Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
The First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China.
Pediatr Obes. 2024 Jul;19(7):e13127. doi: 10.1111/ijpo.13127. Epub 2024 May 15.
Lifestyle factors play an important role in the development and management of childhood obesity and its related cardiometabolic complications.
OBJECTIVE/METHODS: We aimed to explore childhood obesity subtypes based on lifestyle factors and examine their association with cardiometabolic health. We included 1550 children with obesity from the National Health and Nutrition Examination Survey. Cluster analysis identified obesity subtypes based on four lifestyle factors (physical activity, diet quality, sedentary time and smoking). Multiple linear regression assessed their association with cardiometabolic factors.
Five subtypes of childhood obesity were identified: unhealthy subtype (n = 571; 36.8%), physically active subtype (n = 185; 21.1%), healthy diet subtype (n = 404; 26.1%), smoking subtype (n = 125; 8.1%) and non-sedentary subtype (n = 265; 17.1%). Compared with the unhealthy subtype, the physically active subtype had lower insulin and HOMA-IR levels, and smoking subtype was associated with lower HDL levels. When compared with children with normal weight, all obesity subtypes had worse cardiometabolic profile, except the physically active subtype who had similar DBP, HbA1c and TC levels; smoking subtype who had similar TC levels; and healthy diet and non-sedentary subtypes who had similar DBP levels.
Children of different lifestyle-based obesity subtypes might have different cardiometabolic risks. Our new classification system might help personalize assessment of childhood obesity.
生活方式因素在儿童肥胖及其相关心血管代谢并发症的发生和管理中起着重要作用。
目的/方法：我们旨在基于生活方式因素探索儿童肥胖亚型，并研究其与心血管代谢健康的关系。我们纳入了来自全国健康和营养检查调查的 1550 名肥胖儿童。聚类分析根据四项生活方式因素（体力活动、饮食质量、久坐时间和吸烟）确定肥胖亚型。多元线性回归评估了它们与心血管代谢因素的关系。
确定了五种儿童肥胖亚型：不健康亚型（n=571；36.8%）、活跃型亚型（n=185；21.1%）、健康饮食亚型（n=404；26.1%）、吸烟亚型（n=125；8.1%）和非久坐亚型（n=265；17.1%）。与不健康亚型相比，活跃型亚型的胰岛素和 HOMA-IR 水平较低，而吸烟亚型的 HDL 水平较低。与体重正常的儿童相比，所有肥胖亚型的心血管代谢特征均较差，除了活跃型亚型的 DBP、HbA1c 和 TC 水平相似；吸烟亚型的 TC 水平相似；以及健康饮食和非久坐亚型的 DBP 水平相似。
基于不同生活方式的肥胖儿童可能具有不同的心血管代谢风险。我们的新分类系统可能有助于个性化评估儿童肥胖。
