Li Yan-Ping, Yang Xiao-Guang, Zhai Feng-Ying, Piao Jian-Hua, Zhao Wen-Hua, Zhang Jian, Ma Guan-Sheng
National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Beijing 100050, China.
Biomed Environ Sci. 2005 Dec;18(6):401-10.
To estimate the relative risks of dyslipidemia, hypertension, diabetes mellitus, and metabolic syndromes among overweight and obese Chinese children compared with their normal weight counterparts.
Overweight and obesity were defined by age- and sex-specific BMI classification reference for Chinese children and adolescents. Pediatric metabolic syndrome (MetS) and each risk factor for MetS were defined using the criteria for US adolescents. Definition of hyper-TC, LDL, and dyslipidemia for adults was applied as well. General linear model factor analysis and chi-square test were used to compare the difference in metabolic indicators among normal weight, overweight, and obese groups. Multiple logistic regression analysis was performed to estimate the odds ratio of metabolic abnormalities between obesity, overweight, and normal weight children, after adjustment for living area, family economic level, age, sex, and daily exercise time and TV watching time, as well as different dietary indices in the model.
Significant increases in blood lipids, glucose, and blood pressure were found among overweight and obese children as compared with their counterparts with normal weight. By applying WGOC-recommended BMI classification, the risks for hypertriglyceridemia, low HDL and dyslipidemia among overweight children were 1.9, 1.4, and 1.5 times, and was 3.3, 1.5, and 1.8 times among obese groups compared to their counterparts with normal weight after adjustment for age, sex, region, socioeconomic status, physical activity, and dietary intakes. The overweight and obese children (15-17.9 years) had a high-risk of developing hypertension, which was 2.3 and 2.9 times higher than their counterparts with normal weight. Above 90% obese adolescents had abdominal obesity, while less than 1% normal weight ones had abdominal obesity. No obese adolescents were free from any risk factors for MetS, while 36.9% of normal weight adolescents were from the risk factors. 83.3% obese boys and all obese girls had metabolic syndrome, while only 15.5% normal weight boys and 18.8% normal weight girls had metabolic syndrome. Four risk factors for metabolic syndrome were found in 8.3% obese boys while none in normal weight boys and girls. The prevalence of MetS among normal weight, overweight, and obesity groups was 1.5%, 18.3%, and 38.1% respectively.
The cardiovascular disease (CVD) risk factors are clustered in obese Chinese children. Our observations strongly suggest that efforts should be made to prevent the onset of overweight and its associated diseases during early childhood.
评估超重和肥胖中国儿童相较于正常体重儿童患血脂异常、高血压、糖尿病和代谢综合征的相对风险。
超重和肥胖根据中国儿童青少年按年龄和性别的BMI分类参考标准来定义。儿童代谢综合征(MetS)及其各风险因素依据美国青少年的标准来定义。同时采用成人高总胆固醇(hyper-TC)、低密度脂蛋白(LDL)及血脂异常的定义。运用一般线性模型因子分析和卡方检验来比较正常体重、超重和肥胖组之间代谢指标的差异。在对居住地区、家庭经济水平、年龄、性别、日常锻炼时间和看电视时间以及模型中的不同饮食指标进行调整后,进行多因素逻辑回归分析以估计肥胖、超重和正常体重儿童代谢异常的比值比。
与正常体重儿童相比,超重和肥胖儿童的血脂、血糖和血压显著升高。采用中国儿童青少年肥胖筛查标准(WGOC)推荐的BMI分类,调整年龄、性别、地区、社会经济地位、身体活动和饮食摄入后,超重儿童高甘油三酯血症、低高密度脂蛋白血症和血脂异常的风险分别是正常体重儿童的1.9倍、1.4倍和1.5倍,肥胖组则分别是3.3倍、1.5倍和1.8倍。超重和肥胖儿童(15 - 17.9岁)患高血压的风险较高,分别是正常体重儿童的2.3倍和2.9倍。超过90%的肥胖青少年存在腹型肥胖,而正常体重青少年中腹型肥胖者不到1%。没有肥胖青少年不存在任何代谢综合征风险因素,而36.9%的正常体重青少年存在这些风险因素。83.3%的肥胖男孩和所有肥胖女孩患有代谢综合征,而正常体重男孩和女孩中分别只有15.5%和18.8%患有代谢综合征。8.3%的肥胖男孩存在代谢综合征的四个风险因素,而正常体重男孩和女孩均无。正常体重、超重和肥胖组代谢综合征的患病率分别为1.5%、18.3%和38.1%。
心血管疾病(CVD)风险因素在中国肥胖儿童中聚集。我们的观察结果强烈表明,应努力在儿童早期预防超重及其相关疾病的发生。