Jayawardene W P, Lohrmann D, Dickinson S, Talagala S, Torabi M
Applied Health Science, School of Public Health Bloomington, Indiana University, Bloomington, IN, USA.
Epidemiology and Biostatistics, School of Public Health Bloomington, Indiana University, Bloomington, IN, USA.
Clin Obes. 2017 Feb;7(1):11-21. doi: 10.1111/cob.12171. Epub 2016 Dec 27.
Obesity tracks from childhood to adulthood most strongly of all cardiometabolic risk factors. To determine relationship of body mass index (BMI) and waist circumference (WC) with cardiometabolic risk (dyslipidemia, hyperglycemia and elevated blood pressure) in a large U.S. population ages 12-19 and demographic subgroups. Pooled 1999-2014 National Health and Nutrition Examination Survey data were analyzed (N = 23 438). In addition to standard cutoffs of BMI and WC, risk levels were identified for each laboratory variable: HDL-cholesterol, LDL-cholesterol, triglycerides, total cholesterol (category = lipids); fasting glucose, glycated haemoglobin (category = glucose); systolic/diastolic pressures (category =blood pressure). Within each category, being high-risk on any of the variables was high-risk; being borderline-risk on any, without being high-risk on any, was borderline-risk. Obesity severity was strongly associated with increased cardiometabolic risk, with prevalence of borderline-risk greater than high-risk. Anthropometric indicators in males and Hispanics, versus females and Whites/Blacks, respectively, had stronger associations with cardiometabolic risks. BMI and WC performed well for identifying adolescents with at least one borderline-risk or high-risk level measure for lipids, glucose and blood pressure; relationship strength varying by gender and race/ethnicity. Thus, to prevent or better manage clinical diseases of adolescents with elevated BMI and/or WC, all recommended laboratory tests are warranted.
在所有心血管代谢危险因素中，肥胖从儿童期到成年期的关联性最强。为了确定在美国12至19岁的大量人群及其人口亚组中，体重指数（BMI）和腰围（WC）与心血管代谢风险（血脂异常、高血糖和血压升高）之间的关系。对1999 - 2014年全国健康与营养检查调查的汇总数据进行了分析（N = 23438）。除了BMI和WC的标准临界值外，还确定了每个实验室变量的风险水平：高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、总胆固醇（类别 = 血脂）；空腹血糖、糖化血红蛋白（类别 = 血糖）；收缩压/舒张压（类别 = 血压）。在每个类别中，任何一个变量处于高风险即为高风险；任何一个处于临界风险且无高风险变量，则为临界风险。肥胖严重程度与心血管代谢风险增加密切相关，临界风险的患病率高于高风险。男性和西班牙裔的人体测量指标分别与女性和白人/黑人相比，与心血管代谢风险的关联更强。BMI和WC在识别至少有一项血脂、血糖和血压临界风险或高风险水平测量值的青少年方面表现良好；关联强度因性别和种族/族裔而异。因此，为了预防或更好地管理BMI和/或WC升高的青少年的临床疾病，所有推荐的实验室检查都是必要的。
