Kalker U, Hövels O, Kolbe-Saborowski H
Gesundheitsamt Frankfurt/M.
Monatsschr Kinderheilkd. 1993 Jan;141(1):36-41.
In obese adults body fat distribution is more closely associated with cardiovascular risk factors and cardiovascular disease, type II diabetes and gout than the degree of obesity; the android, abdominal body fat pattern carrying more risk than the gynoid, femoral form. For characterizing the different types of fat distribution the ratio of waist to hip girth (WHR) is commonly used. The question was whether these facts can already be demonstrated in obese children. In the studied group of 69 obese children, aged between 3-16 years (mean = 10.8 years) with a mean of 47% overweight no correlations between percentage overweight and waist hip ratio could be found. Better correlations of serum triglycerides, total- and LDL-cholesterol, the atherogenic index LDL/HDL-cholesterol, fasting insulin level, oral glucose tolerance and blood pressure were obtained with percentage overweight than with waist-hip-ratio. HDL-cholesterol was the only parameter showing better and significant correlation with waist-hip-ratio than with percentage overweight. These results are in contrast to the situation in adults but are comparable with other studies in normal weighed and obese children, where correlations of waist hip ratio with body fat and risk factors were low in childhood, becoming higher in adolescence. Only after onset of puberty does waist hip ratio seem to be an indicator for body fat distribution and for possibly associated additional risk factors as in adults. For estimation of the cardiovascular risk in obese children, determination of WHR need not to be recommended.(ABSTRACT TRUNCATED AT 250 WORDS)
在肥胖成年人中,身体脂肪分布与心血管危险因素、心血管疾病、II型糖尿病和痛风的关联,比肥胖程度更为密切;上身型、腹部脂肪分布模式比下身型、臀部脂肪分布模式带来的风险更高。为了描述不同类型的脂肪分布,通常使用腰臀围比(WHR)。问题在于这些情况在肥胖儿童中是否也已得到证实。在所研究的69名肥胖儿童组中,年龄在3至16岁之间(平均 = 10.8岁),平均超重47%,超重百分比与腰臀比之间未发现相关性。与腰臀比相比,超重百分比与血清甘油三酯、总胆固醇和低密度脂蛋白胆固醇、致动脉粥样硬化指数低密度脂蛋白/高密度脂蛋白胆固醇、空腹胰岛素水平、口服葡萄糖耐量及血压的相关性更好。高密度脂蛋白胆固醇是唯一一个与腰臀比的相关性比与超重百分比的相关性更好且具有显著相关性的参数。这些结果与成年人的情况相反,但与其他针对正常体重和肥胖儿童的研究结果相当,在这些研究中,腰臀比与身体脂肪及危险因素在儿童期的相关性较低,在青春期则升高。似乎只有在青春期开始后,腰臀比才如同在成年人中一样,成为身体脂肪分布及可能相关的其他危险因素的一个指标。对于评估肥胖儿童的心血管风险,不建议测定腰臀比。(摘要截选至250词)