Nagel Gabriele, Rapp Kilian, Wabitsch Martin, Büchele Gisela, Kroke Anja, Zöllner Iris, Weiland Stephan K, Koenig Wolfgang
Institute of Epidemiology, Ulm University, Ulm, Germany.
Clin Chem. 2008 Feb;54(2):317-25. doi: 10.1373/clinchem.2007.094821. Epub 2007 Dec 18.
Obesity is associated with substantial metabolic changes and subclinical inflammation. We explored associations between body mass index (BMI) and cardiometabolic biomarkers and their clustering in overweight and obese schoolchildren.
In this population-based, cross-sectional study among 450 children 10 years old, we measured adiponectin, leptin, inflammatory markers, apolipoprotein (apo) AI and B, and lipoprotein-associated phospholipase A(2) (Lp-PLA(2)). Except for adiponectin and apoAI (10th percentile) the 90th percentile was used as cutoff point. Body weight was categorized in age- and sex-specific BMI percentiles and overweight and obesity according to International Obesity Task Force definitions.
In linear regression models, all cardiometabolic markers except apoB were statistically significantly associated with overweight. In logistic regression models, compared with the reference category (25th-75th percentile of BMI), overweight was associated with increased concentrations of leptin [odds ratio (OR) 59.80; 95% CI 16.68-214.39], C-reactive protein (6.30; 2.95-13.45), fibrinogen (2.82; 1.33-6.01), and low apoAI (2.62; 1.19-5.75). Overweight was positively associated with interleukin-6, Lp-PLA(2), and apoB concentrations and inversely with adiponectin concentrations. Most importantly, in obese children 35% showed one, 20% two, 10% three, and 15% four or more abnormal cardiometabolic biomarkers. The number of abnormal cardiometabolic markers increased in overweight (p(trend) <0.001) and obese (p(trend) <0.001) children.
Overweight and obesity in children are associated with complex metabolic changes and a low-grade inflammatory response, and thus might not only accelerate cardiovascular disease later on, but may also be associated with the initiation of atherosclerosis in early life.
肥胖与大量代谢变化及亚临床炎症相关。我们探讨了体重指数（BMI）与心血管代谢生物标志物之间的关联及其在超重和肥胖学童中的聚集情况。
在这项基于人群的横断面研究中，对450名10岁儿童进行了研究，我们测量了脂联素、瘦素、炎症标志物、载脂蛋白（apo）AI和B以及脂蛋白相关磷脂酶A2（Lp-PLA2）。除脂联素和apoAI（第10百分位数）外，第90百分位数用作截断点。根据国际肥胖特别工作组的定义，将体重按年龄和性别特异性BMI百分位数以及超重和肥胖进行分类。
在线性回归模型中，除apoB外，所有心血管代谢标志物均与超重存在统计学显著关联。在逻辑回归模型中，与参考类别（BMI的第25 - 75百分位数）相比，超重与瘦素浓度升高[比值比（OR）59.80；95%置信区间16.68 - 214.39]、C反应蛋白（6.30；2.95 - 13.45）、纤维蛋白原（2.82；1.33 - 6.01）以及低apoAI（2.62；1.19 - 5.75）相关。超重与白细胞介素 - 6、Lp - PLA2和apoB浓度呈正相关，与脂联素浓度呈负相关。最重要的是，在肥胖儿童中，35%有一项、20%有两项、10%有三项以及15%有四项或更多心血管代谢生物标志物异常。超重（p趋势<0.001）和肥胖（p趋势<0.001）儿童中心血管代谢标志物异常的数量增加。
儿童超重和肥胖与复杂的代谢变化和低度炎症反应相关，因此不仅可能在日后加速心血管疾病的发生，还可能与生命早期动脉粥样硬化的起始有关。
