%CI:4.0%-4.8%). Compared with the sustained non-obesity group, increases in SBP, DBP, TG, LDL-C and non-HDL-C were much higher in newly classified obesity group and persistent obesity group, but lower in restored obesity groups except for DBP (all P<0.05). In addition, the incidence risk of hypertension, high glucose, dyslipidemia and cardiometabolic disorders (≥ 2 risks) were much higher in newly classified and persistent obese children than in sustained non-obese children. No difference was found in incidence risks of most cardiovascular disorders between restored obese children and sustained non-obese children, except for hypertension and cardiometabolic risks. Conclusion Both newly classified obesity and persistent obesity increased the incidence risks for multi cardiovascular disorders, while these risks could be reduced when non-obese status restore.
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