Ma C W, Yang L, Zhao M, Xi B
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University/Children Cardiovascular Research Center of Shandong University, Ji'nan 250012, China.
Department of Toxicology and Nutrition, School of Public Health, Cheeloo College of Medicine, Shandong University, Ji'nan 250012, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Sep 10;41(9):1450-1454. doi: 10.3760/cma.j.cn112338-20200225-00171.
To evaluate the association of abdominal obesity and obesity types with carotid intima-media thickness (cIMT) in children and provide scientific evidence for the prevention of abnormal vascular structure. Based on the "Children's Cardiovascular Health Cohort" conducted in Huantai county of Zibo, Shandong province from November 2017 to January 2018, a total of 1 240 children, including 657 boys (53.0%), who had completed data of sex, age, physical examinations, blood biochemical indices and lifestyle variables (collected by questionnaires) were included for the analysis. Covariance analysis was used to compare the levels of cIMT in groups with normal waist circumference, pre-abdominal obesity and abdominal obesity. Logistic regression analysis was used to evaluate the association of pre-abdominal obesity and abdominal obesity with high cIMT, and the association of combined effect of general overweight or obesity and abdominal obesity or pre-abdominal obesity with high cIMT. The levels of cIMT in children with pre-abdominal obesity (0.47±0.03) mm and abdominal obesity (0.50±0.04) mm were higher than that in children with normal waist circumference (0.45±0.05) mm, the difference was significant (<0.001). The detection rates of high cIMT in children with pre-abdominal obesity(20.8%) and abdominal obesity (49.5%) were higher than that in children with normal waist circumference (8.8%), the difference was significant (<0.001). Compared with normal waist circumference, pre-abdominal obesity and abdominal obesity were significantly associated with high cIMT (pre-abdominal obesity: =2.53, 95: 1.67-3.84; abdominal obesity: =8.56, 95: 5.97-12.29) after adjustment for potential covariates. Compared with normal body mass index and normal waist circumference, abdominal obesity or pre-abdominal obesity alone (=2.24, 95: 1.36-3.69), and mixed overweight and obesity (=6.94, 95: 4.87-9.90) were significantly associated with high cIMT. The association between abdominal obesity and high cIMT was significant in children, and the association was stronger between mixed overweight or obesity and high cIMT, suggesting that we should consider mixed overweight and obesity in the prevention of abnormal vascular structure.
评估儿童腹部肥胖及肥胖类型与颈动脉内膜中层厚度（cIMT）的关联，为预防血管结构异常提供科学依据。基于2017年11月至2018年1月在山东省淄博市桓台县开展的“儿童心血管健康队列研究”，纳入1240名儿童，其中包括657名男孩（占53.0%），这些儿童均已完成性别、年龄、体格检查、血液生化指标及生活方式变量（通过问卷收集）的数据，用于分析。采用协方差分析比较腰围正常组、腹型肥胖前期组和腹型肥胖组的cIMT水平。采用逻辑回归分析评估腹型肥胖前期和腹型肥胖与高cIMT的关联，以及一般超重或肥胖与腹型肥胖或腹型肥胖前期的联合效应与高cIMT的关联。腹型肥胖前期儿童（0.47±0.03）mm和腹型肥胖儿童（0.50±0.04）mm的cIMT水平高于腰围正常儿童（0.45±0.05）mm，差异有统计学意义（<0.001）。腹型肥胖前期儿童（20.8%）和腹型肥胖儿童（49.5%）的高cIMT检出率高于腰围正常儿童（8.8%），差异有统计学意义（<0.001）。在调整潜在协变量后，与腰围正常相比，腹型肥胖前期和腹型肥胖与高cIMT显著相关（腹型肥胖前期：=2.53，95%：1.67 - 3.84；腹型肥胖：=8.56，95%：5.97 - 12.29）。与正常体重指数和正常腰围相比，单独的腹型肥胖或腹型肥胖前期（=2.24，95%：1.36 - 3.69）以及混合超重和肥胖（=6.94，95%：4.87 - 9.90）与高cIMT显著相关。腹型肥胖与儿童高cIMT之间的关联显著，混合超重或肥胖与高cIMT之间的关联更强，提示在预防血管结构异常时应考虑混合超重和肥胖。
