6~7岁儿童颈动脉内中膜厚度与内脏脂肪面积的关联性

探索儿童颈动脉内中膜厚度(cIMT)与内脏脂肪面积(VFA)的关系,为预防心血管疾病提供参考依据.方法 采用基于人群普查的方法,纳入北京市顺义区6所公立非寄宿制小学一年级学生1 914名,建立儿童生长与健康队列(PROC),并进行社会人口学调查、身体测量、血液和尿液常规与生化指标的检测.采用单因素和多因素稳健线性回归分析cIMT与其他指标的关系.结果 1 711名被试中,正常、超重、肥胖儿童cIMT均值分别为(0.35±0.02) (0.36±0.02) (0.37±0.03) mm,差异有统计学意义(F=41.4,P<0.01);VFA中位数分别为16.2(13.6~19.3)、22.7(18.6~27.3)、51.5(33.9~73.0) cm2,差异有统计学意义(x2=854.5,P<0.01).单因素稳健线性回归分析结果显示,总体模型校正年龄、性别后,cIMT与身高、收缩压(SBP)、舒张压(DBP)、高密度脂蛋白胆固醇(HDL-C)、VFA的相关均有统计学意义(P值均<0.05);与三酰甘油(TG)相关有边际统计学意义(P=0.055).多因素稳健线性回归分析结果显示,在总体和男生模型中cI-MT与VFA和SBP均呈正相关(β值分别为0.0002,0.000 2;0.000 2,0.000 2,P值均<0.05),在女生模型中cIMT与VFA和TG均呈正相关(β值分别为0.000 2,0.006 2,P值均<0.05).结论 VFA对cIMT的预测能力稳定,可利用VFA对儿童进行简化分类管理,进而开展有针对性的干预来早期预防成年期心血管疾病.

Association between carotid intima-media thickness and visceral fat area in children aged 6-7 years

Objective To identify the association of carotid intima-media thickness(c IMT) and visceral fat area( VFA to inform prevention of cardiovascular disease in later life. Methods All the grade one students of six non-boarding primary schools in Shunyi District,Beijing were enrolled,based on population-based survey design,to establish the child cohort on sensitization,puberty,obesity and cardiovascular risk( PROC). Socio-demographic information survey and anthropometric measure,blood and urine test were carried out. Robust linear regression was used to determine the relationship between c IMT and other factors. Results Among 1 711 participants,a significant difference were observed between normal,overweight and obesity children on c IMT ( 0.35±0.02)( 0.36±0.02)( 0.37±0.03) mm]( F = 41.4,P<0.01) and VFA 16.2( 13.6-19.3),22.7( 18.6-27.3),51.5( 33.9-73.0) cm2]( χ^2= 854.5,P< 0.01). After adjusting age and sex,univariate robust linear regression showed that c IMT was associated with height,SBP,DBP,HDL-C,VFA( P<0.05) and TG( P = 0.055). Multivariable robust linear regression indicated that in total and boys only included models,c IMT was associated with VFA and SBP( β = 0.000 2,0.000 2,0.000 2,0.000 2,P<0.05);while in girls only included model c IMT was associated with VFA and TG( β = 0.000 2,0.006 2,P<0.05). Conclusion VFA is stable to predict the increase of c IMT in children. We can use VFA to simplify the classification management of children and inform targeted early prevention of cardiovascular disease in adulthood.