丹麦/北欧白人儿童和青少年的血脂异常及空腹血浆脂质浓度参考值。
Dyslipidemia and reference values for fasting plasma lipid concentrations in Danish/North-European White children and adolescents.
作者信息
Nielsen Tenna Ruest Haarmark, Lausten-Thomsen Ulrik, Fonvig Cilius Esmann, Bøjsøe Christine, Pedersen Lise, Bratholm Palle Skov, Hansen Torben, Pedersen Oluf, Holm Jens-Christian
机构信息
The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Smedelundsgade 60, DK 4300, Holbæk, Denmark.
Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, DK 2100, Copenhagen, Denmark.
出版信息
BMC Pediatr. 2017 Apr 28;17(1):116. doi: 10.1186/s12887-017-0868-y.
BACKGROUND
Dyslipidemia is reported in 27 - 43% of children and adolescents with overweight/obesity and tracks into adulthood, increasing the risk of cardiovascular morbidity. Cut-off values for fasting plasma lipid concentrations are typically set at fixed levels throughout childhood. The objective of this cross-sectional study was to generate fasting plasma lipid references for a Danish/North-European White population-based cohort of children and adolescents, and investigate the prevalence of dyslipidemia in this cohort as well as in a cohort with overweight/obesity.
METHODS
A population-based cohort of 2141 (1275 girls) children and adolescents aged 6 - 19 (median 11.5) years was recruited from 11 municipalities in Denmark. Additionally, a cohort of children and adolescents of 1421 (774 girls) with overweight/obesity aged 6 - 19 years (median 11.8) was recruited for the study. Height, weight, and fasting plasma lipid concentrations were measured on all participants. Smoothed reference curves and percentiles were generated using the Generalized Additive Models for Location Scale and Shape package in the statistical software R.
RESULTS
In the population-based cohort, plasma concentrations of total cholesterol (TC) (P < 0.05), low-density lipoprotein cholesterol (LDL) (P < 0.005), and high-density lipoprotein cholesterol (HDL) (P < 0.005) were higher in the youngest compared to the oldest tertile. Fasting plasma levels of triglycerides (TG) (P < 0.005) increased with age in both sexes. In boys, non-HDL was lower in the oldest compared to the youngest tertile (P < 0.0005). Concentrations of TC, LDL, non-HDL, and TG were higher (P < 0.05), and HDL lower (P < 0.05) in the cohort with overweight/obesity in both sexes and for all ages except for TC in the youngest girls. The overall prevalence of dyslipidemia was 6.4% in the population-based cohort and 28.0% in the cohort with overweight/obesity. The odds ratio for exhibiting dyslipidemia in the cohort with overweight/obesity compared with the population-based cohort was 6.2 (95% CI: 4.9 - 8.1, P < 2*10).
CONCLUSION
Fasting plasma lipid concentrations change during childhood and adolescence and differ with sex and age. Children and adolescents with obesity have increased concentrations of circulating lipids and exhibit an increased prevalence of dyslipidemia.
TRIAL REGISTRATION
The study is part of The Danish Childhood Obesity Biobank; ClinicalTrials.gov ID-no.: NCT00928473 retrospectively registered on June 25th 2009.
背景
据报道，27%-43%的超重/肥胖儿童和青少年存在血脂异常，且这种情况会持续到成年期，增加心血管疾病的发病风险。儿童期空腹血脂浓度的临界值通常设定为固定水平。这项横断面研究的目的是为丹麦/北欧白人儿童和青少年队列生成空腹血脂参考值，并调查该队列以及超重/肥胖队列中血脂异常的患病率。
方法
从丹麦的11个市镇招募了一个基于人群的队列，共2141名（1275名女孩）6-19岁（中位年龄11.5岁）的儿童和青少年。此外，还招募了一个1421名（774名女孩）6-19岁（中位年龄11.8岁）的超重/肥胖儿童和青少年队列进行研究。对所有参与者测量身高、体重和空腹血脂浓度。使用统计软件R中的位置尺度和形状广义相加模型包生成平滑参考曲线和百分位数。
结果
在基于人群的队列中，与年龄最大的三分位数相比，年龄最小的三分位数的总胆固醇（TC）（P<0.05）、低密度脂蛋白胆固醇（LDL）（P<0.005）和高密度脂蛋白胆固醇（HDL）（P<0.005）血浆浓度更高。空腹甘油三酯（TG）血浆水平（P<0.005）在两性中均随年龄增加。在男孩中，年龄最大的三分位数的非HDL低于年龄最小的三分位数（P<0.0005）。在超重/肥胖队列中，除最年轻女孩的TC外，所有年龄和性别的TC、LDL、非HDL和TG浓度均较高（P<0.05），HDL较低（P<0.05）。基于人群的队列中血脂异常的总体患病率为6.4%，超重/肥胖队列中为28.0%。与基于人群的队列相比，超重/肥胖队列中出现血脂异常的优势比为6.2（95%CI：4.9-8.1，P<2×10）。
结论
儿童和青少年时期空腹血脂浓度会发生变化，且因性别和年龄而异。肥胖儿童和青少年的循环脂质浓度升高，血脂异常患病率增加。
试验注册
该研究是丹麦儿童肥胖生物样本库的一部分；ClinicalTrials.gov识别号：NCT00928473，于2009年6月25日进行回顾性注册。
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