Andersen Lars B, Sardinha Luis B, Froberg Karsten, Riddoch Chris J, Page Angie S, Anderssen Sigmund A
Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Int J Pediatr Obes. 2008;3 Suppl 1:58-66. doi: 10.1080/17477160801896366.
Levels of overweight have increased and fitness has decreased in children. Potentially, these changes may be a threat to future health. Numerous studies have measured changes in body mass index (BMI), but few have assessed the independent effects of low fitness, overweight and physical inactivity on cardiovascular (CVD) risk factors.
A cross-sectional multi-center study including 1 769 children from Denmark, Estonia and Portugal. The main outcome was clustering of CVD risk factors. Independent variables were waist circumference, skinfolds, physical activity and cardio-respiratory fitness.
Both waist circumference and skinfolds were associated with clustered CVD risk. Odds ratios for clustered CVD risk for the upper quartiles compared with the lowest quartile were 9.13 (95% CI: 5.78-14.43) and 11.62 (95% CI: 7.11-18.99) when systolic blood pressure, triglyceride, insulin resistance homeostasis assessment model (HOMA) score, cholesterol:HDL, and fitness were included in the score. When fitness was removed from the clustered risk variable, the association for fatness attenuated and after further adjustment for fitness, only the highest quartiles of the fatness parameters were significant. Fitness showed the same strength of association with the clustered risk score including systolic blood pressure, triglyceride, HOMA score, and cholesterol:HDL with odds ratio for the upper quartile of 4.97 (95% CI: 3.20-7.73). Physical activity was associated with clustered risk even after adjustment for fitness and fatness with an odds ratio for the upper quartile of 1.81 (95% CI: 1.18-2.76).
Physical activity, fitness, skinfold and waist circumference were all independently associated with clustered CVD risk.
儿童超重水平上升，健康水平下降。这些变化可能对未来健康构成威胁。众多研究测量了体重指数（BMI）的变化，但很少有研究评估低健康水平、超重和身体不活动对心血管疾病（CVD）危险因素的独立影响。
一项横断面多中心研究，纳入了来自丹麦、爱沙尼亚和葡萄牙的1769名儿童。主要结局是CVD危险因素聚集。自变量为腰围、皮褶厚度、身体活动和心肺适能。
腰围和皮褶厚度均与CVD危险因素聚集相关。当收缩压、甘油三酯、胰岛素抵抗稳态评估模型（HOMA）评分、胆固醇与高密度脂蛋白比值（cholesterol:HDL）以及适能纳入评分时，与最低四分位数相比，上四分位数的CVD危险因素聚集的比值比分别为9.13（95%置信区间：5.78 - 14.43）和11.62（95%置信区间：7.11 - 18.99）。当从聚集风险变量中去除适能后，肥胖的关联性减弱，在进一步调整适能后，仅肥胖参数的最高四分位数具有显著性。适能与包括收缩压、甘油三酯、HOMA评分和胆固醇与高密度脂蛋白比值的聚集风险评分显示出相同强度的关联性，上四分位数的比值比为4.97（95%置信区间：3.20 - 7.73）。即使在调整了适能和肥胖因素后，身体活动仍与聚集风险相关，上四分位数的比值比为1.81（95%置信区间：1.18 - 2.76）。
身体活动、适能、皮褶厚度和腰围均与CVD危险因素聚集独立相关。
