Western Norway University of Applied Sciences, Department of Sport, Food and Natural Sciences, PO BOX 133, N-6856, Sogndal, Norway; Norwegian School of Sport Sciences, Department of Sports Medicine, PO Box 4014, Sognsveien 220, Ullevaal Stadion, Oslo, Norway.
Western Norway University of Applied Sciences, Department of Sport, Food and Natural Sciences, PO BOX 133, N-6856, Sogndal, Norway.
Atherosclerosis. 2018 Nov;278:299-306. doi: 10.1016/j.atherosclerosis.2018.10.003. Epub 2018 Oct 6.
International reference values for cardiometabolic risk variables, to allow for standardization of continuous risk scores in children, are not currently available. The aim of this study was to provide international age- and gender-specific reference values for cardiometabolic risk factors in children and adolescents.
Cohorts of children sampled from different parts of Europe (North, South, Mid and Eastern) and from the United States were pooled. In total, 22,479 observations (48.7% European vs. 51.3% American), 11,234 from girls and 11,245 from boys, aged 6-18 years were included in the study. Linear mixed-model regression analysis was used to analyze the associations between age and each cardiometabolic risk factor.
Reference values for 14 of the most commonly used cardiometabolic risk variables in clustered risk scores were calculated and presented by age and gender: systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), body mass index (BMI), sum of 4 skinfolds (sum4skin), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TC:HDL-C ratio, glucose, insulin, homeostatic model assessment-score (HOMA-score), and cardiorespiratory fitness (CRF).
This study suggests a common standard to define cardiometabolic risk in children. Adapting this approach makes single risk factors and clustered cardiometabolic disease risk scores comparable to the reference material itself and comparable to cardiometabolic risk values in studies using the same strategy. This unified approach therefore increases the prospect to estimate and compare prevalence and trends of cardiometabolic risk in children when using continuous cardiometabolic risk scores.
目前，尚无用于儿童心血管代谢风险变量的国际参考值，无法对连续风险评分进行标准化。本研究旨在为儿童和青少年的心血管代谢危险因素提供国际年龄和性别特异性参考值。
我们汇集了来自欧洲不同地区（北部、南部、中部和东部）和美国的儿童样本队列。共有 22479 例观察结果（48.7%为欧洲人，51.3%为美国人），包括 11234 名女孩和 11245 名男孩，年龄在 6-18 岁之间，纳入本研究。采用线性混合模型回归分析来分析年龄与每种心血管代谢危险因素之间的关系。
计算并按年龄和性别呈现了聚类风险评分中最常用的 14 种心血管代谢风险变量的参考值：收缩压（SBP）、舒张压（DBP）、腰围（WC）、体质量指数（BMI）、4 个皮褶厚度之和（sum4skin）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、TC:HDL-C 比值、血糖、胰岛素、稳态模型评估评分（HOMA-score）和心肺适能（CRF）。
本研究提出了一种定义儿童心血管代谢风险的通用标准。采用这种方法，单一风险因素和聚类心血管代谢疾病风险评分可以与参考资料本身以及使用相同策略的研究中的心血管代谢风险值相媲美。因此，这种统一的方法增加了使用连续心血管代谢风险评分估计和比较儿童心血管代谢风险的流行率和趋势的可能性。
