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儿童和青少年的心脏代谢风险与肥胖严重程度
Cardiometabolic Risks and Severity of Obesity in Children and Young Adults


Asheley C. Skinner ... 心脑血管疾病 糖尿病 妇产科和儿科 • 2015.10.01
相关阅读
• 儿童肥胖的诊断、治疗和预防指南 • 从儿童期至成年早期超重的变化与2型糖尿病风险的关系

摘要


背景

在过去十年中,儿童和青少年重度肥胖的发生率有所增高。尽管超重或肥胖儿童和青少年的心脏代谢危险因素的发生率相对较低,但较严重肥胖患者的风险可能更高。

 

方法

我们纳入了1999~2012年国家健康和营养调查(National Health and Nutrition Examination Survey)中3~19岁的超重或肥胖儿童以及青少年的数据进行横断面分析,以评估不同肥胖严重程度的多种心脏代谢危险因素的发生率。我们根据测量的身高和体重对体重状态进行了分类。我们采用了总胆固醇、高密度脂蛋白(HDL)胆固醇、低密度脂蛋白胆固醇、甘油三酯、血压、糖化血红蛋白和空腹血糖异常值的标准定义,报告了不同体重状态的儿童和青少年中异常值的发生率。

 

结果

体质指数在第85百分位数或更高(根据疾病控制和预防中心增长图表)的8,579名儿童和青少年中,46.9%为超重,36.4%为Ⅰ级肥胖,11.9%为 Ⅱ级肥胖,4.8%为Ⅲ级肥胖。肥胖程度更高的男性和女性研究对象的一些(但不是全部)心脏代谢变量的平均值也更高,男性的值高于女性;对于HDL胆固醇,肥胖程度越高则平均值越低。校正了年龄、种族和性别的多变量模型显示,肥胖的严重程度越高,则HDL胆固醇水平低、收缩压和舒张压高以及甘油三酯和糖化血红蛋白水平高的风险越大。

 

结论

儿童和青少年的重度肥胖与心脏代谢风险因素的发生率增加有关,特别是在男孩和年轻男性中。





作者信息

Asheley C. Skinner, Ph.D., Eliana M. Perrin, M.D., M.P.H., Leslie A. Moss, M.H.A., C.H.E.S., and Joseph A. Skelton, M.D.
From the Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, School of Medicine (A.C.S., E.M.P.), Department of Health Policy and Management, Gillings School of Global Public Health (A.C.S.), and Injury Prevention Research Center (L.A.M.), University of North Carolina at Chapel Hill, Chapel Hill, and the Department of Pediatrics, Wake Forest School of Medicine, and Brenner FIT (Families in Training), Brenner Children’s Hospital, Winston-Salem (J.A.S.) — all in North Carolina. Address reprint requests to Dr. Skinner at the Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, 231 MacNider, 229B, CB 7225, Chapel Hill, NC 27599, or at asheley@unc.edu.

 

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