Srinivasan S R, Bao W, Wattigney W A, Berenson G S
Tulane Center for Cardiovascular Health, School of Public Health and Tropical Medicine, New Orleans, LA 70112-2824, USA.
Metabolism. 1996 Feb;45(2):235-40. doi: 10.1016/s0026-0495(96)90060-8.
Overweight in adolescence is considered an important predictor of long-term morbidity and mortality. The impact of adolescent overweight on adult overweight and related multiple cardiovascular risk factors was examined in a biracial (black-white) cohort (N = 783) who participated in two cross-sectional surveys as adolescents aged 13 to 17 years and as young adults aged 27 to 31 years. The cohort was categorized as adolescent-onset adult overweight (N = 110) or lean (N = 81) according to age-, race-, and sex-specific body mass index (BMI) greater than the 75th percentile or between the 25th and 50th percentiles on both surveys. The risk for overweight adolescents to remain overweight as young adults ranged from 52% in black males to 62% in black females. As young adults, the overweight cohort showed adverse levels of body fatness measures, systolic and diastolic blood pressure, lipoprotein cholesterol, insulin, and glucose as compared with the lean cohort (P < .01 to P < .0001). The prevalence of clinically recognized hypertension and dyslipidemia increased 8.5-fold and 3.1- to 8.3-fold, respectively, in the overweight cohort versus the lean cohort (P < .05 to P < .0001). The prevalence of parental history of diabetes mellitus and hypertension increased 2.4-fold (P < .01) and 1.3-fold (P < .05), respectively, in the overweight cohort. Clustering of adverse values (> 75th percentile) for the total cholesterol to high-density lipoprotein (HDL) cholesterol ratio, insulin level, and systolic blood pressure occurred only among the overweight cohort (P < .0001). Thus, excess weight in adolescence persists into young adulthood, and has a strong adverse impact on multiple cardiovascular risk factors, requiring primary prevention early in life.
青少年超重被认为是长期发病和死亡的重要预测因素。在一个双种族(黑人和白人)队列(N = 783)中,研究了青少年超重对成人超重及相关多种心血管危险因素的影响。该队列中的参与者在13至17岁青少年时期和27至31岁青年时期分别参与了两次横断面调查。根据两次调查中按年龄、种族和性别划分的体重指数(BMI)大于第75百分位数或在第25至50百分位数之间,将该队列分为青少年期开始的成人超重组(N = 110)或瘦组(N = 81)。超重青少年在青年期仍超重的风险在黑人男性中为52%,在黑人女性中为62%。与瘦组相比,作为青年,超重队列在身体脂肪测量、收缩压和舒张压、脂蛋白胆固醇、胰岛素和血糖水平方面呈现出不良水平(P <.01至P <.0001)。与瘦组相比,超重队列中临床诊断的高血压和血脂异常患病率分别增加了8.5倍和3.1至8.3倍(P <.05至P <.0001)。超重队列中糖尿病和高血压家族史的患病率分别增加了2.4倍(P <.01)和1.3倍(P <.05)。总胆固醇与高密度脂蛋白(HDL)胆固醇比值、胰岛素水平和收缩压的不良值(>第75百分位数)聚集仅出现在超重队列中(P <.0001)。因此,青少年时期的超重会持续到青年期,并对多种心血管危险因素产生强烈的不良影响,需要在生命早期进行一级预防。