Cooper Sharon P, Shipp Eva M, Del Junco Deborah J, Cooper Charles J, Bautista Leonelo E, Levin Jeffrey
From the School of Public Health and Medical School, University of Texas Health Science Center, Houston, the Texas A&M School of Public Health, College Station, the University of Wisconsin School of Medicine and Public Health, Madison, and the University of Texas Health Science Center at Tyler.
South Med J. 2016 Feb;109(2):130-6. doi: 10.14423/SMJ.0000000000000411.
Despite a national crisis of increased prevalence of obesity and type 2 diabetes mellitus in adolescents, especially among Hispanics, there is a paucity of data on health indicators among farmworker adolescents and their peers. The main aim of this study was to estimate the prevalence of cardiovascular disease risk factors in a population of Hispanic adolescent students in south Texas. The study also aimed to compare the prevalence of these risk factors between students enrolled in the Migrant Education Program (MEP) and other students, and between boys and girls.
In partnership with the Weslaco (Texas) Independent School District and the Migrant Education Department, a cohort study was conducted from 2007 to 2010 to estimate the prevalence of overall obesity (body mass index ≥85th percentile for age and sex), abdominal obesity (waist circumference ≥75th percentile for age, sex, and ethnicity), acanthosis nigricans (AN), and high blood pressure (HBP; ≥90th percentile for age, height, and sex or systolic/diastolic BP ≥120/80 mm Hg) among MEP students compared with other students from two south Texas high schools. Multilevel logistic regression was used to assess the relation between sex and our main outcomes of interest while accounting for within-school nesting of participants.
Among 628 sampled students, 508 (80.9%) completed the consent procedure and participated in the study. Of these, 257 were MEP students and 251 were non-MEP peers. Approximately 96.7% of participants were Hispanic and 50.0% were boys. Analyses of data across the years comparing MEP students and non-MEP students show an average prevalence of 44.8% versus 47.7% for overall obesity, 43.2% versus 43.7% for abdominal obesity, 24.7% versus 24.7% for AN, and 29.2% versus 32.8% for HBP. Across recruitment and follow-up years, the prevalence of overall obesity, abdominal obesity, and HBP was 1.3 to 1.5, 1.2 to 1.8, and 2.9 to 4.6 times higher in boys than in girls, respectively. In contrast, the prevalence of AN varied little by sex.
The high prevalence of cardiovascular risk factors in both groups suggests a compelling need for comprehensive, culturally targeted interventions to prevent future cardiovascular diseases in these high-risk Hispanic adolescents, especially among boys. There were not, however, substantial differences between MEP students and other students. These findings also support the feasibility of conducting future epidemiologic studies among adolescent farmworkers and their families, as well as culturally appropriate school or community-based interventions.
尽管全国范围内青少年肥胖症和2型糖尿病的患病率不断上升已成为一场危机，尤其是在西班牙裔青少年中，但关于农场工人青少年及其同龄人健康指标的数据却很少。本研究的主要目的是估计南德克萨斯州西班牙裔青少年学生群体中心血管疾病风险因素的患病率。该研究还旨在比较参加移民教育计划（MEP）的学生与其他学生之间，以及男孩和女孩之间这些风险因素的患病率。
与韦斯拉科（德克萨斯州）独立学区和移民教育部合作，于2007年至2010年进行了一项队列研究，以估计总体肥胖（体重指数≥年龄和性别的第85百分位数）、腹部肥胖（腰围≥年龄、性别和种族的第75百分位数）、黑棘皮病（AN）和高血压（HBP；≥年龄、身高和性别的第90百分位数或收缩压/舒张压≥120/80 mmHg）在MEP学生中的患病率，并与来自南德克萨斯州两所高中的其他学生进行比较。使用多水平逻辑回归来评估性别与我们感兴趣的主要结局之间的关系，同时考虑参与者在学校内的嵌套情况。
在628名抽样学生中，508名（80.9%）完成了同意程序并参与了研究。其中，257名是MEP学生，251名是MEP以外的同龄人。大约9 / 6.7%的参与者是西班牙裔，50.0%是男孩。对各年份数据进行分析，比较MEP学生和非MEP学生，总体肥胖的平均患病率分别为44.8%和47.7%，腹部肥胖为43.2%和43.7%，AN为24.7%和24.7%，HBP为29.2%和32.8%。在整个招募和随访年份中，总体肥胖、腹部肥胖和HBP的患病率在男孩中分别比女孩高1.3至1.5倍、1.2至1.8倍和2.9至4.6倍。相比之下，AN的患病率在性别上差异不大。
两组中心血管疾病风险因素的高患病率表明，迫切需要针对这些高危西班牙裔青少年，尤其是男孩，开展全面的、具有文化针对性的干预措施，以预防未来的心血管疾病。然而，MEP学生和其他学生之间并没有实质性差异。这些发现也支持了在青少年农场工人及其家庭中开展未来流行病学研究以及进行适合文化背景的学校或社区干预措施的可行性。
