中国六省学龄儿童体重指数、体脂百分比评价肥胖与心血管代谢危险因素的相关性

目的 探讨单纯体重指数(BMI)、体脂百分比(FMP)分类肥胖及二者交叉分组与心血管代谢危险因素的关联,为儿童肥胖及相关代谢异常的防控提供依据。方法 基于在6省(黑龙江、内蒙古、宁夏、四川、云南和湖南)完成的横断面调查,选取10～18岁的学龄儿童11 542人为研究对象。分别以BMI(+-)]和FMP(+-)]单独或交叉分类肥胖状况分组,采用Logistic回归模型分析比较心血管代谢危险因素异常的风险。结果 不调整腰围(WC)的影响,BMI(-)+FMP(+)]组低高密度脂蛋白胆固醇(HDL-C)和血糖升高风险较低,其余各组与肥胖相关代谢异常的关联较高。调整WC后,男生中 BMI(+)+FMP(+)]组高三酰甘油(TG)OR(95%CI):2.55(1.29~5.02)]、合并血脂异常OR(95%CI):2.07(1.19~3.61)]和血压升高OR(95%CI):2.20(1.29~3.77)]的风险较高。女生中BMI(+)+FMP(+)]组合并血脂异常OR(95%CI):2.02(1.09~3.74)]的风险较高。结论 结合FMP对儿童肥胖评价可提高对血脂异常和血压升高的筛查效果。

Association of obesity classified by body mass index and fat mass percentage with cardiometabolic risk factors among school-age children in 6 provinces,China

Objective To explore the association of obesity classified by body mass index (BMI), body fat mass percentage (FMP) and the cross-grouping of BMI and FMP with cardiometabolic risk factors, so as to provide basis for the prevention and control of childhood obesity and related metabolic abnormalities. Methods Based on the cross-sectional data of the survey in China completed in 6 provinces (Heilongjiang, Inner Mongolia, Ningxia, Sichuan, Yunnan and Hunan), 11 542 school-age children aged 10 to 18 were selected as the research subjects. The obesity status was classified separately or cross-classified by BMI and FMP, and the Logistic regression model was used to analyze and compare the risks of cardiometabolic risk factors. Results Without adjusting for the waist circumference (WC), the group BMI(-)+FMP(+)] had a lower risk of elevated low high-density lipoprotein cholesterol (HDL-C) and elevated blood glucose, however, the other groups had a higher risk of obesity-related metabolic abnormalities. After adjusting for WC, the BMI(+)+FMP(+)] group had a higher risk of high triglycerides(TG) OR(95%CI):2.55 (1.29 - 5.02)], dyslipidemia OR(95%CI):2.07 (1.19 - 3.61)] and elevatedfasting blood pressure OR(95%CI):2.20 (1.29 - 3.77)] among boys. Among girls, the BMI(+)] and FMP(+)] group had a higher risk of dyslipidemia OR(95%CI):2.02(1.09 - 3.74)]. Conclusion It is necessary to add FMP when assessing child obesity to screen for the risk of dyslipidemia and elevated blood pressure.