Kim Minseung, Kim Jaehyun
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Ann Pediatr Endocrinol Metab. 2022 Dec;27(4):289-299. doi: 10.6065/apem.2142230.115. Epub 2022 Jun 20.
Data regarding cardiometabolic risk factors (CMRFs) and metabolic syndrome (MetS) by body mass index (BMI) category in Korean youth are sparse.
Among the participants of the Korea National Health and Nutrition Examination Survey 2007-2018, 9,984 youth aged 10-18 years were included in the study. Participants were classified into 4 groups based on BMI status: normal weight, overweight, class I, and class II/III obesity. CMRF prevalence, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, fasting glucose, glycated hemoglobin, and MetS, were determined using the International Diabetes Federation (IDF) and modified National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria based on BMI category.
The prevalence of overweight, class I, class II, and class III obesity was 9.52%, 7.73%, 2.10%, and 0.32%, respectively. Mean CMRF values increased with BMI, except high-density lipoprotein cholesterol. Age- and sex-adjusted odds ratios (ORs) for prediction of CMRFs also increased with BMI. Adjusted ORs for MetS among overweight, class I, and class II/II obesity were 54.2, 283.3, and 950.3 for IDF criteria and 9.56, 37.9, and 126.8 for NCEP-ATP III criteria, respectively (all p<0.001).
Class II and III obesity in Korean children and adolescents was associated with significantly increased CMRF and MetS prevalence. Therefore, it can be useful to measure CMRFs in obese children and adolescents. Further studies are required to establish screening guidelines based on obesity severity.
关于韩国青少年按体重指数(BMI)类别划分的心血管代谢危险因素(CMRFs)和代谢综合征(MetS)的数据较为稀少。
在2007 - 2018年韩国国家健康与营养检查调查的参与者中,9984名10 - 18岁的青少年被纳入研究。参与者根据BMI状况分为4组:正常体重、超重、I类肥胖和II/III类肥胖。使用国际糖尿病联盟(IDF)和改良的美国国家胆固醇教育计划成人治疗小组(NCEP - ATP)III标准,根据BMI类别确定CMRFs的患病率,包括总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、血压、空腹血糖、糖化血红蛋白以及MetS。
超重、I类、II类和III类肥胖的患病率分别为9.52%、7.73%、2.10%和0.32%。除高密度脂蛋白胆固醇外,平均CMRF值随BMI升高而增加。预测CMRFs的年龄和性别调整优势比(ORs)也随BMI升高而增加。对于MetS,超重、I类和II/II类肥胖者根据IDF标准的调整ORs分别为54.2、283.3和950.3,根据NCEP - ATP III标准分别为9.56、37.9和126.8(所有p<0.001)。
韩国儿童和青少年的II类和III类肥胖与CMRFs和MetS患病率显著增加相关。因此,对肥胖儿童和青少年测量CMRFs可能有用。需要进一步研究以建立基于肥胖严重程度的筛查指南。