Department of Nutrition Science, School of Nutrition, Federal University of Bahia, Basílio da Gama Street, 40110-907, Canela, Salvador, BA, Brazil; Postgraduate Program in Food, Nutrition and Health, School of Nutrition, Federal University of Bahia, Basílio da Gama Street, 40110-907, Canela, Salvador, BA, Brazil.
Department of Nutrition Science, School of Nutrition, Federal University of Bahia, Basílio da Gama Street, 40110-907, Canela, Salvador, BA, Brazil; Postgraduate Program in Food, Nutrition and Health, School of Nutrition, Federal University of Bahia, Basílio da Gama Street, 40110-907, Canela, Salvador, BA, Brazil.
Clin Nutr ESPEN. 2020 Feb;35:167-173. doi: 10.1016/j.clnesp.2019.10.004. Epub 2019 Oct 25.
BACKGROUND & AIMS: Overweight children and adolescents are more likely to evolve with high cholesterol, be obese adults and develop cardiovascular disease. The objective of this study was to identify the influence of anthropometric status on the changes in the lipid profile of children and adolescents during an 18-month follow-up period.
A cohort study involving 540 boys and girls from 7 to 15 years of age was conducted over 18 months' follow-up. The outcome variables were the lipid indicators and the principal exposure variable was anthropometric status, measured by different indicators. A generalized estimating equation (GEE) approach was used to identify the associations of interest.
Irrespective of age, sex, socio-economic status, physical activity and diet, for each gain of 1 cm in the waist circumference (WC) mean in the adjusted model, triglyceride levels increased by a mean of 0.5 mg/dl (p < 0.000) and there was an increase of 0.21 mg/dL in the total cholesterol after the 18-month period. The increase of 0.1 in the mean body mass index (BMI) Z-score promoted a gain of 2.7 mg/dL in the triglycerides mean levels (p < 0.000) and an increase of 1.5 mg/dL in the total cholesterol mean levels (p = 0.014) after the follow-up period. Regarding the waist-to-height ratio (WHtR) and conicity index (CI), an increment of 40.6 mg/dL (p = 0.02) and of 30.1 mg/dL (p = 0.01) was observed in the triglycerides' mean when the participants increased 0.1 in the WHtR mean and CI mean, and the same was observed in the total cholesterol mean, with an increase of 45.4,g/dL (p = 0.02) and 19.3 mg/dL (p = 0.03), for each indicator, respectively. Changes of the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of LDL-cholesterol. HDL-cholesterol was not influenced by the changes in the anthropometric indicators.
At the baseline, a higher triglyceride mean and lower levels of HDL-c were observed in children and adolescents with altered anthropometric status for all measures. Mean triglyceride and total cholesterol levels are influenced by changes in the anthropometric status, regardless of the measure, after 18 months of follow-up. However, for LDL-cholesterol, it was observed that changes in the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of this biochemical variable, while HDL-c was not influenced by changes in any of the anthropometric indicators.
超重的儿童和青少年更有可能发展为高胆固醇、肥胖成年人和心血管疾病。本研究的目的是确定在 18 个月的随访期间，人体测量学状态对儿童和青少年血脂谱变化的影响。
对 7 至 15 岁的 540 名男孩和女孩进行了为期 18 个月的随访队列研究。主要的观察指标是脂质指标，主要的暴露变量是通过不同指标测量的人体测量学状态。采用广义估计方程（GEE）方法来确定感兴趣的关联。
无论年龄、性别、社会经济地位、身体活动和饮食如何，在调整后的模型中，腰围（WC）每增加 1 厘米，甘油三酯水平平均升高 0.5mg/dl（p<0.000），18 个月后总胆固醇升高 0.21mg/dL。平均体重指数（BMI）Z 评分增加 0.1，甘油三酯平均水平升高 2.7mg/dL（p<0.000），总胆固醇平均水平升高 1.5mg/dL（p=0.014）。在腰围与身高比（WHtR）和锥形指数（CI）方面，参与者 WHtR 均值和 CI 均值每增加 0.1，甘油三酯均值分别增加 40.6mg/dL（p=0.02）和 30.1mg/dL（p=0.01），总胆固醇均值也分别增加 45.4mg/dL（p=0.02）和 19.3mg/dL（p=0.03）。传统人体测量学指标（WC 和 BMI）的变化并没有导致 LDL-胆固醇平均水平的变化。HDL-胆固醇不受人体测量指标变化的影响。
在基线时，所有指标中，人体测量状态异常的儿童和青少年的甘油三酯平均水平较高，HDL-c 水平较低。在 18 个月的随访后，无论采用何种测量方法，人体测量学状态的变化都会影响甘油三酯和总胆固醇的平均水平。然而，对于 LDL-胆固醇，传统人体测量学指标（WC 和 BMI）的变化并没有导致这种生化变量平均水平的变化，而 HDL-c 不受任何人体测量学指标变化的影响。
