Heshmat Ramin, Qorbani Mostafa, Shahr Babaki Amir Eslami, Djalalinia Shirin, Ataei-Jafari Asal, Motlagh Mohammad Esmaeil, Ardalan Gelayol, Arefirad Tahereh, Rezaei Fatemeh, Asayesh Hamid, Kelishadi Roya
Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
PLoS One. 2016 May 11;11(5):e0154502. doi: 10.1371/journal.pone.0154502. eCollection 2016.
Metabolic syndrome (MetS) and its contributing factors are considered important health problems in the pediatric age group. This study was designed to assess the joint association of ST and PA with cardiometabolic risk factors among Iranian adolescents. A representative sample of 5625 (50.2% boys) school students with a mean age of 14.73 (SD: 2.41) were selected through multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran. ST and PA were assessed by self-administered validated questionnaires. Anthropometric measures (height, weight and waist circumference (WC)) and MetS components (abdominal obesity, elevated blood pressure (BP), low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides (TG) and high fasting blood sugar (FBG)) were measured according to standardized protocols. MetS was defined according to the Adult Treatment Panel III criteria modified for the pediatric age group. Moreover, elevated total cholesterol (TC), elevated low-density lipoprotein cholesterol (LDL-C), and generalized obesity were considered as other cardiometabolic risk factors. Students with high ST levels had significantly higher body mass index z-score (BMI z-score), WC, TG, LDL-C, and BP as well as lower HDL-C level; whereas those with high PA levels had significantly higher HDL-C levels as well as lower BMI z-score, TC, and BP. Adolescents with low PA/ high ST levels had significantly higher BMI, WC, LDL-C levels, as well as higher SBP and DBP compared to their other counterparts. In Multivariate model, joint effect of low PA/ high ST (compared to the high PA/low ST group) increased the odds of overweight, abdominal obesity and low HDL-C and decreased the odds of elevated TC. The findings of this study showed that joint association of high ST and low PA have direct association with abdominal obesity, overweight and low HDL-C and indirect association with elevated TC.
代谢综合征（MetS）及其相关因素被认为是儿童年龄组中的重要健康问题。本研究旨在评估伊朗青少年中静态时间（ST）和身体活动（PA）与心血管代谢危险因素的联合关联。通过多阶段随机整群抽样方法，从伊朗27个省的城乡地区选取了5625名平均年龄为14.73岁（标准差：2.41）的在校学生作为代表性样本，其中男生占50.2%。通过自行填写的有效问卷评估ST和PA。根据标准化方案测量人体测量指标（身高、体重和腰围（WC））以及MetS组分（腹型肥胖、血压（BP）升高、高密度脂蛋白胆固醇（HDL-C）降低、甘油三酯（TG）升高和空腹血糖（FBG）升高）。MetS根据针对儿童年龄组修改的成人治疗小组III标准进行定义。此外，总胆固醇（TC）升高、低密度脂蛋白胆固醇（LDL-C）升高和全身性肥胖被视为其他心血管代谢危险因素。ST水平高的学生的体重指数z评分（BMI z评分）、WC、TG、LDL-C和BP显著更高，而HDL-C水平更低；而PA水平高的学生的HDL-C水平显著更高，BMI z评分、TC和BP更低。与其他同龄人相比，PA水平低/ST水平高的青少年的BMI、WC、LDL-C水平以及收缩压（SBP）和舒张压（DBP）显著更高。在多变量模型中，低PA/高ST的联合效应（与高PA/低ST组相比）增加了超重、腹型肥胖和低HDL-C的几率，并降低了TC升高的几率。本研究结果表明，高ST和低PA的联合关联与腹型肥胖、超重和低HDL-C直接相关，与TC升高间接相关。
