Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
BMC Public Health. 2011 May 18;11:333. doi: 10.1186/1471-2458-11-333.
With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs.
A case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise children into the two weight groups. Blood pressure (BP) was taken, and blood was drawn after an overnight fast to determine fasting blood glucose (FBG) and full lipid profile, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). International Diabetes Federation (2007) criteria for children were used to identify metabolic syndrome.
Participants comprised 60.9% (n = 245) Malay, 30.9% (n = 124) Chinese and 8.2% (n = 33) Indian. Overweight/obese children showed significantly poorer biochemical profile, higher body fat percentage and anthropometric characteristics compared to the normal-weight group. Among the metabolic risk factors, WC ≥90th percentile was found to have the highest odds (OR = 189.0; 95%CI 70.8, 504.8), followed by HDL-C≤1.03 mmol/L (OR = 5.0; 95%CI 2.4, 11.1) and high BP (OR = 4.2; 95%CI 1.3, 18.7). Metabolic syndrome was found in 5.3% of the overweight/obese children but none of the normal-weight children (p < 0.01). Overweight/obese children had higher odds (OR = 16.3; 95%CI 2.2, 461.1) of developing the metabolic syndrome compared to normal-weight children. Binary logistic regression showed no significant association between age, gender and family history of communicable diseases with the metabolic syndrome. However, for ethnicity, Indians were found to have higher odds (OR = 5.5; 95%CI 1.5, 20.5) compared to Malays, with Chinese children (OR = 0.3; 95%CI 0.0, 2.7) having the lowest odds.
We conclude that being overweight or obese poses a greater risk of developing the metabolic syndrome among children. Indian ethnicity is at higher risk compared to their counterparts of the same age. Hence, primary intervention strategies are required to prevent this problem from escalating.
随着儿童肥胖症患病率的增加，许多国家都对儿童代谢综合征进行了研究，但马来西亚尚未开展此类研究。因此，本研究旨在比较超重/肥胖和正常体重儿童之间的代谢风险因素，并确定性别和种族对吉隆坡及其大都市郊区 9-12 岁学龄儿童代谢综合征的影响。
本病例对照研究纳入了 402 名儿童，其中 193 名体重正常，209 名超重/肥胖。测量体重、身高、腰围（WC）和身体成分，并使用世界卫生组织（2007 年）生长标准将儿童分为两组。测量血压（BP），并在隔夜禁食后抽取血液，以测定空腹血糖（FBG）和完整的血脂谱，包括甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和总胆固醇（TC）。采用国际糖尿病联合会（2007 年）制定的儿童标准来确定代谢综合征。
参与者中，60.9%（n=245）为马来人，30.9%（n=124）为华人，8.2%（n=33）为印度人。与体重正常组相比，超重/肥胖组的生化指标明显较差，体脂百分比和人体测量学特征较高。在代谢风险因素中，WC≥第 90 百分位数的比值最高（OR=189.0；95%CI 70.8，504.8），其次是 HDL-C≤1.03mmol/L（OR=5.0；95%CI 2.4，11.1）和高血压（OR=4.2；95%CI 1.3，18.7）。超重/肥胖组中发现 5.3%的儿童患有代谢综合征，而体重正常组无一例（p<0.01）。与体重正常组相比，超重/肥胖组儿童患代谢综合征的比值更高（OR=16.3；95%CI 2.2，461.1）。二元逻辑回归显示，年龄、性别和传染病家族史与代谢综合征之间无显著关联。然而，在种族方面，与马来人相比，印度人患代谢综合征的比值更高（OR=5.5；95%CI 1.5，20.5），而华人儿童（OR=0.3；95%CI 0.0，2.7）患病比值最低。
我们得出的结论是，超重或肥胖使儿童患代谢综合征的风险增加。与同年龄的其他人相比，印度裔儿童的风险更高。因此，需要采取初级干预策略来防止问题恶化。
