Hetherington-Rauth Megan, Bea Jennifer W, Lee Vinson R, Blew Robert M, Funk Janet, Lohman Timothy G, Going Scott B
Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721, USA.
College of Agriculture and Life Sciences, Department of Nutritional Sciences, University of Arizona, Shantz Building, PO Box 210038, 1177 E. 4th Street, Tucson, AZ, 85721-0034, USA.
Nutr J. 2017 Feb 23;16(1):15. doi: 10.1186/s12937-017-0236-7.
Childhood overweight and obesity remains high, contributing to cardiometabolic risk factors at younger ages. It is unclear which measures of adiposity serve as the best proxies for identifying children at metabolic risk. This study assessed whether DXA-derived direct measures of adiposity are more strongly related to cardiometabolic risk factors in children than indirect measures.
Anthropometric and DXA measures of adiposity and a comprehensive assessment of cardiometabolic risk factors were obtained in 288, 9-12 year old girls, most being of Hispanic ethnicity. Multiple regression models for each metabolic parameter were run against each adiposity measure while controlling for maturation and ethnicity. In addition, regression models including both indirect and direct measures were developed to assess whether using direct measures of adiposity could provide a better prediction of the cardiometabolic risk factors beyond that of using indirect measures alone.
Measures of adiposity were significantly correlated with cardiometabolic risk factors (p < 0.05) except fasting glucose. After adjusting for maturation and ethnicity, indirect measures of adiposity accounted for 29-34% in HOMA-IR, 10-13% in TG, 14-17% in HDL-C, and 5-8% in LDL-C while direct measures accounted for 29-34% in HOMA-IR, 10-12% in TG, 13-16% in HDL-C, and 5-6% in LDL-C. The addition of direct measures of adiposity to indirect measures added significantly to the variance explained for HOMA-IR (p = 0.04).
Anthropometric measures may perform as well as the more precise direct DXA-derived measures of adiposity for assessing most CVD risk factors in preadolescent girls. The use of DXA-derived adiposity measures together with indirect measures may be advantageous for predicting insulin resistance risk.
NCT02654262 . Retrospectively registered 11 January 2016.
儿童超重和肥胖现象仍然普遍，导致在较年轻时就出现心血管代谢危险因素。目前尚不清楚哪种肥胖测量指标最适合用于识别有代谢风险的儿童。本研究评估了双能X线吸收法（DXA）得出的肥胖直接测量指标与间接测量指标相比，是否与儿童心血管代谢危险因素的关联更强。
对288名9至12岁的女孩进行了人体测量和DXA肥胖测量，并对心血管代谢危险因素进行了全面评估，这些女孩大多为西班牙裔。在控制成熟度和种族的同时，针对每个肥胖测量指标建立了针对每个代谢参数的多元回归模型。此外，还建立了包括间接和直接测量指标的回归模型，以评估使用肥胖直接测量指标是否比仅使用间接测量指标能更好地预测心血管代谢危险因素。
除空腹血糖外，肥胖测量指标与心血管代谢危险因素显著相关（p < 0.05）。在调整成熟度和种族后，肥胖间接测量指标在胰岛素抵抗稳态模型评估（HOMA-IR）中占29 - 34%，甘油三酯（TG）中占10 - 13%，高密度脂蛋白胆固醇（HDL-C）中占14 - 17%，低密度脂蛋白胆固醇（LDL-C）中占5 - 8%；而直接测量指标在HOMA-IR中占29 - 34%，TG中占10 - 12%，HDL-C中占13 - 16%，LDL-C中占5 - 6%。将肥胖直接测量指标添加到间接测量指标中，可显著增加HOMA-IR的方差解释量（p = 0.04）。
在评估青春期前女孩的大多数心血管疾病风险因素时，人体测量指标的效果可能与更精确的DXA得出的肥胖直接测量指标相当。将DXA得出的肥胖测量指标与间接测量指标结合使用，可能有利于预测胰岛素抵抗风险。
NCT02654262。2016年1月11日进行回顾性注册。
