单纯性肥胖儿童影响因素分析

单纯性肥胖儿童的逐年增加是儿童保健工作面临的重大课题。为了了解其影响因素,我们在2005年6月对哈尔滨市道里城区7岁以下儿童单纯性肥胖症进行了流行病学调查,并在此基础上,进行了影响因素的分析。1对象与方法在儿童单纯性肥胖症流行病学调查中,随机抽取被检出的肥胖儿童119名作为研究对象,按与单纯性肥胖儿童的性别、年龄、身高相似的原则,随机抽取正常健康儿童119名作为对照组。根据调查结果,对儿童的饮食、日常生活习惯、家庭情况进行了分析。2结果2.1肥胖组与对照组儿童饮食习惯比较肥胖组儿童的食欲、主食量摄入,喜欢睡前吃食物的习…     

滕州市学龄前儿童单纯性肥胖危险因素分析

儿童单纯性肥胖已成为危害儿童生长发育的一个重要因素,若不及早预防,常会发展为成人肥胖症,导致更多更严重的疾病.为了解滕州市7岁以下学龄前儿童单纯性肥胖现状及影响因素,对2002年6月～2004年6月两年入托查体的9 605名儿童进行相关因素调查,结果报告如下.     

7岁以下儿童单纯性肥胖的检出率及肥胖因素研究

目的 探讨0－7岁儿童肥胖的患病情况及危险因素。方法 采用整群随机抽样及发放问卷方式，对西安城区22653名0－7岁儿童进行调查，并将检出的140例肥胖儿童与正常儿童进行1：1的配对研究。结果 西安城区0－7岁儿童超重和肥胖的检出率分别为5．93％和2．34％。肥胖发生的危险因素有：家族中肥胖人数、母亲的BMI、父亲较少参加运动、家庭不正确的运动和饮食习惯及父母的错误认知。结论 单纯性肥胖是由遗传因素和环境因素共同作用而形成的，且环境因素起着重要作用，其中生活方式、个人行为主双亲的营养知识是主要的危险因素。     

吉林市儿童单纯性肥胖及其影响因素分析

目的:了解吉林市儿童单纯性肥胖的发生情况,并对影响因素进行分析,为制定儿童肥胖防治策略提出科学依据。方法:采用随机整群抽样法对吉林市1 960名5～10岁儿童进行问卷调查和体格测量,并进行非条件Logistic回归分析。结果:1 960名5～10岁儿童中单纯性肥胖的发生率为7.81%,其中男、女童肥胖发生率分别为9.27%、6.20%,两者比较具有统计学意义(P<0.05);非条件Logistic回归分析结果显示,肥胖与遗传因素、食欲、喜欢洋快餐及油炸食品、出生体重、进食速度、运动时间、家庭饮食习惯等因素有相关性。结论:吉林市儿童单纯性肥胖发生率较高,预防儿童肥胖应逐步改善膳食习惯与生活方式,这需要家长、学校和社会的共同关注及配合。     

儿童单纯性肥胖环境影响因素调查分析

据流行病学调查结果显示肥胖儿童不断增加已成为当今医学亟待解决的课题之一.肥胖易延续至成年,使其成年后患高血压、高血脂症、冠心病、糖尿病等慢性病的危险性增加,对儿童未来的身体健康造成威胁,影响其生活质量.因此明确与肥胖相关的危险因素,有针对性的开展早期预防工作显得尤为重要.为了解儿童单纯性肥胖的影响因素,我们于1999年5月对城区一所小学全部学生共902名进行了健康检查和人格测定,以家长问卷的形式进行了肥胖危险因素调查,并进行了统计分析.     

学龄前儿童单纯性肥胖影响因素探讨

目的 探讨学龄前儿童单纯性肥胖的流行情况和影响因素及相关干预措施。方法 对县属镇4所幼儿园的1499名幼儿进行身高体重测量，评价，对检出的85名肥胖儿及对照组儿童家长采用问卷调查。结果 学龄前儿童单纯性肥胖发生率为5．67％，男童高于女童（男童发生率为6．39％，女童为4．88％）,出生体重过高，肥胖发生率明显增加，低出生体重组（＜2500g)肥胖发生率为3．23％，正常出生体重组（2500－3999g)为5．21％，高出生体重组（≥4000 )为9．82％，而且以中重度肥胖为主。肥胖组儿童每天睡眠时间比对照组多，食俗但比对照组大，喜甜食，肉类食物的比例明显高于对照组。结论 高出生体重，活动量少，睡眠时间长，不合理的饮食习惯等与单纯性肥胖症的发生有关。儿童肥胖的预防必须从胎儿期抓起，加强对儿童家长的喂养指导，避免不良的生活和饮食习惯，是降低单纯性肥胖的重要措施。     

单纯性肥胖儿童的行为危险因素探讨

为了更好地控制和预防儿童单纯性肥胖症的发生,现将儿童单纯性肥胖行为的影响因素及干预措施分析报告如下.     

单纯性肥胖儿童脂肪肝影响因素分析

目的探讨单纯性肥胖儿童脂肪肝的影响因素,为预防和治疗儿童脂肪肝提供参考依据。方法采用多级整群分层抽样,对江苏省徐州市10所学校中121名8～13岁单纯性肥胖儿童进行问卷调查、体格检查、B超检查及血脂检测。结果单纯性肥胖儿童脂肪肝的检出率为71.9%;脂肪肝组体质指数(BMI)、低密度脂蛋白(LDL)、甘油三酯(TG)分别为29.36,3.30,2.45mmol/L,明显高于非脂肪肝组,差异有统计学意义(P0.01);多因素非条件Logistic逐步回归结果显示,腰围、每次食用煎炸食品量多、体质指数、不吃早餐和LDL、TG为单纯性肥胖儿童脂肪肝危险因素;不吃零食、喜欢运动为保护因素。结论单纯性肥胖儿童脂肪肝与肥胖程度和血脂密切相关。     

3岁以下儿童单纯性肥胖影响因素分析

流行病学研究表明,儿童肥胖发生率正逐年加速上升[1]。为了探讨长兴县3岁以下儿童单纯性肥胖的影响因素,为制定干预对策提供基础资料,进行了此次调查。     

单纯性肥胖儿童危险因素Logistic回归分析

进入 2 1世纪 ,我国人民生活水平飞速提高 ,肥胖儿童日渐增多 ,并引起了人们的广泛关注。肥胖是由于营养过剩、缺乏运动及遗传因素共同作用而引起的身体中脂肪的过度堆积。为探讨遗传因素和环境因素对儿童单纯性肥胖的影响 ,我们收集了15 0例肥胖儿童和 181例对照资料 ,采用非条件Ｌｏｇｉｓｔｉｃ回归分析 ,进行危险因素分析 ,现报告如下。1　材料与方法1.1　材料肥胖组 :以整群抽样的方法 ,选取奉化大桥六所中小学校初三以下的全体学生为代表 ,在奉化市疾病预防控制中心进行健康体检后 ,对每位学生营养评价标准采用《中国学生 7～ 2 2岁身…     

超重或单纯性肥胖儿童人体质量指数与心血管疾病风险因子的相关性研究

目的探讨超重或单纯性肥胖儿童人体质量指数(BMI)与心血管疾病风险因子的相关性。 方法选择2013年3月至2015年1月,在自贡市第一人民医院儿科初次就诊即诊断为超重或单纯性肥胖的62例儿童纳入观察组,以及同期进行健康体检的46例正常体重儿童纳入对照组。统计学比较两组儿童一般临床指标[年龄、人体质量指数(BMI)、腰围、收缩压、舒张压],脂代谢指标[动脉粥样硬化指数(AI)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、三酰甘油(TG)],以及糖代谢指标[胰岛素抵抗指数(HOMA-IR)、口服葡萄糖耐量试验2小时血糖(OGTT GLU2h)、空腹血糖、空腹胰岛素]差异;并对观察组儿童BMI与上述9项心血管疾病风险因子(脂代谢和糖代谢指标)进行相关性分析。两组儿童年龄及性别构成比比较,差异无统计学意义(P>0.05)。所有参与本次研究的儿童,均由其监护人签署知情同意书,并获得自贡市第一人民医院伦理委员会同意。 结果①观察组儿童一般临床指标BMI[(31.8±2.3) kg/m²]、腰围[(86.7±12.3) cm]及收缩压[(128.0±11.2) mmHg(1 mmHg＝0.133 kPa)]均较对照组[(19.4±0.8) kg/m²、(61.1±8.0) cm、(102.0±12.9) mmHg]高,且差异有统计学意义(t＝－38.171、－12.770、－2.120,P<0.05)。②观察组儿童脂代谢指标AI(4.0±0.8)及TC、LDL、TG浓度[(4.9±0.6) mmol/L、(3.07±0.23) mmol/L、(1.85±0.13) mmol/L]均较对照组高[(1.0±0.4)、(4.0±0.4) mmol/L、(1.46±0.13) mmol/L、(0.80±0.21) mmol/L],而HDL浓度[(0.89±0.09) mmol/L]则较对照组[(2.14±0.49) mmol/L]低,且差异均有统计学意义(t＝－35.96、－7.66、－51.29、－22.03、36.62,P<0.01)。③观察组儿童糖代谢指标HOMA-IR(12.5±1.3)及OGTT GLU2h、空腹血糖、空腹胰岛素浓度[(7.5±0.9) mmol/L、(5.97±0.22) mmol/L、(47.0±4.2) pmol/L]均较对照组高[(2.8±0.3)、(4.0±0.4) mmol/L、(4.47±0.13) mmol/L、(14.0±1.4) pmol/L],且差异均有统计学意义(t＝－38.64、－25.44、－43.65、－57.31,P<0.01)。④观察组儿童BMI与AI、TC、LDL、TG、HOMA-IR、OGTT GLU2h、空腹血糖及空腹胰岛素之间呈正相关关系(r＝0.964、0.707、0.960、0.948、0.974、0.969、0.967、0.965,P<0.001);BMI与HDL间呈负相关关系(r＝－0.939,P<0.001)。 结论与正常体重儿童比较,超重或单纯性肥胖儿童更易罹患心血管疾病,应加强对超重或单纯性肥胖儿童的合理饮食指导,采取健康生活方式,预防心血管疾病发生。     

The relationship between parental history of vascular disease and cardiovascular disease risk factors in children: the Bogalusa Heart Study

The relationship between parental history of vascular disease (heart attack, stroke, diabetes mellitus, and hypertension) and risk factor variables for cardiovascular disease was assessed in 3,312 offspring aged 5-17 years during the 1981-1982 school year in the biracial community of Bogalusa, Louisiana. Risk factors studied included systolic blood pressure, diastolic blood pressure, serum total cholesterol, triglycerides, and individual lipoprotein cholesterol (beta-, low density lipoprotein (LDL) cholesterol; pre-beta, very low density lipoprotein (VLDL) cholesterol; and alpha-, high density lipoprotein (HDL) cholesterol). Risk factors were adjusted for age, race, sex, and height (blood pressure only) prior to testing parental history effects. Univariate comparisons between risk factors in children and vascular disease in parents resulted in statistically significant increases in systolic and diastolic pressures associated with the presence of maternal or paternal hypertension (p less than 0.001). Paternal heart attack was also associated with elevations in diastolic pressure (p less than 0.01) of children. Maternal diabetes mellitus was associated with an increase in serum total cholesterol (p less than 0.05). Paternal diabetes mellitus and maternal heart attack (for female progeny only) were associated with increases in mean triglyceride levels of children. VLDL cholesterol results were similar to those for triglycerides. For HDL cholesterol, paternal diabetes mellitus was associated with a small decrease in mean levels (p less than 0.05). Dramatic increases to the highest decile of risk were found in association with the following parental disease combinations: paternal heart attack-paternal diabetes for serum total cholesterol (p less than 0.0001), maternal heart attack-paternal diabetes (p less than 0.001) and paternal stroke-maternal diabetes (p less than 0.0001) for LDL cholesterol. Multivariate analysis detected no significant effects of single parental vascular disease. However, paternal heart attack in combination with either diabetes mellitus or hypertension was statistically significant in their relationship to the risk factors overall.     

Familial aggregation of cardiovascular disease risk factors: the Cuenca Study

OBJECTIVE: The familial aggregation of lipid levels, blood pressure, and body mass index (BMI) was studied in schoolchildren in Cuenca, Spain. METHODS: A cross-sectional observation study was made of 307 schoolchildren of both sexes, age range 9-12 years, from three schools in Cuenca, Spain, and of 346 parents. Social and demographic variables, weight, height, body mass index, systolic blood pressure, diastolic blood pressure, and fasting plasma concentrations of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides were evaluated. RESULTS: The Spearman coefficients of correlation for total cholesterol, LDL-cholesterol, and BMI for parents and daughters were 0.34-0.42 (P < 0.01). These coefficients of correlation for parents and sons were lower (P > 0.05). The coefficient of correlation for blood pressure in parents and sons was low (P < 0.05). None of the variables showed any coefficient of correlation between spouses. The sexual differences in the correlations between the levels of the different variables were confirmed by multiple regression analysis. Total cholesterol and LDL-cholesterol levels and BMI accounted for larger percentages of variability in these parameters in daughters than in sons. The paternofilial aggregation of HDL-cholesterol and triglyceride levels was weak. The only variable that accounted for a significant variability in blood pressure (systolic and diastolic) was weight in children of both sexes. CONCLUSIONS: The familial aggregation of lipid levels and body mass index showed sex differences. The paternofilial aggregation of blood pressure was weak. There was no relation between spouses.     

肥胖儿童尿酸水平与糖尿病及心血管疾病危险因子的相关性

探讨单纯性肥胖儿童尿酸(UA)水平与糖尿病及心血管疾病危险因素之间的关系,为在相关人群中开展健康教育提供参考.方法 选择2014年7--8月参加上海市某体重管理中心组织的暑期减肥夏令营全国范围的79例肥胖儿童青少年为研究对象.按照尿酸水平将其分为正常组(35名)和高尿酸组(44名),分别检测2组儿童的身高、体重、体质量指数(BMI)、体脂率、脂肪体重(FM)、去脂体重(FFM)、腰围、臀围、腰臀比(WHR)、腰围身高比(WHtR)、收缩压、舒张压、空腹血糖(FBG)、空腹胰岛素(FINS)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及UA,计算胰岛素分泌功能指数(HOMA-β)、稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(IAI)及空腹胰岛素/空腹血糖比值,并对UA与各指标进行相关性分析.结果 高尿酸组体脂率,腰围,WHR,WHtR,FINS,HOMA-β,HOMA-IR,IAI,FNIS/FBG,LDL-C,HDL-C,TG,收缩压和舒张压与正常组差异均无统计学意义(P值均>0.05).高尿酸组体重,BMI,FM,FFM,臀围,FBG和TC均高于正常组,差异均有统计学意义(P值均<0.05).UA水平与体重,BMI,FM,FFM,臀围,TC,TG,LDL-C,收缩压均呈正相关(JP值均<0.05).多元向后回归分析显示,腰围,WHtR,FBG,HOMA-β,TC及收缩压对尿酸水平有影响(P值均<0.05).结论 肥胖儿童高尿酸血症与糖尿病及心血管疾病危险因子密切相关;肥胖儿童应定期监测血尿酸水平.     

Relation of cardiovascular fitness and physical activity to cardiovascular disease risk factors in children and adults

The associations of physical activity and cardiovascular fitness with cardiovascular disease risk factors were studied in 88 male adults, 180 female adults, 148 male children, and 142 female children. Subjects were families recruited from elementary schools in San Diego, California. Fitness (VO2 max) was measured by a submaximal cycle ergometer test. Physical activity was assessed by seven-day recall interview, yielding caloric expenditure, and by a simple self-rating of activity level. Risk factors included blood pressure, high density lipoprotein (HDL) cholesterol, the ratio of high density lipoproteins to low density lipoproteins (LDL), and body mass index. For all subgroups, fitness was strongly and significantly correlated with virtually all risk factors. After adjustment for body mass index, most fitness-risk factor associations were no longer significant. Seven-day caloric expenditure was significantly correlated with HDL/LDL only in female adults and children. The activity rating was significantly correlated with body mass index in all subgroups and with HDL/LDL in female adults and male adults. The simple activity rating tended to be correlated with fitness. The pattern of association was similar for adults and children.     

运动对学龄儿童心血管疾病风险因素干预效果Meta分析

  目的  了解运动对学龄儿童心血管疾病风险因素的干预效果,为开展儿童心血管疾病风险因素运动干预提供依据和指导。  方法  对万方、中国知网、维普、PubMed、Web of Science等数据库的相关文献进行检索,纳入标准为针对学龄儿童心血管风险因素的随机对照干预试验相关的文献。中文检索式有(身体活动或运动)和(学龄儿童或幼儿)和(心血管疾病或血压或血脂谱或胰岛素抵抗或炎症因子或动脉僵硬或动脉厚度或心血管综合风险因子)和(干预实验或随机对照实验),英文检索式有(physical activity OR exercise OR exercise intervention)AND(school-age OR children OR 7~12)AND(cardiovascular disease OR CVD OR lipid profile OR insulin resistance OR inflammation OR arterial thickness OR arterial stiffness OR CVD combined score)AND(randomized controlled trial)等。  结果  共纳入37篇文献,涉及6个结局指标。Meta分析结果显示,运动干预对学龄儿童的高密度脂蛋白(SMD=0.31,95%CI=0.03~0.59)、低密度脂蛋白(SMD=-0.37,95%CI=-0.59~-0.15)、三酰甘油(SMD=-0.45,95%CI=-0.72~-0.18)、胰岛素抵抗指数(SMD=-0.35,95%CI=-0.58~-0.12)、收缩压(SMD=-0.25,95%CI=-0.36~-0.14)、舒张压(SMD=-0.29,95%CI=-0.40~-0.18)均有较好的改善效果。  结论  运动干预对学龄儿童心血管风险因素有积极效果,可以在改善儿童的血脂状况、降低血压的同时改善胰岛素抵抗。     

Long-term follow-up of cardiovascular disease risk factors in children after an obesity intervention

BACKGROUND: Data concerning the long-term improvement of cardiovascular disease (CVD) risk factors after an obesity intervention in children are limited. OBJECTIVE: We studied changes in weight status and CVD risk factors in children in an intervention program and evaluated whether these changes were sustained 1 y after the end of the intervention. DESIGN: We analyzed changes in the SD score (SDS) of body mass index [BMI; in kg/m2 (SDS-BMI)], blood pressure (BP), lipids, and homeostasis model assessment index of insulin resistance (HOMA-IR) over the course of 2 y in 240 obese (BMI > 97th percentile) children aged 6-14 y (x age: 10.4 y; x BMI: 26.9). Of these 240 children, 203 participated in a 1-y intervention program of physical exercise, nutrition education, and behavior therapy. We compared these children with 37 obese children who underwent no intervention and with 12 normal-weight children of the same age and sex. RESULTS: Obese children had significantly (P < 0.05) higher BP, HOMA-IR, and insulin, triacylglycerol, and LDL-cholesterol concentrations and lower HDL-cholesterol concentrations than did normal-weight children. Twenty-nine children dropped out of the intervention. Only in the 126 children who reduced their SDS-BMI did BP (8% and 12% decreases in systolic and diastolic BP, respectively), lipids (12% and 5% decreases in triacylglycerol and LDL cholesterol, respectively; 7% increase in HDL cholesterol), insulin (13% decrease), and HOMA-IR (17% decrease) improve significantly (P < 0.05). Reduction in SDS-BMI and all benefits regarding CVD risk factors were sustained 1 y after the end of the intervention in the children whose SDS-BMI decreased. CONCLUSIONS: Long-term multidisciplinary intervention led to a reduction in SDS-BMI in most of the obese children 1 y after the end of the intervention. Reduction in SDS-BMI was accompanied by an improvement in CVD risk factors.     

Clustering of cardiovascular disease risk factors

In a population-based cardiovascular disease study we analyzed the associations among five risk factors—cholesterol, triglycerides, blood pressure, obesity, and cigarette smoking. Two methods were used: standard correlation analysis, and a percentile analysis method limited to associations at higher levels of these risk factors. The study population, 4,839 men and women aged 30–89, showed significantly positive standard and age-adjusted correlation coefficients for all comparisons between any two risk factors except for those comparisons involving smoking. In the percentile analysis, subjects with moderate or greater (?70th percentile) or high (?90th percentile) levels on one of these risk factors showed clustering of elevations in other risk factors in that observed/expected ratios were generally greater than unity, again excepting smoking comparisons. Clustering was strongest in subjects at the highest levels of these risk factors, a phenomenon which has not, to our knowledge, previously been reported. Because of the particularly high risk of subjects with several risk factors, this finding should caution clinicians who identify a patient with an elevation of one of these risk factors to evaluate the patient carefully for elevations of other risk factors.