Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, 31982, Saudi Arabia.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej, 55, 5230, Odense, Denmark.
BMC Public Health. 2022 Aug 30;22(1):1639. doi: 10.1186/s12889-022-14035-6.
Cardiovascular disease (CVD) risk assessment of children typically includes evaluating multiple CVD risk factors some of which tend to correlate each other. However, in older children and young adolescents, there are little data on the level of independence of CVD risk factors. The purpose of this study was to examine the relationships among various CVD risk factors to determine the level of independence of each risk factor in a sample of 5-grade public school students.
A cross-sectional analysis of 1525 children (856 girls and 669 boys; age: 9-12 years) who participated in baseline CVD risk assessment for the (S)Partners for Heart Health program from 2010 - 2018. Thirteen CVD risk factor variables were used in the analysis and included blood lipids [low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglycerides], resting systolic and diastolic blood pressure (BP); anthropometrics [height, weight, body mass index (BMI), % body fat, waist circumference (WC)]. Additionally, acanthosis nigricans (a marker insulin resistance and diabetes), and cardiorespiratory fitness (VO2 ml/kg) was estimated using the PACER. Descriptive statistics, bivariate Pearson correlations, and principal component analysis were used to determine the relationships among these variables and the independence.
Parallel analysis indicated two components should be extracted. Among the two components extracted, WC, % body fat, and BMI loaded highest on component 1, which explained 34% of the total variance. Systolic BP and diastolic BP loaded predominantly on component 2 and accounted for 17% of the variance. Cardiorespiratory fitness, acanthosis nigricans, HDL, and triglycerides loaded highest on the first component (loadings between 0.42 and 0.57) but still suggest some non-shared variance with this component. Low-density lipoprotein had low loadings on each component. Factor loadings were stable across sex.
Among the various CVD risk indicators, measures of adiposity loaded highest on the component that explained the largest proportion of variability in the data reinforcing the importance of assessing adiposity in CVD risk assessment. In addition, blood pressure loaded highest on the second component, suggesting their relative independence when assessing CVD risk. The data also provide support and rationale for determining what CVD risk factors to include- based on resource needs. For example, researchers or public health programs may choose to assess WC instead of lipid profile for cardiovascular related problems if ease of assessment and cost are considerations.
儿童心血管疾病（CVD）风险评估通常包括评估多个 CVD 风险因素，其中一些因素往往相互关联。然而，在较大的儿童和青少年中，关于 CVD 风险因素独立性的数据较少。本研究的目的是检查各种 CVD 风险因素之间的关系，以确定在一个五年级公立学校学生样本中每个风险因素的独立性水平。
这是一项横断面分析，纳入了 2010 年至 2018 年期间参加（S）Partners for Heart Health 计划 CVD 风险基线评估的 1525 名儿童（856 名女孩和 669 名男孩；年龄：9-12 岁）。分析中使用了 13 个 CVD 风险因素变量，包括血脂[低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、总胆固醇（TC）和甘油三酯]、静息收缩压和舒张压（BP）；人体测量学[身高、体重、体重指数（BMI）、体脂肪百分比、腰围（WC）]。此外，还使用 PACER 估计黑棘皮病（胰岛素抵抗和糖尿病的标志物）和心肺适能（VO2 ml/kg）。使用描述性统计、双变量 Pearson 相关分析和主成分分析来确定这些变量之间的关系和独立性。
平行分析表明应提取两个分量。在所提取的两个分量中，WC、%体脂肪和 BMI 主要加载在第一分量上，解释了总方差的 34%。收缩压和舒张压主要加载在第二分量上，占方差的 17%。心肺适能、黑棘皮病、HDL 和甘油三酯主要加载在第一分量上（负荷在 0.42 到 0.57 之间），但仍与该分量存在一些非共享方差。低密度脂蛋白在每个分量上的负荷都较低。性别之间的因子负荷稳定。
在各种 CVD 风险指标中，肥胖指标在解释数据中最大变异比例的分量上的负荷最高，这强化了在 CVD 风险评估中评估肥胖的重要性。此外，血压在第二分量上的负荷最高，这表明在评估 CVD 风险时它们具有相对独立性。该数据还为确定要包含哪些 CVD 风险因素提供了支持和依据-基于资源需求。例如，如果评估和成本是考虑因素，研究人员或公共卫生计划可能会选择评估 WC 而不是血脂谱来评估与心血管相关的问题。
