Kelishadi Roya, Cook Stephen R, Motlagh Mohammad Esmaeil, Gouya Mohammad Mehdi, Ardalan Gelayol, Motaghian Molouk, Majdzadeh Reza, Ramezani Mohammad A
Preventive Pediatric Cardiology Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
J Am Diet Assoc. 2008 Jan;108(1):82-90. doi: 10.1016/j.jada.2007.10.013.
The objectives of this study were to estimate the prevalence and distribution of cardiovascular risk factors and the metabolic syndrome in children with generalized, central, or combined types of obesity and to possibly discover if a phenotypically obese metabolically normal and a metabolically obese normal weight phenotype could be identified in children and adolescents.
This cross-sectional study is the baseline survey of a national longitudinal study. SUBJECT/SETTING: Overall 4,811 nationally representative children, aged 6 to 18 years, were recruited from the community through randomly selected schools within six provinces in Iran. In addition to physical examination, fasting glucose and lipid profile were assessed.
Obesity type was considered the independent variable, cardiovascular risk factors and the metabolic syndrome were dependent variables. Prevalence of risk factors in different types of obesity was compared by multivariate analysis of variance and post-hoc tests. Logistic regression analysis was used to examine the associations between obesity type and the metabolic syndrome.
Varying with age and sex groups, 6% to 9% of children were categorized into the isolated central obesity group, 7.5% to 11% into the isolated generalized obesity, and 14% to 16.5% into the combined type group. The prevalence of dyslipidemia, high blood pressure, and metabolic syndrome was higher in those children with combined obesity than in those with the other two types of obesity, as well as in the central than in the generalized obesity groups. Phenotypically obese metabolically normal subjects were more prevalent in the generalized obesity group. The likelihood of metabolic syndrome was highest in those with combined obesity (odds ratio 3.7, 95% confidence interval 3.1 to 4), and lowest in generalized obesity group (odds ratio 2.1, 95% confidence interval 1.8 to 2.5).
This study complements recent research about the adverse health hazards of abdominal obesity in children. The finding of metabolically obese normal weight children suggests that additional investigation for cardiovascular risk factors may be warranted in normal-weight children with an ethnic predisposition to chronic diseases.
本研究的目的是评估全身性、中心性或复合型肥胖儿童心血管危险因素和代谢综合征的患病率及分布情况，并探讨是否能在儿童和青少年中识别出表型肥胖但代谢正常以及代谢性肥胖但体重正常的表型。
本横断面研究是一项全国性纵向研究的基线调查。
研究对象/地点：通过在伊朗六个省份随机选取的学校，从社区招募了总共4811名具有全国代表性的6至18岁儿童。除了体格检查外，还评估了空腹血糖和血脂谱。
肥胖类型被视为自变量，心血管危险因素和代谢综合征为因变量。通过多因素方差分析和事后检验比较不同类型肥胖中危险因素的患病率。采用逻辑回归分析来检验肥胖类型与代谢综合征之间的关联。
根据年龄和性别分组不同，6%至9%的儿童被归类为单纯中心性肥胖组，7.5%至11%为单纯全身性肥胖组，14%至16.5%为复合型肥胖组。复合型肥胖儿童中血脂异常、高血压和代谢综合征的患病率高于其他两种肥胖类型的儿童，中心性肥胖组高于全身性肥胖组。表型肥胖但代谢正常的受试者在全身性肥胖组中更为普遍。代谢综合征的可能性在复合型肥胖者中最高（比值比3.7，95%置信区间3.1至4），在全身性肥胖组中最低（比值比2.1，95%置信区间1.8至2.5）。
本研究补充了近期关于儿童腹部肥胖对健康危害不利影响的研究。代谢性肥胖但体重正常儿童的发现表明对于有慢性疾病族裔易感性的体重正常儿童，可能有必要进一步调查心血管危险因素。
