5 岁及以下儿童肥胖指标与心脏代谢结局的相关性。
Associations of cardiometabolic outcomes with indices of obesity in children aged 5 years and younger.
机构信息
Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
出版信息
PLoS One. 2019 Jul 5;14(7):e0218816. doi: 10.1371/journal.pone.0218816. eCollection 2019.
BACKGROUND
Childhood obesity is a world-wide concern due to its growing prevalence and association with cardiometabolic risk factors in childhood and subsequent adult cardiovascular disease. In young pre-school children, there is uncertainty regarding which of the commonly used anthropometric measures of childhood obesity is best associated with cardiometabolic risk factors. This study compared the utility of common measures used in identifying obesity in these young children.
METHODS
The four commonly used metrics for identifying obesity in children: body fat percentage ≥ 90th percentile, waist circumference ≥ 90th percentile, BMI z score > 2 SD and waist-to-height ratio (WHtR) ≥ 0.5, were measured in a cohort of children born singleton, at full term and followed from birth (n = 761) to 5 years of age (n = 513). The utility of each in identifying cardiometabolic risk factors (fasting lipid profile, fasting blood glucose and blood pressure) was examined.
RESULTS
At age 5 years, children with percent body fat ≥ 90th percentile or waist circumference ≥ 90th percentile, were associated with higher levels of triglycerides, glucose, and systolic and diastolic blood pressures than those < 90th percentile, respectively. Such differences were not obvious at age 3 years or at birth. A BMI z-score > 2 SD was associated with higher levels of triglycerides and systolic and diastolic blood pressure but not glucose at age 5 years. Differences in HDL cholesterol, fasting glucose and systolic blood pressure were observed in children with BMI z score > 2 SD at age 3 years but not with the other indices of obesity. As almost all children had WHtR ≥ 0.5 at birth, ages 1 and 3 years, this measure could not differentiate increased cardiometabolic risk. At age 5 years, the differences were much more obvious, with significant differences in triglycerides and systolic and diastolic blood pressures between those with WHtR ≥ 0.5 and those with < 0.5.
CONCLUSION
Each of the four commonly used measures of childhood obesity shows moderate associations with cardiometabolic risk factors at 5 years, with no advantage of one measure over the other. These associations were less consistent at 3 years of age or younger. These observations have not been reported previously.
背景
由于儿童肥胖症的发病率不断上升，且与儿童时期的心血管代谢危险因素及随后的成人心血管疾病相关，因此它成为了一个全球性的关注点。在幼儿中，对于哪种常用的儿童肥胖衡量标准与心血管代谢危险因素的相关性最好，目前还存在不确定性。本研究比较了这些年幼儿童中常用的肥胖识别方法的效用。
方法
在一个由足月单胎出生并随访至 5 岁（n = 513）的队列中，测量了四种常用于识别儿童肥胖的常用指标：体脂百分比≥第 90 百分位数、腰围≥第 90 百分位数、BMI z 评分>2SD 和腰高比（WHtR）≥0.5。研究了每种方法在识别心血管代谢危险因素（空腹血脂谱、空腹血糖和血压）方面的效用。
结果
在 5 岁时，体脂百分比≥第 90 百分位数或腰围≥第 90 百分位数的儿童，与<第 90 百分位数的儿童相比，分别具有更高水平的甘油三酯、血糖和收缩压及舒张压。在 3 岁或出生时，这种差异并不明显。BMI z 评分>2SD 与 5 岁时更高的甘油三酯和收缩压及舒张压水平相关，但与血糖无关。在 3 岁时，BMI z 评分>2SD 的儿童中观察到高密度脂蛋白胆固醇、空腹血糖和收缩压的差异，但其他肥胖指标没有差异。由于几乎所有儿童在出生时、1 岁和 3 岁时的 WHtR 都≥0.5，因此该指标无法区分心血管代谢风险的增加。在 5 岁时，差异更为明显，WHtR≥0.5 的儿童与<0.5 的儿童在甘油三酯和收缩压及舒张压方面存在显著差异。
结论
四种常用的儿童肥胖衡量标准在 5 岁时均与心血管代谢危险因素中度相关，没有一种标准优于另一种标准。这些关联在 3 岁或更小时不太一致。这些观察结果以前没有报道过。
Zotero 插件