Dong Yangyang, Bai Ling, Cai Rongrong, Zhou Jinyu, Ding Wenqing
School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China.
Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Nov 23;14:4579-4587. doi: 10.2147/DMSO.S337412. eCollection 2021.
The predictive capacity between children's lipid accumulation product (CLAP) combining visceral adiposity index (VAI), CLAP, and VAI with metabolically unhealthy phenotype remained unclear. This study aimed to compare the ability of CLAP combining VAI, CLAP, VAI and traditional adiposity indicators (body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR)) to predict metabolically unhealthy phenotype among Chinese children and adolescents.
In the cross-sectional study, 1714 children and adolescents aged 12 to 18 were selected by random cluster sampling, underwent a questionnaire survey, physical examination, biochemical tests and body composition was measured by bioelectrical impedance analysis (BIA). Participants were divided into four phenotypes according to BMI and metabolic syndrome components. The logarithmic CLAP (LnCLAP), VAI, BMI, WC, WHtR and WHR were standardized for sex and age using the z-score method (standardized variables: LnCLAP-z, VAI-z, BMI-z, WC-z, WHtR-z and WHR-z).
LnCLAP-z ≥ 1, VAI-z ≥ 1, WC-z ≥ 1, and WHR-z ≥ 1 increased the risk of metabolically unhealthy normal-weight phenotype (the OR and 95% CI were 4.18 (1.75-10.02), 24.05 (12.79-45.21), 6.17 (1.14-33.51), 2.69 (1.07-6.72), respectively), LnCLAP-z ≥ 1, VAI-z ≥ 1 and WC-z ≥ 1 increased the risk of metabolically unhealthy overweight or obese phenotype (the OR and 95% CI were 2.67 (1.40-5.09), 10.30 (3.03-35.03), 2.19 (1.18-4.09), respectively). The area under the ROC curve (AUC) for CLAP combining VAI in the prediction of the metabolically unhealthy phenotype were 0.837 (0.776-0.899) and 0.876 (0.834-0.918) for boys and girls with normal-weight, 0.853 (0.803-0.903) and 0.794 (0.711-0.878) for boys and girls with overweight and obese (all < 0.001), which were higher than CLAP, VAI, BMI, WC, WHtR and WHR.
Among Chinese children and adolescents, CLAP combining VAI was a more effective indicator than CLAP, VAI and traditional adiposity indicators in predicting unhealthy metabolic phenotype.
儿童脂质蓄积产物（CLAP）联合内脏脂肪指数（VAI）、CLAP及VAI与代谢不健康表型之间的预测能力尚不清楚。本研究旨在比较CLAP联合VAI、CLAP、VAI以及传统肥胖指标（体重指数（BMI）、腰围（WC）、腰高比（WHtR）和腰臀比（WHR））预测中国儿童和青少年代谢不健康表型的能力。
在这项横断面研究中，通过随机整群抽样选取了1714名12至18岁的儿童和青少年，进行问卷调查、体格检查、生化检测，并采用生物电阻抗分析（BIA）测量身体成分。根据BMI和代谢综合征组分将参与者分为四种表型。使用z评分法对对数CLAP（LnCLAP）、VAI、BMI、WC、WHtR和WHR进行性别和年龄标准化（标准化变量：LnCLAP-z、VAI-z、BMI-z、WC-z、WHtR-z和WHR-z）。
LnCLAP-z≥1、VAI-z≥1、WC-z≥1和WHR-z≥1增加了代谢不健康正常体重表型的风险（OR及95%CI分别为4.18（1.75 - 10.02）、24.05（12.79 - 45.21）、6.17（1.14 - 33.51）、2.69（1.07 - 6.72）），LnCLAP-z≥1、VAI-z≥1和WC-z≥1增加了代谢不健康超重或肥胖表型的风险（OR及95%CI分别为2.67（1.40 - 5.09）、10.30（3.03 - 35.03）、2.19（1.18 - 4.09））。CLAP联合VAI预测代谢不健康表型的受试者工作特征曲线（ROC）下面积（AUC），对于正常体重的男孩和女孩分别为0.837（0.776 - 0.899）和0.876（0.834 - 0.918），对于超重和肥胖的男孩和女孩分别为0.853（0.803 - 0.903）和0.794（0.711 - 0.878）（均P<0.001），高于CLAP、VAI、BMI、WC、WHtR和WHR。
在中国儿童和青少年中，CLAP联合VAI在预测不健康代谢表型方面比CLAP、VAI及传统肥胖指标更有效。
