Yan Yinkun, Hou Dongqing, Liu Junting, Zhao Xiaoyuan, Cheng Hong, Yang Ping, Shan Xinying, Mi Jie
Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2016 Jan;50(1):28-33. doi: 10.3760/cma.j.issn.0253-9624.2016.01.006.
To observe the effect of childhood excessive adiposity on long-term risk of adult carotid atherosclerosis and arterial stiffness.
At baseline, in 1987, by using stratified cluster sampling design, 3 198 healthy children aged 6-18 were recruited from six primary schools and six middle schools from three districts (Chaoyang, Xicheng, and Haidian) in Beijing, with blood pressure, weight, height and left scapular skinfold thickness (LSSF) measured. From April 2010 to July 2012, 1 225 subjects were followed from childhood to adulthood. Questionnaire, biochemistry parameters, carotid-femoral pulse wave velocity (cfPWV), and carotid intima media thickness (cIMT) were measured at follow-up. Based on weight statuses in childhood and adulthood, subjects were classified into four groups (persistent non-overweight from childhood to adulthood, overweight in childhood but non-overweight in adulthood, non-overweight in childhood but overweight in adulthood, persistent overweight from childhood to adulthood). Multiple logistic regression model was used to analyze the association between weight statuses changing from childhood to adulthood and adult high cfPWV and high cIMT.
The prevalence of overweight (including obesity) at adulthood was 52.2% (639). Males had higher prevalence of smoking (62.5%(422/675) vs 29.4%(160/550), χ(2)=133.21, P<0.001), drinking (52.1%(353/675) vs 26.1%(140/550), χ(2)=87.13, P<0.001), overweight (including obesity) (69.3% (468/675) vs 31.1% (171/550), χ(2)=182.18, P< 0.001) than females. With adjusting for gender, age, and length of follow-up, the risk of high cfPWV and high cIMT increased by 26% and 58% for 1 units increase in BMI, and by 30% and 36% for 1 units increase in LSSF. Compared to subjects with persistent non-overweight from childhood to adulthood, subjects with overweight in childhood but non-overweight in adulthood had similar risks of high cfPWV (OR=1.59, 95%CI: 0.77-3.30)and high cIMT (OR=1.47, 95%CI:0.65-3.31). The risks of high cfPWV and high cIMT increased among subjects with non-overweight in childhood but overweight in adulthood (OR=1.92, 95%CI:1.37-2.68; OR=3.69, 95% CI:2.61- 5.23) and among subjects with persistent overweight from childhood to adulthood (OR=2.53, 95%CI:1.70-3.76; OR=5.37, 95%CI:3.62-7.97).
We concluded that a overweight children changed to a healthy weight adult, the risks of adult subclinical atherosclerosis and arterial stiffness would not be increased.
观察儿童期过度肥胖对成人颈动脉粥样硬化和动脉僵硬度长期风险的影响。
1987年基线时，采用分层整群抽样设计，从北京市朝阳区、西城区和海淀区三个区的6所小学和6所中学招募3198名6 - 18岁健康儿童，测量其血压、体重、身高和左肩胛下皮褶厚度（LSSF）。2010年4月至2012年7月，对1225名受试者进行从儿童期到成年期的随访。随访时测量问卷调查、生化参数、颈股脉搏波速度（cfPWV）和颈动脉内膜中层厚度（cIMT）。根据儿童期和成年期的体重状况，将受试者分为四组（从儿童期到成年期持续非超重、儿童期超重但成年期非超重、儿童期非超重但成年期超重、从儿童期到成年期持续超重）。采用多因素logistic回归模型分析从儿童期到成年期体重状况变化与成人高cfPWV和高cIMT之间的关联。
成年期超重（包括肥胖）患病率为52.2%（639人）。男性吸烟（62.5%（422/675）对29.4%（160/550），χ² = 133.21，P < 0.001）、饮酒（52.1%（353/675）对26.1%（140/550），χ² = 87.13，P < 0.001）、超重（包括肥胖）（69.3%（468/675）对31.1%（171/550），χ² = 182.18，P < 0.001）的患病率均高于女性。在调整性别、年龄和随访时间后，BMI每增加1个单位，高cfPWV和高cIMT的风险分别增加26%和58%，LSSF每增加1个单位，风险分别增加30%和36%。与从儿童期到成年期持续非超重的受试者相比，儿童期超重但成年期非超重的受试者高cfPWV（OR = 1.59，95%CI：0.77 - 3.30）和高cIMT（OR = 1.47，95%CI：0.65 - 3.31）的风险相似。儿童期非超重但成年期超重的受试者（OR = 1.92，95%CI：1.37 - 2.68；OR = 3.69，95%CI：2.61 - 5.23）以及从儿童期到成年期持续超重的受试者（OR = 2.53，95%CI：1.70 - 3.76；OR = 5.37，95%CI：3.62 - 7.97）中，高cfPWV和高cIMT的风险增加。
我们得出结论，超重儿童转变为健康体重的成年人，成人亚临床动脉粥样硬化和动脉僵硬度的风险不会增加。
