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高海拔地区非肥胖的阿根廷土着儿童的血脂异常。

Dyslipidemia without obesity in indigenous Argentinean children living at high altitude.

机构信息

Hospital San Antonio de los Cobres, Salta, Argentina.

出版信息

J Pediatr. 2012 Oct;161(4):646-51.e1. doi: 10.1016/j.jpeds.2012.04.008. Epub 2012 Jun 1.

DOI:10.1016/j.jpeds.2012.04.008
PMID:22658786
Abstract

OBJECTIVES

To compare the prevalence of cardiovascular disease risk factors in Indian children from San Antonio de los Cobres (SAC) and children from Buenos Aires (BA), and to examine body mass index (BMI), waist circumference (WC), and WC/height as predictors of dyslipidemia in both groups.

STUDY DESIGN

Data were collected cross-sectionally from BMI, WC, blood pressure, Tanner scale, glucose, lipids, and insulin. Dyslipidemia was defined by the National Cholesterol Education Program and American Heart Association.

RESULTS

The mean ages were 10.6 ± 3.0 and 9.5 ± 2.0 years in SAC vs BA children. Of the 330 SAC children, 15 (4.5%) were overweight and 12 (3.6%) obese, and of the 603 BA, 97 (16.1%) were overweight and 82 (13.6%) obese per Centers for Disease Control. There was a significantly higher prevalence of high triglycerides (28.8% vs 3.5%) and low high-density lipoprotein cholesterol (30.0% vs 5.5%) in SAC vs BA children. The areas under the receiver operating characteristic curve in predicting high triglycerides were BMI = 0.55 (95% CI, 0.48-0.62; P = .15) in SAC and BMI = 0.65 (95% CI, 0.52-0.77; P = .02) in BA children. Similar results from the areas under the receiver operating characteristic curve were obtained when low high-density lipoprotein cholesterol was used, indicating that BMI was not a significant predictor for dyslipidemia in SAC children. When BMI was replaced by WC and WC/height, results were similar.

CONCLUSIONS

Anthropometric markers were not an acceptable predictor for National Cholesterol Education Program cutoffs for dyslipidemia in SAC children. Longitudinal studies should determine if SAC children are at high risk for cardiovascular diseases because of genetic background.

摘要

目的

比较来自阿根廷圣安东尼奥德洛斯科布雷斯(SAC)的儿童与来自布宜诺斯艾利斯(BA)的儿童的心血管疾病风险因素的患病率,并检验身体质量指数(BMI)、腰围(WC)和 WC/身高作为两组人群血脂异常的预测指标。

研究设计

从 BMI、WC、血压、Tanner 量表、血糖、血脂和胰岛素中收集横断面数据。血脂异常的定义采用国家胆固醇教育计划和美国心脏协会。

结果

SAC 组的平均年龄为 10.6 ± 3.0 岁,BA 组为 9.5 ± 2.0 岁。在 330 名 SAC 儿童中,15 名(4.5%)超重,12 名(3.6%)肥胖,而在 603 名 BA 儿童中,97 名(16.1%)超重,82 名(13.6%)肥胖,采用疾病控制中心的标准。SAC 组儿童高甘油三酯血症(28.8%比 3.5%)和低高密度脂蛋白胆固醇血症(30.0%比 5.5%)的患病率明显更高。预测高甘油三酯血症的受试者工作特征曲线下面积在 SAC 组中为 BMI=0.55(95%CI,0.48-0.62;P=0.15),在 BA 组中为 BMI=0.65(95%CI,0.52-0.77;P=0.02)。当使用低高密度脂蛋白胆固醇时,从受试者工作特征曲线下面积获得了类似的结果,表明 BMI 不是 SAC 儿童血脂异常的重要预测指标。当 BMI 被 WC 和 WC/身高取代时,结果相似。

结论

在 SAC 儿童中,人体测量指标不能作为国家胆固醇教育计划血脂异常切点的可接受预测指标。纵向研究应确定 SAC 儿童是否因遗传背景而面临患心血管疾病的高风险。

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