Department of Child Health Care, Children's Hospital of Fudan University, Shanghai 201102, China.
Lipids Health Dis. 2013 Aug 28;12:129. doi: 10.1186/1476-511X-12-129.
The prevalence of adolescents' obesity and overweight has dramatically elevated in China. Obese children were likely to insulin resistance and dyslipidemia, which are risk factors of cardiovascular diseases. However there was no cut-off point of anthropometric values to predict the risk factors in Chinese adolescents. The present study was to investigate glycolipid metabolism status of adolescents in Shanghai and to explore the correlations between body mass index standard deviation score (BMI-SDS) and metabolic indices, determine the best cut-off value of BMI-SDS to predict dyslipidemia.
Fifteen schools in Shanghai's two districts were chosen by cluster sampling and primary screening was done in children aged 9-15 years old. After screening of bodyweight and height, overweight and obese adolescents and age-matched children with normal body weight were randomly recruited in the study. Anthropometric measurements, biochemical measurements of glycolipid profiles were done. SPSS19.0 was used to analyze the data. Receiver operating characteristic (ROC) curves were made and the best cut-off values of BMI-SDS to predict dyslipidemia were determined while the Youden indices were maximum.
Five hundred and thirty-eight adolescents were enrolled in this research, among which 283 have normal bodyweight, 115 were overweight and 140 were obese. No significant differences of the ages among 3 groups were found. There were significant differences of WC-SDS (p<0.001), triacylglycerol (p<0.05), high and low density lipoprotein cholesterol (p<0.01), fasting insulin (p<0.01) and C-peptide (p<0.001) among 3 groups. Significant difference of fasting glucose was only found between normal weight and overweight group. Significant difference of total cholesterol was found between obese and normal weight group. There was no significant difference of glycated hemoglobin among 3 groups. The same tendency was found in boys but not in girls. Only HDL-C reduced and TG increased while BMI elevated in girls. The best cut-off value of BMI-SDS was 1.22 to predict dyslipidemia in boys. The BMI cut-off was 21.67 in boys.
Overweight and obese youths had reduced insulin sensitivity and high prevalence of dyslipidemia.When BMI-SDS elevated up to 1.22 and BMI was higher than 21.67 in boys, dyslipidemia may happen.
在中国，青少年肥胖和超重的患病率显著上升。肥胖儿童可能存在胰岛素抵抗和血脂异常，这是心血管疾病的危险因素。然而，目前还没有针对中国青少年的预测危险因素的人体测量学值的截断点。本研究旨在调查上海青少年的糖脂代谢状况，并探讨 BMI-SDS 与代谢指标的相关性，确定 BMI-SDS 预测血脂异常的最佳截断值。
采用整群抽样法选择上海市两个区的 15 所学校，对 9-15 岁儿童进行初步筛查。在筛查体重和身高后，随机招募超重和肥胖青少年以及年龄匹配的正常体重儿童进行研究。进行人体测量学测量和糖脂代谢谱的生化测量。采用 SPSS19.0 进行数据分析。绘制受试者工作特征（ROC）曲线，确定 BMI-SDS 预测血脂异常的最佳截断值，同时取 Youden 指数最大值。
本研究共纳入 538 名青少年，其中 283 名体重正常，115 名超重，140 名肥胖。三组间年龄无显著差异。三组间 WC-SDS（p<0.001）、三酰甘油（p<0.05）、高低密度脂蛋白胆固醇（p<0.01）、空腹胰岛素（p<0.01）和 C 肽（p<0.001）均有显著差异。仅在正常体重组和超重组之间空腹血糖有显著差异。在肥胖组和正常体重组之间总胆固醇有显著差异。三组间糖化血红蛋白无显著差异。在男孩中发现了相同的趋势，但在女孩中则不然。只有在女孩中，随着 BMI 的升高，HDL-C 降低，TG 升高。BMI-SDS 预测男孩血脂异常的最佳截断值为 1.22。男孩的 BMI 截断值为 21.67。
超重和肥胖青少年的胰岛素敏感性降低，血脂异常患病率较高。当 BMI-SDS 升高至 1.22 及以上，且男孩 BMI 高于 21.67 时，可能发生血脂异常。
