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青少年人体测量指数与成年早期代谢综合征发生的关联:德黑兰血脂与血糖研究(TLGS)

The association of anthropometric indices in adolescence with the occurrence of the metabolic syndrome in early adulthood: Tehran Lipid and Glucose Study (TLGS).

作者信息

Barzin M, Asghari G, Hosseinpanah F, Mirmiran P, Azizi F

机构信息

Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Pediatr Obes. 2013 Jun;8(3):170-7. doi: 10.1111/j.2047-6310.2012.00102.x. Epub 2012 Oct 8.

Abstract

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

Little is known about the predictive ability of anthropometric indices in adolescence for prediction of early adulthood metabolic syndrome (MetS). There are controversies about the predictive power of body mass index (BMI) vs. waist circumference (WC) for prediction of MetS in late adolescence; some of the studies did not support the need to measure WC in mid-adolescence, in addition to BMI; on the other hand, some other studies proposed either similar predictability or superiority of WC to identify MetS in late adolescence.

WHAT THIS STUDY ADDS

This is the first study to evaluate the adolescent anthropometric indices in relation to early adulthood MetS incidence one decade later in the Middle East region. There is an important sex difference regarding the incidence of MetS in Tehranian adolescents. It is interesting to know that all anthropometric indices in the pubertal age group (11-14 years) had better predictive ability compared to late-pubertal (15-18 years) adolescents. In addition, adolescent abdominal obesity surrogates, including WC and waist-to-height ratio, predicted adulthood MetS better than BMI in boys. It seems that WC had an independent role beyond BMI in identification of adulthood MetS in Tehranian boys (11-18 years old).

BACKGROUND

Little is known about the predictive ability of anthropometric indices in adolescence for prediction of early adulthood metabolic syndrome (MetS).

OBJECTIVE

Our purpose was to explore incidence of MetS and the optimal anthropometric indicator to predict early adulthood MetS in Tehranian adolescents.

METHODS

Using data from the population-based, prospective, Tehran Lipid and Glucose Study, the utility of four anthropometric indices of adolescents in predicting early adulthood MetS (2009 Joint Scientific Statement definition) was examined among 1100 participants, aged 11-18 years, who were free of MetS at baseline, during a mean of 10.2 years of follow-up.

RESULTS

The cumulative incidence of MetS was 25.5% (95% confidence interval [CI]: 21.8-29.2%) for young men and 1.8% (95% CI: 0.6-3%) for young women. In boys, waist circumference (WC) had the highest odds ratio (OR) for the MetS risk, followed by waist-to-height ratio (WHtR). Adjusting body mass index (BMI) in addition to WC did not change the results in the 11-14-year age group (OR for WC: 2.28 [1.64-3.16] without BMI adjustment vs. 1.98 [1.05-3.73] with BMI adjustment), suggesting that WC may predict MetS risk beyond BMI. None of the anthropometric indices were found to have significant associations with subsequent MetS risk in girls.

CONCLUSIONS

Measures of abdominal obesity including WHtR and WC predicted early adulthood MetS better than BMI in Tehranian male adolescents (11-18 years old).

摘要

关于该主题已知的信息

关于青少年人体测量指标对成年早期代谢综合征(MetS)的预测能力知之甚少。对于体重指数(BMI)与腰围(WC)在青春期后期预测MetS的预测能力存在争议;一些研究不支持在青春期中期除测量BMI外还需测量WC的必要性;另一方面,其他一些研究提出WC在识别青春期后期的MetS方面具有相似的预测性或更具优势。

本研究的新增内容

这是中东地区第一项评估青少年人体测量指标与十年后成年早期MetS发病率之间关系的研究。德黑兰青少年中MetS的发病率存在重要的性别差异。有趣的是,与青春期后期(15 - 18岁)的青少年相比,青春期年龄组(11 - 14岁)的所有人体测量指标具有更好的预测能力。此外,青少年腹部肥胖替代指标,包括WC和腰高比,在预测成年男性MetS方面比BMI更好。在德黑兰男孩(11 - 18岁)中,WC在识别成年期MetS方面似乎具有超越BMI的独立作用。

背景

关于青少年人体测量指标对成年早期代谢综合征(MetS)的预测能力知之甚少。

目的

我们的目的是探讨德黑兰青少年中MetS的发病率以及预测成年早期MetS的最佳人体测量指标。

方法

利用基于人群的前瞻性德黑兰脂质和葡萄糖研究的数据,在1100名年龄在11 - 18岁、基线时无MetS的参与者中,在平均10.2年的随访期间,检查青少年的四种人体测量指标预测成年早期MetS(2009年联合科学声明定义)的效用。

结果

年轻男性MetS的累积发病率为25.5%(95%置信区间[CI]:21.8 - 29.2%),年轻女性为1.8%(95%CI:0.6 - 3%)。在男孩中,腰围(WC)对MetS风险的优势比(OR)最高,其次是腰高比(WHtR)。在11 - 14岁年龄组中,除WC外调整体重指数(BMI)并未改变结果(WC的OR:未调整BMI时为2.28[1.64 - 3.16],调整BMI后为1.98[1.05 - 3.73]),这表明WC可能在BMI之外预测MetS风险。在女孩中,未发现任何人体测量指标与随后的MetS风险有显著关联。

结论

在德黑兰男性青少年(11 - 18岁)中,包括WHtR和WC在内的腹部肥胖测量指标在预测成年早期MetS方面比BMI更好。

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