Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK.
Eur J Pediatr. 2013 Jul;172(7):913-8. doi: 10.1007/s00431-013-1973-z. Epub 2013 Feb 26.
The aim of this study was to investigate levels of clustered cardiometabolic risk and the odds of being 'at risk' according to cardiorespiratory fitness status in children. Data from 88 10-11.9-year-old children (mean age 11.05 ± 0.51 years), who participated in either the REACH Year 6 or the Benefits of Fitness Circuits for Primary School Populations studies were combined. Waist circumference, systolic blood pressure, diastolic blood pressure, glucose, triglycerides, high-density lipoprotein cholesterol, adiponectin and C-reactive protein were assessed and used to estimate clustered cardiometabolic risk. Participants were classified as 'fit' or 'unfit' using recently published definitions (46.6 and 41.9 mL/kg/min for boys and girls, respectively), and continuous clustered risk scores between fitness groups were assessed. Participants were subsequently assigned to a 'normal' or 'high' clustered cardiometabolic risk group based on risk scores, and logistic regression analysis assessed the odds of belonging to the increased cardiometabolic risk group according to fitness. The unfit group exhibited significantly higher clustered cardiometabolic risk scores (p < 0.001) than the fit group. A clear association between fitness group and being at increased cardiometabolic risk (B = 2.509, p = 0.001) was also identified, and participants classed as being unfit were found to have odds of being classified as 'at risk' of 12.30 (95 % CI = 2.64-57.33). Conclusion Assessing cardiorespiratory fitness is a valid method of identifying children most at risk of cardiometabolic pathologies. The ROC thresholds could be used to identify populations of children most at risk and may therefore be used to effectively target a cardiometabolic risk-reducing public health intervention.
本研究旨在调查儿童中心血管代谢风险的聚类水平以及根据心肺适能状态处于“风险”状态的几率。这项研究的数据来自于 88 名 10-11.9 岁的儿童(平均年龄 11.05 ± 0.51 岁),他们参加了 REACH 研究的第 6 年或适合小学人群的健身循环研究。评估了腰围、收缩压、舒张压、血糖、甘油三酯、高密度脂蛋白胆固醇、脂联素和 C 反应蛋白,用于估计聚类心血管代谢风险。使用最近公布的定义(男孩和女孩分别为 46.6 和 41.9 mL/kg/min)将参与者分类为“健康”或“不健康”,并评估了两组之间的连续聚类风险评分。随后,根据风险评分将参与者分配到“正常”或“高”聚类心血管代谢风险组,并进行逻辑回归分析,以评估根据健康状况属于增加心血管代谢风险组的几率。不健康组的聚类心血管代谢风险评分明显高于健康组(p<0.001)。还确定了健康组和增加心血管代谢风险之间存在明显的关联(B=2.509,p=0.001),并且被归类为不健康的参与者被发现属于“风险”类别的几率为 12.30(95%CI=2.64-57.33)。结论:评估心肺适能是识别最易患心血管代谢疾病风险的儿童的有效方法。ROC 阈值可用于识别最易患心血管代谢疾病风险的人群,因此可用于有效针对心血管代谢风险降低的公共卫生干预措施。