新疆哈萨克族6～13岁超重和肥胖儿童代谢综合征特征分析

李敏; 张涛; 徐佩茹

Abstract

李敏,张涛,徐佩茹.新疆哈萨克族6～13岁超重和肥胖儿童代谢综合征特征分析[J].Chinese journal of Epidemiology,2013,34(4):336-341

新疆哈萨克族6～13岁超重和肥胖儿童代谢综合征特征分析

Epidemiological characteristics of metabolic syndrome among Kazakh children aged from 6 to 13 in Xinjiang, China

Received:October 25, 2012

DOI：

KeyWord: 代谢综合征肥胖儿童哈萨克族

English Key Word: Metabolic syndrome Obesity Child Kazak

FundProject:国家自然科学基金(81060072)

Author Name	Affiliation
Li Min
ZHANG Tao
XU Pei-ru

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Abstract:

目的 <\b>了解新疆哈萨克族6～13岁超重、肥胖儿童中代谢综合征(MetS)的流行现状和特征.方法 <\b>以2009-2010年伊犁哈萨克自治州哈萨克族学龄儿童健康体检中筛查出的超重和肥胖儿童为研究对象,并同期选取一组正常体重儿童为对照组,检测空腹血糖、胰岛素、甘油三酯和高密度脂蛋白胆固醇水平,计算胰岛素抵抗指数(稳态模式评估法).分别采用新制定的中国儿童青少年人群≥10岁的MetS诊断标准(中国标准)和美国国家胆固醇教育计划(NCEP-ATPⅢ)定义计算MetS检出率并进行比较；对6岁≤年龄＜10岁的儿童采用新制定的指南检测心血管疾病(CVD)的危险因素.按照男女生腰围身高比(WHtR)界值分析与代谢指标关系.结果 <\b>(1)采用中国标准,对照组MetS检出率为0％,超重组和肥胖组分别为9.57％和19.64％(x2=27.763,P＜0.01)；采用NCEP-ATPⅢ定义,对照组MetS检出率为0.64％,超重组和肥胖组分别为2.61％和16.07％(x2=20.745,P＜0.01)；两定义标准诊断的MetS检出率仅超重组的差异有统计学意义(f=4.868,P=0.027),且均随体重指数升高而有增加的趋势(趋势检验P＜0.01).(2)肥胖儿童MetS单项异常检出率依次为中心性肥胖(78.95％)、高血压(29.82％)、高甘油三酯(26.32％)、低高密度脂蛋白胆固醇(22.81％)、高空腹血糖(0.88％)；超重儿童单项异常检出率居前三位依次为高甘油三酯(31.15％)、中心性肥胖(23.77％)、低高密度脂蛋白胆固醇(22.95％),并随体重指数增加,MetS指标多项异常者呈增加趋势(P＜0.01).(3)＜10岁超重肥胖儿童CVD检出率从高至低分别为肥胖或腰围异常、低高密度脂蛋白胆固醇、高甘油三酯、空腹血糖受损、高血压；超重肥胖组高甘油三酯、低高密度脂蛋白胆固醇、肥胖或腰围异常检出率均高于正常对照组(P＜0.05).(4)WHtR与空腹胰岛素水平(r=0.205,P＜0.001)、胰岛素抵抗指数(r=0.201,P＜0.001)、低密度脂蛋白胆固醇(r=0.195,P＜0.001)存在相关性.结论 <\b>新疆哈萨克族6～13岁肥胖儿童中MetS呈现流行趋势；中心性肥胖、高血压、高甘油三酯是哈萨克族肥胖儿童最常见的代谢异常；相对NCEP-ATPⅢ的标准,中国标准对超重青少年群体代谢异常的检测更为敏感；WHtR与胰岛素抵抗相关.

English Abstract:

Objective <\b>This study was designed to evaluate the epidemiology and clinical characteristics on metabolic syndrome (MetS) among overweight and obese children aged from 6 to 13 years old in Kazakh ethnic populations.Methods <\b>Based on the data including body mass index (BMI),waist circumference (WC) and blood pressure measured from the‘Kazakh ethnic child Health examination study in Yili’,5360 Kazakh children aged 6-13 were screened for overweight and obesity in Xinjiang,using the Chinese BMI cutoffs for schoolchildren (7-18 years) and WHO growth reference for school-aged children and adolescents (6 year).Simultaneously a group of children with normal BMI were selected as the control group.Fasting plasma glucose (FPG),insulin(FINS),serum high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were examined.HOMA-IR index was calculated to estimate the individual insulin resistance.Children under study were older than or equal to 10 years and met the criteria according to the definition of metabolic syndrome,prophylaxis and treatment on Chinese children and adolescents,proposed by the Society of Pediatrics in China or NCEP-ATP Ⅲ definition as MetS.Risk factors related to cardiovascular diseases were analyzed according to the criteria by the Society of Pediatrics among those aged from 6 to 10 years old children.Connection between waist-to-height ratio (WHtR) and biochemical indexes was explored.Results <\b>Prevalence rates of MetS according to the criteria from Society of Pediatrics in China were:0％,9.57％,19.64％ in the normal weight,overweight and obese children,respectively.The rates diagnosed by NCEP-ATP Ⅲ definition were 0.64％,2.61％,16.07％ respectively.The detective rates of individual MetS component among obese children were:78.95％ for abdominal obesity,29.82％ for elevated BPs,26.32％ for high TG,22.81％ for low HDL-C,0.88％ for FPG.High TG (31.15％),abdominal obesity (23.77％) and low HDL-C (22.95％) appeared as the leading three abnormal indices among the overweight children.With increased BMI,the clustering of MetS components were also remarkably increasing.The detective rates of cardiovascular-related risk factors among overweight or obesity children from 6 to 10 years old were:abdominal obesity or obesity,low HDL-C,high TG,impaired FPG,elevated BPs.Differences were seen between overweight or obesity children and normal weight children on the detective rates of high TG,low HDL-C,abdominal obesity or obesity.WHtR was related with FINS,HOMA-IR index and LDL-C.Conclusion <\b>MetS seemed epidemic among obese Hazakh children.Abdominal obesity,elevated BPs and high TG were the leading three abnormal factors among obese children.Compare to NCEP-ATP Ⅲ,abnormal biochemical indices on overweight Kazakh children seemed to be more sensitive,proposed by the Society of Pediatrics in China.

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