杭州市萧山区儿童青少年代谢综合征组分的正交因子分析

目的 了解儿童青少年代谢综合征（MS）各组分的相互关系，探索其潜在病理生理机制。方法 对2010 年3 月杭州市萧山区的1 550 名7~14 岁儿童青少年的体格检查及空腹血脂血糖数据进行回顾性分析，对其体重指数z 值（BMI-z）、腰围z 值（WC-z）、腰臀比（WHp）、腰围身高比（WHt）、甘油三酯（TG）、总胆固醇（CHOL）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、血压、空腹血糖（FPG）等指标进行因子分析。结果 主成分分析法提取5 个主因子，贡献率最大的为肥胖因子，可解释23.56% 的变异度，其中的3个变量根据因子负荷从大到小排列分别为WC-z、WHt、BMI-z。其余主因子根据贡献率从大到小排列依次为血脂因子1（TG、CHOL、LDL），血压因子，血脂因子2（TG、HDL），血糖及腰臀比因子（FPG、WHp）。5个因子累计贡献率为77.76%。结论 MS 的发生不只一个病理生理机制，肥胖，尤其是中心性肥胖是其中最重要的一个影响因子。脂代谢紊乱并不能完全解释胰岛素抵抗，两者可能共同作用于MS。

Orthogonal factor analysis of metabolic syndrome components in children and adolescents in the Xiaoshan District of Hangzhou, China

Objective To study the relationship between various metabolic syndrome (MS) components in children and adolescents and to explore its potential pathophysiological mechanism. Methods A total of 1 550 children and adolescents aged 7-14 years from the Xiaoshan District of Hangzhou, China were enrolled in March 2010. The anthropometric parameters such as height, weight, waist circumference (WC), and hip circumference, as well as blood pressure, were measured; after adjustment for age and sex, body mass index z score (BMI-z), waist circumference z score (WC-z), waist-to-hip ratio (WHp), and waist-to-height ratio (WHt) were calculated. Fasting blood samples were collected for determination of fasting plasma glucose (FPG), total cholesterol (CHOL), triglyceride (TG), high-density lipoproteins (HDL), and low-density lipoproteins (LDL). Principal component analysis was used for extraction of factors. Results Principal component analysis revealed 5 uncorrelated factors that cumulatively explained 77.76% of the observed variance. Adiposity factor, which accounted for 23.56% of the variance, was the primary factor; it consisted of 3 variables, i.e., WC-z, WHt, and BMI-z, in which WC-z had the highest loading. The remaining factors identified were blood lipid factor 1 (TG, CHOL, and LDL), blood pressure factor, blood lipid factor 2 (TG and HDL), and blood glucose and WHp factor (FPG and WHp). Conclusions More than one pathophysiological mechanism could account for the development of MS in children and adolescents. Obesity, especially central obesity, is the most important factor in the development of MS. Dyslipidemia may not fully explain insulin resistance; they may work together in MS.