Li Min, Zhang Tao, Xu Pei-ru
Department of Pediatrics, First Affiliated Hospital.
Zhonghua Liu Xing Bing Xue Za Zhi. 2013 Apr;34(4):336-41.
This study was designed to evaluate the epidemiology and clinical characteristics on metabolic syndrome (MetS) among overweight and obese children aged from 6 to 13 years old in Kazakh ethnic populations.
Based on the data including body mass index (BMI), waist circumference (WC) and blood pressure measured from the 'Kazakh ethnic child Health examination study in Yili', 5360 Kazakh children aged 6 - 13 were screened for overweight and obesity in Xinjiang, using the Chinese BMI cutoffs for schoolchildren (7 - 18 years) and WHO growth reference for school-aged children and adolescents (6 year). Simultaneously a group of children with normal BMI were selected as the control group. Fasting plasma glucose (FPG), insulin (FINS), serum high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were examined. HOMA-IR index was calculated to estimate the individual insulin resistance. Children under study were older than or equal to 10 years and met the criteria according to the definition of metabolic syndrome, prophylaxis and treatment on Chinese children and adolescents, proposed by the Society of Pediatrics in China or NCEP-ATPIII definition as MetS. Risk factors related to cardiovascular diseases were analyzed according to the criteria by the Society of Pediatrics among those aged from 6 to 10 years old children. Connection between waist-to-height ratio (WHtR) and biochemical indexes was explored.
Prevalence rates of MetS according to the criteria from Society of Pediatrics in China were: 0%, 9.57%, 19.64% in the normal weight, overweight and obese children, respectively. The rates diagnosed by NCEP-ATPIII definition were 0.64%, 2.61%, 16.07% respectively. The detective rates of individual MetS component among obese children were: 78.95% for abdominal obesity, 29.82% for elevated BPs, 26.32% for high TG, 22.81% for low HDL-C, 0.88% for FPG. High TG (31.15%), abdominal obesity (23.77%) and low HDL-C (22.95%) appeared as the leading three abnormal indices among the overweight children. With increased BMI, the clustering of MetS components were also remarkably increasing. The detective rates of cardiovascular-related risk factors among overweight or obesity children from 6 to 10 years old were:abdominal obesity or obesity, low HDL-C, high TG, impaired FPG, elevated BPs. Differences were seen between overweight or obesity children and normal weight children on the detective rates of high TG, low HDL-C, abdominal obesity or obesity. WHtR was related with FINS, HOMA-IR index and LDL-C.
MetS seemed epidemic among obese Hazakh children. Abdominal obesity, elevated BPs and high TG were the leading three abnormal factors among obese children. Compare to NCEP-ATPIII, abnormal biochemical indices on overweight Kazakh children seemed to be more sensitive, proposed by the Society of Pediatrics in China.
本研究旨在评估哈萨克族6至13岁超重及肥胖儿童代谢综合征(MetS)的流行病学特征及临床特点。
基于“伊犁哈萨克族儿童健康检查研究”中测量的体重指数(BMI)、腰围(WC)及血压数据,采用中国学龄儿童(7 - 18岁)BMI切点及世界卫生组织学龄儿童和青少年(6岁)生长参考标准,对新疆5360名6 - 13岁哈萨克族儿童进行超重及肥胖筛查。同时选取一组BMI正常的儿童作为对照组。检测空腹血糖(FPG)、胰岛素(FINS)、血清高密度脂蛋白胆固醇(HDL-C)及甘油三酯(TG)。计算HOMA-IR指数以评估个体胰岛素抵抗。研究对象为年龄大于或等于10岁且符合中国儿科学会提出的中国儿童及青少年代谢综合征防治定义标准或NCEP-ATPIII代谢综合征定义标准的儿童。按照中国儿科学会标准分析6至10岁儿童心血管疾病相关危险因素。探讨腰高比(WHtR)与生化指标之间的关联。
根据中国儿科学会标准,正常体重、超重及肥胖儿童的MetS患病率分别为:0%、9.57%、19.64%。按照NCEP-ATPIII定义的患病率分别为0.64%
、2.61%、16.07%。肥胖儿童中各MetS组分的检出率分别为:腹型肥胖78.95%、血压升高29.82%、高TG 26.32%、低HDL-C 22.81%、FPG 0.88%。超重儿童中前三位异常指标为高TG(31.15%)、腹型肥胖(23.77%)及低HDL-C(22.95%)。随着BMI升高,MetS组分聚集也显著增加。6至10岁超重或肥胖儿童心血管相关危险因素的检出率为:腹型肥胖或肥胖、低HDL-C、高TG、FPG受损、血压升高。超重或肥胖儿童与正常体重儿童在高TG、低HDL-C、腹型肥胖或肥胖的检出率上存在差异。WHtR与FINS、HOMA-IR指数及LDL-C相关。
MetS在肥胖哈萨克族儿童中呈流行趋势。腹型肥胖、血压升高及高TG是肥胖儿童中前三位异常因素。与NCEP-ATPIII相比,中国儿科学会提出的标准对超重哈萨克族儿童异常生化指标的检出似乎更敏感。