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目的探讨儿童青少年不同肥胖类型与代谢异常的关系,为儿童青少年心血管病危险因素的防制提供科学依据。方法选取济南市城区1 170名7~17岁儿童青少年,测量身高、体重、腰围(WC)和血压,同时测定空腹血糖、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等血生化指标,分析不同肥胖类型与代谢异常的关系。结果儿童青少年各类生化指标平均水平(血糖、总胆固醇除外)和代谢异常检出率(高血糖除外)在不同肥胖类型组的差异均有统计学意义(P值均<0.05),且表现为复合型肥胖组>全身性肥胖或中心性肥胖组>体质量指数(BMI)和WC均正常组。以BMI与WC均正常为对照组,任意肥胖类型组以及复合型肥胖组罹患各类代谢异常的风险均较高。以预测代谢异常≥2个为例,任意肥胖类型的风险OR值为1.50(95%CI=0.78~2.90),复合型肥胖的风险OR值为7.84(95%CI=5.00~12.30)。结论在学生体检工作中,应联合使用BMI和WC来判定儿童肥胖,从而更有效地防控儿童青少年心血管病危险因素。
Objective To explore the relationship between different types of obesity and metabolic disorders in children and adolescents and to provide a scientific basis for prevention of cardiovascular risk factors in children and adolescents. Methods A total of 1 170 children aged 7-17 years in urban area of Jinan City were selected to measure height, weight, waist circumference (WC) and blood pressure. Blood levels of fasting blood glucose, triglyceride, high density lipoprotein cholesterol and low density lipoprotein cholesterol Indicators, analyze the relationship between different types of obesity and metabolic abnormalities. Results There were significant differences in the average levels of various biochemical indexes (except blood glucose and total cholesterol) and metabolic abnormalities (excluding hyperglycemia) in children and adolescents with different types of obesity (P <0.05) Compound obesity group> General obesity or central obesity group> Body mass index (BMI) and WC were normal group. BMI and WC were normal control group, any type of obesity group and the compound obesity group suffering from various types of metabolic abnormalities were higher risk. Taking the prediction of ≥2 metabolic abnormalities as an example, the risk OR of any obesity type was 1.50 (95% CI = 0.78-2.90), and the risk OR of combined obesity was 7.84 (95% CI = 5.00-12.30). Conclusions In the examination of students, the combination of BMI and WC should be used to determine childhood obesity so as to prevent and control more risk factors of cardiovascular disease in children and adolescents.