儿童腹型肥胖及其肥胖类型与颈动脉内中膜厚度的关系

马传伟; 羊柳; 赵敏; 席波

Abstract

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].Chinese journal of Epidemiology,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

Received:February 25, 2020

DOI：10.3760/cma.j.cn112338-20200225-00171

KeyWord: 腹型肥胖颈动脉内中膜厚度儿童

English Key Word: Abdominal obesity Carotid intima-media thickness Children

FundProject:国家自然科学基金（81673195）

Author Name	Affiliation	E-mail
Ma Chuanwei	Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University/Children Cardiovascular Research Center of Shandong University, Ji'nan 250012, China
Yang Liu	Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University/Children Cardiovascular Research Center of Shandong University, Ji'nan 250012, China
Zhao Min	Department of Toxicology and Nutrition, School of Public Health, Cheeloo College of Medicine, Shandong University, Ji'nan 250012, China
Xi Bo	Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University/Children Cardiovascular Research Center of Shandong University, Ji'nan 250012, China	xibo2010@sdu.edu.cn

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Abstract:

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。

English Abstract:

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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