北京市青少年肥胖与代谢综合征的关系

目的 通过调查北京市青少年肥胖与代谢综合征(MS)的流行特点,探讨肥胖与MS及其组分的关系以及肥胖4种评价指标[体重指数(BMI)、腰围(WC)、腰围身高比(WHtR)、脂肪百分比(FAT%)]与MS及其组分的关系,从而为青少年MS的防治提供依据。 方法 对来自北京市儿童青少年MS随访队列(BCAMS队列)的214名14~26岁青少年进行人体测量,同时测定肝、肾功能、血脂及糖化血红蛋白等指标。根据BMI分为体重正常组(99例)、超重组(53例)、肥胖组(62例)。根据国际糖尿病联盟的成人、儿童和青少年MS定义诊断MS,用趋势2检验进行MS及MS组分检出率的比较。用ROC曲线分析四种肥胖评价指标对MS的诊断价值。 结果 共检出MS患者21例,其中男性14例,女性7例,总检出率为9.8%,男、女性检出率分别为14.9%、5.8%;肥胖组的白蛋白、总胆固醇、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇、甘油三酯(TG)、超敏C反应蛋白、天冬氨酸氨基转移酶、丙氨酸氨基转移酶、尿酸、收缩压(SBP)、舒张压(DBP)检测值均高于体重正常组,差异有统计学意义(P0.05);TG、WC、SBP、DBP与肥胖4种评价指标呈正相关性,而HDL与之呈负相关性,空腹血糖仅与BMI、WC呈正相关性;4种评价指标ROC曲线下面积最大者为BMI,次之为WC,最小为FAT%。 结论 北京市青少年随着体重指数的增加,MS及MS组分、相关危险代谢因素显著增加。4种肥胖评价指标中,BMI、WC与MS及其组分关系更为密切。提示应对青少年的肥胖进行早期干预以降低MS及其组分、相关危险因素的发病率。

Correlation between obesity and metabolic syndrome in adolescents in Beijing

Objective To understand correlation between obesity and metabolic syndrome in adolescents and provide evidence for the prevention and control of metabolic syndrome in this population. Methods A total of 214 subjects aged 14-26 years were selected in Beijing. Their body height, body weight, waist circumference, fat proportion (FAT%), blood pressure, Liver and kidney function, blood lipid and HbA1c were measured. According to the BMI, the subjects were divided into 3 groups: i.e. 99 subjects in normal group, 53 subjects in overweight group and 62 subjects in obese group. Metabolic syndrome was diagnosed according to IDF's definition. Trend chi-square test was used to compare the detection rates of different forms of metabolic syndrome and ROC curve was used to evaluate the roles of BMI, WC, WHtR and FAT% in diagnosis of metabolic syndrome. Results Metabolic syndrome was diagnosed in 21 subjects (9.8%), i.e. 14 boys (14.9%) and 7 girls (5.8%). The detection levels of ALB, TC, HDL-C, LDL-C, TG, hs-CRP, ALT, AST, UA, SBP, DBP were higher in obese group than in normal group, and differences were statistically significant (P0.05). There was positive correlation between TG, WC, SBP and DBP levels and BMI, WC, WHtR and FAT% levels,and there was negative correlation between HDL-C level and BMI, WC, WHtR and FAT% levels. FPG level was only positively correlated with BMI and WC levels. The biggest area under the ROC curve belonged to BMI, followed by WC. Conclusion The prevalence of different forms of metabolic syndrome and related risk factors increased with the increase of BMI in the adolescents and youths in Beijing. Among the four obesity evaluation indexes (BMI, WC, WHtR and FAT%), BMI and WC were closely related with different forms of metabolic syndrome, suggesting that early intervention should be conduct among adolescents and youths to reduce the prevalence of different forms of metabolic syndrome and related risk factors.