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高敏 C 反应蛋白是儿童肥胖的预测因素:识别和预防儿童和婴儿饮食和生活方式引起的健康影响研究(IDEFICS)的结果。

High-sensitivity C-reactive protein is a predictive factor of adiposity in children: results of the identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) study.

机构信息

Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.

出版信息

J Am Heart Assoc. 2013 Jun 6;2(3):e000101. doi: 10.1161/JAHA.113.000101.

Abstract

BACKGROUND

Whereas cross-sectional studies have shown that obesity is associated with increased C-reactive protein (CRP) levels in children, little is known about the impact of low-grade inflammation on body mass changes during growth.

METHODS AND RESULTS

We assessed cross-sectionally and longitudinally the association of high-sensitivity (hs)-CRP levels with overweight/obesity and related cardiometabolic risk factors in the Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and InfantS (IDEFICS) cohort. 16 224 children from 8 European countries (2 to 9 years) were recruited during the baseline survey (T0). After the exclusion of 7187 children because of missing hs-CRP measurements and 2421 because of drug use during the previous week, the analysis was performed on 6616 children (Boys=3347; Girls=3269; age=6.3 ± 1.7 years). Of them, 4110 were reexamined 2 years later (T1). Anthropometric variables, blood pressure, hs-CRP, blood lipids, glucose and insulin were measured. The population at T0 was divided into 3 categories, according to the baseline hs-CRP levels. Higher hs-CRP levels were associated with significantly higher prevalence of overweight/obesity, body mass index (BMI) z-score and central adiposity indices (P values all <0.0001), and with higher blood pressure and lower HDL-cholesterol levels. Over the 2-year follow-up, higher baseline hs-CRP levels were associated with a significant increase in BMI z-score (P<0.001) and significantly higher risk of incident overweight/obesity.

CONCLUSIONS

Higher hs-CRP levels are associated to higher body mass and overweight/obesity risk in a large population of European children. Children with higher baseline levels of hs-CRP had a greater increase in BMI z-score and central adiposity over time and were at higher risk of developing overweight/obesity during growth.

摘要

背景

尽管横断面研究表明肥胖与儿童 C 反应蛋白(CRP)水平升高有关,但对于低度炎症对生长过程中体重变化的影响知之甚少。

方法和结果

我们在Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and InfantS(IDEFICS)队列中评估了高敏(hs)-CRP 水平与超重/肥胖及相关心血管代谢危险因素的横断面和纵向关联。来自 8 个欧洲国家(2 至 9 岁)的 16224 名儿童在基线调查(T0)时被招募。在排除了 7187 名因 hs-CRP 测量缺失和 2421 名因上周使用药物而被排除的儿童后,对 6616 名儿童(男孩 3347 名;女孩 3269 名;年龄 6.3±1.7 岁)进行了分析。其中,4110 名儿童在 2 年后(T1)重新接受了检查。测量了体重指数、血压、hs-CRP、血脂、血糖和胰岛素。根据基线 hs-CRP 水平,将 T0 人群分为 3 类。较高的 hs-CRP 水平与超重/肥胖、体重指数(BMI)z 评分和中心性肥胖指数(所有 P 值均<0.0001)的显著更高发生率显著相关,且与血压升高和高密度脂蛋白胆固醇水平降低相关。在 2 年的随访中,较高的基线 hs-CRP 水平与 BMI z 评分的显著增加(P<0.001)和超重/肥胖的发生风险显著增加相关。

结论

在欧洲儿童的大型人群中,较高的 hs-CRP 水平与更高的体重和超重/肥胖风险相关。基线 hs-CRP 水平较高的儿童在随访期间 BMI z 评分和中心性肥胖的增加幅度更大,且在生长过程中超重/肥胖的风险更高。

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