Sapunar Jorge, Aguilar-Farías Nicolás, Navarro Juan, Araneda Gustavo, Chandía-Poblete Damian, Manríquez Víctor, Brito Roberto, Cerda Álvaro
CEMT-BIOREN, Centro de Excelencia en Medicina Traslacional, Universidad de La Frontera, Temuco, Chile.
Centro de Investigación en Epidemiología Cardiovascular y Nutricional, Universidad de La Frontera, Temuco, Chile.
Rev Med Chil. 2018 Dec;146(10):1112-1122. doi: 10.4067/S0034-98872018001001112.
Dyslipidemias in childhood increase the risk of cardiovascular events in adult life.
To evaluate the prevalence of dyslipidemia and risk of atherogenicity based in the atherogenic index of plasma (AIP) in a sample of school children and adolescents.
Cross-sectional study of 208 children aged 10.4 ± 1.0 years (107 women). Demographic data were obtained, and a clinical evaluation was conducted, including pubertal development according to Tanner and anthropometric parameters. A fasting blood sample was obtained to measure total cholesterol (CT), HDL cholesterol (cHDL) and triglycerides (TG), glucose and insulin. LDL cholesterol (cLDL), Non-HDL cholesterol and the indices CT/cHDL, cLDL/cHDL and AIP (log[TG/cHDL]) were calculated. Risk categories according to AIP for the pediatric population were also determined (low: AIP < 0.11, intermediate: AIP 0.11-0.21, high: AIP > 0.21).
Thirty eight percent of participants had dyslipidemia, without differences by gender and pubertal development. The frequency of dyslipidemia was significantly higher in children with obesity (54%, p < 0.01) and a waist circumference over percentile 90 (61%; p < 0.01). The later conditions had also higher CT/cHDL, cLDL/cHDL and AIP. According to AIP, 54% of children had a high atherogenicity risk along with alterations in anthropometric parameters and insulin resistance. All anthropometric and insulin resistance parameters were significantly correlated with the AIP.
There is a high prevalence of dyslipidemia in the studied population, which is associated with an increased cardiometabolic risk. The indices of atherogenicity and particularly AIP are correlated with nutritional status, abdominal obesity and parameters of insulin resistance.
儿童血脂异常会增加成年后患心血管疾病的风险。
评估学龄儿童和青少年样本中血脂异常的患病率以及基于血浆致动脉粥样硬化指数（AIP）的致动脉粥样硬化风险。
对208名年龄为10.4±1.0岁的儿童（107名女性）进行横断面研究。获取人口统计学数据，并进行临床评估，包括根据坦纳分期法评估青春期发育情况和人体测量参数。采集空腹血样以测量总胆固醇（CT）、高密度脂蛋白胆固醇（cHDL）、甘油三酯（TG）、血糖和胰岛素。计算低密度脂蛋白胆固醇（cLDL）、非高密度脂蛋白胆固醇以及CT/cHDL、cLDL/cHDL和AIP（log[TG/cHDL]）指数。还确定了儿科人群根据AIP划分的风险类别（低：AIP<0.11，中：AIP 0.11 - 0.21，高：AIP>0.21）。
38%的参与者患有血脂异常，在性别和青春期发育方面无差异。肥胖儿童（54%，p<0.01）和腰围超过第90百分位数的儿童（61%；p<0.01）中血脂异常的发生率显著更高。后两种情况的CT/cHDL、cLDL/cHDL和AIP也更高。根据AIP，54%的儿童具有高致动脉粥样硬化风险，同时伴有人体测量参数改变和胰岛素抵抗。所有人体测量和胰岛素抵抗参数均与AIP显著相关。
在研究人群中血脂异常的患病率很高，这与心脏代谢风险增加有关。致动脉粥样硬化指数，尤其是AIP，与营养状况、腹部肥胖和胰岛素抵抗参数相关。
