Wang Xia, Cheng Hong, Xiong Jingfan, Liu Junting, Dong Hongbo, Fu Liwan, Xie Xiangjun, Shan Xinying, Zhao Xiaoyuan, Yan Yinkun, Xiao Pei, Mi Jie
Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100035, China.
Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100035, China.
Children (Basel). 2025 Feb 28;12(3):308. doi: 10.3390/children12030308.
To establish and validate age- and sex-specific visceral fat area (VFA) cutoff values for the effective identification of cardiometabolic risk (CMR) in children and adolescents. A cross-sectional study involving 8133 participants was conducted to derive age- and sex-specific VFA cutoffs, which were validated in a longitudinal cohort comprising 10,805 individuals. The predictive performance of the derived VFA cutoffs for CMR was evaluated using the area under the receiver operating characteristic curve (AUC). Additionally, logistic regression models were utilized to calculate the relative risk (RR) of CMR associated with elevated VFA levels. The 75th percentile of the VFA was identified as the optimal cutoff for screening for hypertension, hyperglycemia, dyslipidemia, and CMR clustering in boys. In girls, the 75th percentile was optimal for screening hypertension, dyslipidemia, and CMR clustering, while the 80th percentile proved best for hyperglycemia. No significant difference in predicative performance was observed between the optimal and simplified VFA cutoffs. Longitudinal validation demonstrated that individuals exceeding the VFA cutoff had a significantly higher risk for CMR, with RRs ranging from 1.33 to 3.89 (all < 0.001) for boys and from 1.63 to 3.16 (all < 0.001) for girls. Notably, normal-weight boys with VFA above the cutoff had a significantly higher CMR risk compared to their peers in other weight status categories. Both the optimal and simplified VFA cutoffs are robust tools for screening CMR in Chinese children and adolescents, with significant implications for early intervention strategies.
建立并验证针对儿童和青少年的年龄及性别特异性内脏脂肪面积（VFA）临界值，以有效识别心血管代谢风险（CMR）。开展了一项涉及8133名参与者的横断面研究，以得出年龄及性别特异性VFA临界值，并在一个由10805名个体组成的纵向队列中进行验证。使用受试者工作特征曲线下面积（AUC）评估所推导的VFA临界值对CMR的预测性能。此外，利用逻辑回归模型计算与VFA水平升高相关的CMR相对风险（RR）。VFA的第75百分位数被确定为筛查男孩高血压、高血糖、血脂异常和CMR聚集的最佳临界值。在女孩中，第75百分位数是筛查高血压、血脂异常和CMR聚集的最佳临界值，而第80百分位数被证明是筛查高血糖的最佳临界值。最佳和简化的VFA临界值在预测性能上未观察到显著差异。纵向验证表明，超过VFA临界值的个体发生CMR的风险显著更高，男孩的RR范围为1.33至3.89（均<0.001），女孩的RR范围为1.63至3.16（均<0.001）。值得注意的是，VFA高于临界值的正常体重男孩与其他体重状况类别的同龄人相比，CMR风险显著更高。最佳和简化的VFA临界值都是筛查中国儿童和青少年CMR的有力工具，对早期干预策略具有重要意义。
