Zhao Weiying, Su Danyan, Mo Luxia, Chen Cheng, Ye Bingbing, Qin Suyuan, Liu Jie, Pang Yusheng
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Front Pediatr. 2021 Dec 16;9:728841. doi: 10.3389/fped.2021.728841. eCollection 2021.
Unhealthy dietary and lifestyle behaviors are associated with a higher prevalence of non-communicable chronic diseases and higher mortality in adults. However, there remains some uncertainty about the magnitude of the associations between lifestyle behaviors and cardiovascular factors in adolescents. We conducted a school-based cross-sectional study of 895 Chinese adolescents aged 15-19 years. They participated in a questionnaire survey, physical examination, and blood sample collection. Latent class analysis (LCA) was used to identify heterogeneous subgroups of lifestyle behaviors. A set of 12 latent class indicators, which reflected lifestyle behaviors including dietary habits, physical activity, sleep duration, screen time, and pressure perception, were included in the analysis. Logistic regression analysis was performed to determine whether the derived classes were related to a cardiometabolic risk. In total, 13.7 and 5.6% of the participants were overweight and obese, respectively, and 8.4 and 14.1% reported having pre-hypertension and hypertension, respectively. A two-class model provided the best fit with a healthy lifestyle pattern (65.8%) and a sub-healthy lifestyle pattern (34.2%). There were more female participants with a healthy lifestyle (56.2 vs. 43.8%), whereas there were more males with a sub-healthy lifestyle (45.4 vs. 54.6%), (all = 0.002). Increased risk of cardiometabolic abnormality (BMI categories, blood pressure and lipids) was not significant across lifestyle patterns, except for waist circumference (70.5 vs 69.1 cm, = 0.044). There was no significant difference in physical activity and intake of fruit and vegetable between the two patterns. Primary prevention based on lifestyle modification should target patterns of behaviors at high risk in adolescents. Due to the complex effect of lifestyle clusters on cardiometabolic risks, well-designed and prospective studies in adolescents are needed in the future.
不健康的饮食和生活方式行为与成年人非传染性慢性病的较高患病率和较高死亡率相关。然而，青少年生活方式行为与心血管因素之间关联的程度仍存在一些不确定性。我们对895名15 - 19岁的中国青少年进行了一项基于学校的横断面研究。他们参与了问卷调查、体格检查和血液样本采集。潜在类别分析（LCA）用于识别生活方式行为的异质子组。分析中纳入了一组12个潜在类别指标，这些指标反映了包括饮食习惯、身体活动、睡眠时间、屏幕时间和压力感知在内的生活方式行为。进行逻辑回归分析以确定所衍生的类别是否与心血管代谢风险相关。总体而言，分别有13.7%和5.6%的参与者超重和肥胖，分别有8.4%和14.1%的参与者报告有高血压前期和高血压。一个两类模型与健康生活方式模式（65.8%）和亚健康生活方式模式（34.2%）最为拟合。健康生活方式的女性参与者更多（56.2%对43.8%），而亚健康生活方式的男性参与者更多（45.4%对54.6%），（P均 = 0.002）。除腰围外，不同生活方式模式中心血管代谢异常（体重指数类别、血压和血脂）风险的增加并不显著（70.5对69.1厘米，P = 0.044）。两种模式在身体活动以及水果和蔬菜摄入量方面没有显著差异。基于生活方式改变的一级预防应针对青少年中高风险的行为模式。由于生活方式集群对心血管代谢风险的复杂影响，未来需要在青少年中开展精心设计的前瞻性研究。
