Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
J Glob Health. 2023 May 19;13:04041. doi: 10.7189/jogh.13.04041.
BACKGROUND: Comparing body fat and the effect of body fat on metabolic abnormalities in Chinese and USA teenagers may provide clues for the early prevention and control of cardiovascular disease (CVD). We aimed to compare the prevalence of glucose and lipid metabolism abnormalities, body fat amount and distribution, and the effect of body fat on glucose and lipid metabolism in Chinese and US teenagers. METHODS: We included 5424 Chinese teenagers (48.5% male) from the China Child and Adolescent Cardiovascular Health (CCACH) study and 8704 USA teenagers (55.6% male) from the USA National Health and Nutrition Examination Survey (NHANES). Blood lipid, blood glucose, and body fat indicators were obtained using the same standardised measurements. RESULTS: The prevalence of dyslipidaemia in Chinese teenagers was of those in the USA (hypercholesterolaemia = 3.5% vs 7.4%; high low-density lipoprotein cholesterol (LDL-C) = 3.6% vs 5.0%; low high-density lipoprotein cholesterol (HDL-C) = 9.9% vs 14.3%; hypertriglyceridaemia = 3.7% vs 10.1%) (P < 0.05). However, with the increase in body mass index (BMI), the prevalence of high LDL-C increased more in Chinese than in US teenagers, even exceeding them in the obese group (2.7% in non-overweight to 9.7% in overweight group in China, P < 0.05; 3.5% in non-overweight to 6.5% in the obese group in the USA, P < 0.05). The prevalence of impaired fasting glucose was higher in China than in the USA (28.0% vs 17.5%, P < 0.05). Besides, Chinese adolescents are more likely to accumulate fat in the abdomen, and the per-unit fat increase would bring a higher risk of dyslipidaemia in Chinese boys than in USA boys. CONCLUSIONS: Dyslipidaemia was more prevalent in US teenagers than in Chinese teenagers, but with the increase in BMI, the prevalence of high LDL-C increased more in Chinese than in US teenagers. Impaired fasting glucose (IFG) was significantly more prevalent in China than in the USA. The unfavoured body fat and higher risk of body fat on metabolic disorders in Chinese teenagers suggest that Chinese teenagers should pay more attention to the adverse effect of body fat on metabolic abnormalities.
背景：比较中、美青少年体脂及体脂对代谢异常的影响，可为心血管疾病（CVD）的早期预防和控制提供线索。本研究旨在比较中、美青少年葡萄糖和脂质代谢异常的发生率、体脂量和分布，以及体脂对葡萄糖和脂质代谢的影响。
方法：我们纳入了来自中国儿童青少年心血管健康研究（CCACH）的 5424 名中国青少年（48.5%为男性）和来自美国国家健康和营养检查调查（NHANES）的 8704 名美国青少年（55.6%为男性）。采用相同的标准化测量方法获得血脂、血糖和体脂指标。
结果：中国青少年血脂异常的发生率与美国相当（高胆固醇血症=3.5%比 7.4%；高 LDL-C=3.6%比 5.0%；低 HDL-C=9.9%比 14.3%；高甘油三酯血症=3.7%比 10.1%）（P<0.05）。然而，随着 BMI 的增加，中国青少年高 LDL-C 的发生率增加幅度大于美国青少年，甚至在肥胖组中超过了美国青少年（中国青少年非超重组至超重组高 LDL-C 的发生率分别为 2.7%至 9.7%，P<0.05；美国青少年非超重组至肥胖组高 LDL-C 的发生率分别为 3.5%至 6.5%，P<0.05）。中国青少年空腹血糖受损的发生率高于美国（28.0%比 17.5%，P<0.05）。此外，中国青少年更容易在腹部堆积脂肪，且中国男孩单位体脂增加与美国男孩相比，血脂异常的风险更高。
结论：与中国青少年相比，美国青少年的血脂异常更为普遍，但随着 BMI 的增加，中国青少年高 LDL-C 的发生率增加幅度大于美国青少年。中国青少年空腹血糖受损的发生率显著高于美国。中国青少年不利的体脂状况和体脂对代谢紊乱的更高风险提示，中国青少年应更加关注体脂对代谢异常的不良影响。
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