USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA.
Metab Syndr Relat Disord. 2012 Apr;10(2):128-36. doi: 10.1089/met.2011.0064. Epub 2011 Dec 13.
The influence of moderate-to-vigorous physical activity (MVPA) and general versus central adiposity on pediatric metabolic risk is not well described.
Secondary analyses on pediatric participants from the National Health and Nutrition Examination Survey, 2003-2006 (n=2,155). MVPA (min/day) and adherence to MVPA recommendations were assessed objectively by accelerometers. Body mass index (BMI) z-score and waist circumference (WC) were measured by standard protocols. The main dependent variables included an overall metabolic risk score and clinical tests related to metabolic risk. A series of linear regression analyses were used to examine BMI z-score versus WC as a mediator of the relationship between MVPA and the metabolic risk score or the individual components, controlling for sociodemographic covariates. All analyses with BMI z-score as an independent variable controlled for WC and vice versa. The product-of-coefficients method was used to test for mediation.
MVPA adherence was inversely associated and WC was positively associated with the metabolic risk score (all P<0.05). MVPA was inversely associated with systolic blood pressure and positively associated with high-density lipoprotein cholesterol (HDL-C) (all P<0.05). WC was inversely associated with HDL-C and positively associated with C-reactive protein (CRP), glycohemoglobin, fasting triglycerides, and fasting insulin (all P<0.05). WC mediated the relationship between MVPA and CRP or HDL-C (both P<0.05).
MVPA correlated with pediatric metabolic risk and this relationship was mediated by central adiposity for CRP and HDL-C. This finding suggests the need for programs to screen for and improve children's MVPA and WC.
中高强度体力活动（MVPA）和一般与中心性肥胖对儿童代谢风险的影响尚未得到充分描述。
对 2003-2006 年全国健康和营养调查（NHANES）中儿科参与者进行二次分析（n=2155）。使用加速度计客观评估 MVPA（min/天）和对 MVPA 建议的依从性。通过标准方案测量体重指数（BMI）z 评分和腰围（WC）。主要因变量包括整体代谢风险评分和与代谢风险相关的临床检查。使用一系列线性回归分析来检查 BMI z 评分与 WC 作为 MVPA 与代谢风险评分或单个成分之间关系的中介，控制社会人口统计学协变量。所有以 BMI z 评分作为自变量的分析均控制 WC，反之亦然。乘积系数法用于检验中介作用。
MVPA 依从性与代谢风险评分呈负相关，WC 与代谢风险评分呈正相关（均 P<0.05）。MVPA 与收缩压呈负相关，与高密度脂蛋白胆固醇（HDL-C）呈正相关（均 P<0.05）。WC 与 HDL-C 呈负相关，与 C 反应蛋白（CRP）、糖化血红蛋白、空腹甘油三酯和空腹胰岛素呈正相关（均 P<0.05）。WC 介导了 MVPA 与 CRP 或 HDL-C 之间的关系（均 P<0.05）。
MVPA 与儿科代谢风险相关，这种关系通过 CRP 和 HDL-C 与中心性肥胖的关系来介导。这一发现表明，需要制定计划来筛查和改善儿童的 MVPA 和 WC。
