Lee Arthur M, Gurka Matthew J, DeBoer Mark D
Department of Pediatrics, University of Virginia, Charlottesville, Virginia; and.
Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, Florida.
Pediatrics. 2016 Mar;137(3):e20153177. doi: 10.1542/peds.2015-3177. Epub 2016 Feb 9.
Childhood metabolic syndrome (MetS) is a risk factor for adverse outcomes later in life. Our goal was to identify temporal trends among US adolescents in the severity of MetS, its individual components, and factors related to diet and physical activity.
We analyzed 5117 participants aged 12 to 19 from NHANES. We used regression analysis of individual waves of data, 1999 to 2012. MetS severity was calculated using a gender- and race/ethnicity-specific MetS severity z score.
There was a linear trend of decreasing MetS severity in US adolescents from 1999 to 2012 (P = .030). This occurred despite a trend of increasing BMI z score (P = .005); instead, the decrease in MetS severity appeared to be due to trends in increasing high-density lipoprotein (HDL; P < .0001) and decreasing triglyceride (P = .0001) levels. In considering lifestyle factors, there was no change in physical activity over the time period. Regarding dietary patterns, total calorie consumption and carbohydrate consumption were positively associated with triglyceride levels and negatively associated with HDL levels, whereas unsaturated fat consumption exhibited the opposite associations. Consistent with these associations, there was a trend of decreasing total calorie consumption (P < .0001), decreasing carbohydrate consumption (P < .0001), and increasing unsaturated fat consumption (P = .002).
The healthier trend of declining MetS severity in adolescents appeared to be due to favorable increases in HDL and decreases in fasting triglyceride measurements. These were in turn associated with favorable changes in dietary patterns among US adolescents. Future studies should investigate the causality of dietary differences on changes in MetS severity in adolescents.
儿童代谢综合征（MetS）是日后生活中不良后果的一个风险因素。我们的目标是确定美国青少年中代谢综合征严重程度、其各个组成部分以及与饮食和身体活动相关因素的时间趋势。
我们分析了来自美国国家健康与营养检查调查（NHANES）的5117名年龄在12至19岁的参与者。我们对1999年至2012年各波次的数据进行了回归分析。使用特定性别和种族/族裔的代谢综合征严重程度z评分来计算代谢综合征的严重程度。
1999年至2012年期间，美国青少年的代谢综合征严重程度呈线性下降趋势（P = 0.030）。尽管体重指数z评分呈上升趋势（P = 0.005），但代谢综合征严重程度的下降似乎是由于高密度脂蛋白（HDL）水平上升（P < 0.0001）和甘油三酯水平下降（P = 0.0001）的趋势所致。在考虑生活方式因素时，该时间段内身体活动没有变化。关于饮食模式，总热量消耗和碳水化合物消耗与甘油三酯水平呈正相关，与HDL水平呈负相关，而不饱和脂肪消耗则呈现相反的关联。与这些关联一致，总热量消耗呈下降趋势（P < 0.0001），碳水化合物消耗呈下降趋势（P < 0.0001），不饱和脂肪消耗呈上升趋势（P = 0.002）。
青少年代谢综合征严重程度下降这一更健康的趋势似乎是由于HDL的有利增加和空腹甘油三酯测量值的下降。这些反过来又与美国青少年饮食模式的有利变化相关。未来的研究应调查饮食差异对青少年代谢综合征严重程度变化的因果关系。
