Mastroeni Silmara Salete de Barros Silva, Mastroeni Marco Fabio, Gonçalves Muryel de Carvalho, Debortoli Guilherme, da Silva Nilza Nunes, Bernal Regina Tomie Ivata, Adamovski Maristela, Veugelers Paul J, Rondó Patrícia Helen de Carvalho
a Department of Physical Education, University of Joinville Region, Rua Paulo Malschitzki, no. 10, Joinville, 89219-710, Brazil.
b Population Health Intervention Research Unit, School of Public Health, University of Alberta, 3-50 University Terrace, 8303 - 112 St., Edmonton, AB T6G 2T4, Canada.
Appl Physiol Nutr Metab. 2016 Jun;41(6):659-65. doi: 10.1139/apnm-2015-0632. Epub 2016 Feb 18.
Excess body weight leads to a variety of metabolic changes and increases the risk for cardiovascular diseases (CVD) in adulthood. The objective of this study was to investigate the presence of risk markers for CVD among Brazilian adolescents of normal weight and with excess body weight. The markers included blood pressure, C-reactive protein, homocysteine, tumor necrosis factor alpha, fibrinogen, fasting insulin and glucose, homeostasis model assessment of insulin resistance (HOMA-IR), leptin, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and triglycerides. We calculated odds ratios (OR) using logistic regression and adjusted for potential confounders such as age, sex, physical activity, and socioeconomic background. Compared with normal weight subjects, overweight/obese adolescents were more likely to have higher systolic blood pressure (OR = 3.49, p < 0.001), fasting insulin (OR = 8.03, p < 0.001), HOMA-IR (OR = 8.03, p < 0.001), leptin (OR = 5.55, p < 0.001), and LDL-c (OR = 5.50, p < 0.001) and lower serum HDL-c concentrations (OR = 2.76, p = 0.004). After adjustment for confounders, the estimates did not change substantially, except for leptin for which the risk associated with overweight increased to 11.09 (95% CI: 4.05-30.35). In conclusion, excess body weight in adolescents exhibits strong associations with several markers that are established as causes of CVD in adults. This observation stresses the importance of primary prevention and of maintaining a healthy body weight throughout adolescence to reduce the global burden of CVD.
超重会导致多种代谢变化,并增加成年后患心血管疾病(CVD)的风险。本研究的目的是调查体重正常和超重的巴西青少年中CVD风险标志物的存在情况。这些标志物包括血压、C反应蛋白、同型半胱氨酸、肿瘤坏死因子α、纤维蛋白原、空腹胰岛素和葡萄糖、胰岛素抵抗的稳态模型评估(HOMA-IR)、瘦素、总胆固醇、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)和甘油三酯。我们使用逻辑回归计算优势比(OR),并对年龄、性别、身体活动和社会经济背景等潜在混杂因素进行了调整。与体重正常的受试者相比,超重/肥胖青少年更有可能出现较高的收缩压(OR = 3.49,p < 0.001)、空腹胰岛素(OR = 8.03,p < 0.001)、HOMA-IR(OR = 8.03,p < 0.001)、瘦素(OR = 5.55,p < 0.001)和LDL-c(OR = 5.50,p < 0.001),以及较低的血清HDL-c浓度(OR = 2.76,p = 0.004)。在对混杂因素进行调整后,估计值没有实质性变化,但瘦素除外,超重相关风险增加到了11.09(95%CI:4.05 - 30.35)。总之,青少年超重与几种在成年人中被确定为CVD病因的标志物密切相关。这一观察结果强调了一级预防以及在整个青春期保持健康体重以减轻CVD全球负担的重要性。