Li M L, Zhen G X, Duan J W, Li L, Shu W, Zhao F F, Li Z A, Amaerjiang Nubiya, Xiao H D, Zhao R L, Hu Y F
Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China.
Department of Environmental Health, Shunyi District Center for Disease Control and Prevention, Beijing 101300, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Dec 6;54(12):1408-1413. doi: 10.3760/cma.j.cn112150-20200612-00873.
The study is to explore the association between trunk fat index (TFI) and carotid intima-media thickness (cIMT) among children aged 6-8 years old in Shunyi District, Beijing. The participants were enrolled from the child cohort on sensitization, puberty, obesity and cardiovascular risk (PROC) conducted in Shunyi District, Beijing from October 2018 to June 2019. The PROC used a community-based census-like design, and all eligible first-grade children from six public non-boarding primary schools in urban area were approached. Finally, a total of 1 503 children with written informed consent from parents and had complete data of TFI and cIMT were included for the present study. Sequential baseline surveys including anthropometric measurements, laboratory testing and ultrasonography measurement were conducted to collect the data on height, weight, body composition, blood pressure, serum lipids and cIMT. Linear regression was used to determine the predictors of cIMT, receiver operating characteristic (ROC) curve analysis was used to determine the cut-off value of TFI to identify children with high cIMT, and analysis of covariance was used to evaluate the post-consistency classification of cIMT by TFI. The age of 1 503 participants was (6.7±0.3) years, and 752 boys accounted for 50.0%. The average cIMT was (0.358±0.024) and (0.355±0.023) mm, and the (, ) of TFI was 0.70 (0.22, 1.78) and 0.74 (0.23, 1.52) kg/m for boys and girls, respectively. The detection rates for boys and girls of high cIMT were 2.1% and 3.3%, respectively. Linear regression analysis showed that height, systolic blood pressure (SBP), diastolic blood pressure (DBP), TFI were positively correlated with cIMT in boys ( values<0.05). And height, SBP, triglyceride (TG), TFI were positively correlated with cIMT, and high-density lipoprotein cholesterol (HDL-C) was negatively correlated with cIMT in girls ( values<0.05). ROC curve analysis indicated that the best cut-off values for TFI to identify children with high cIMT were 1.78 and 1.14 kg/m, at and for boys and girls, respectively. After grouped with the cut-off value of TFI and adjusted for age, height, SBP, DBP, TG, HDL-C, multivariable covariance analysis showed a consistent cut-off of inter-group cIMT mean by TFI groups ( values<0.005). TFI is associated with cIMT, which underscore its application potential in identifying early vascular structural damage.
本研究旨在探讨北京市顺义区6至8岁儿童的躯干脂肪指数（TFI）与颈动脉内膜中层厚度（cIMT）之间的关联。研究对象来自于2018年10月至2019年6月在北京市顺义区开展的儿童致敏、青春期、肥胖与心血管风险队列研究（PROC）。PROC采用基于社区的类普查设计，对城区6所公立非寄宿制小学的所有符合条件的一年级儿童进行了调查。最终，本研究纳入了1503名获得家长书面知情同意且拥有TFI和cIMT完整数据的儿童。通过进行包括人体测量、实验室检测和超声测量在内的序贯基线调查，收集了身高、体重、身体成分、血压、血脂和cIMT的数据。采用线性回归确定cIMT的预测因素，采用受试者工作特征（ROC）曲线分析确定TFI的临界值以识别cIMT较高的儿童，并采用协方差分析评估TFI对cIMT的一致性分类。1503名参与者的年龄为（6.7±0.3）岁，其中752名男孩，占50.0%。男孩和女孩的平均cIMT分别为（0.358±0.024）和（0.355±0.023）mm，TFI的（，）分别为0.70（0.22，1.78）和0.74（0.23，1.52）kg/m。男孩和女孩cIMT较高的检出率分别为2.1%和3.3%。线性回归分析显示，在男孩中，身高、收缩压（SBP）、舒张压（DBP）、TFI与cIMT呈正相关（值<0.05）。在女孩中，身高、SBP、甘油三酯（TG）、TFI与cIMT呈正相关，而高密度脂蛋白胆固醇（HDL-C）与cIMT呈负相关（值<0.05）。ROC曲线分析表明，识别cIMT较高儿童的TFI最佳临界值在男孩和女孩中分别为1.78和1.14 kg/m，对应的和分别为和。以TFI临界值分组并对年龄、身高、SBP、DBP、TG、HDL-C进行校正后，多变量协方差分析显示TFI组间cIMT均值的组间临界值具有一致性（值<0.005）。TFI与cIMT相关，这突出了其在识别早期血管结构损伤方面的应用潜力。
