卫生研究

目的探讨儿童青少年肥胖与血脂各指标之间的关系。方法从分层整群随机抽取的10 648人中,依据中国学龄儿童青少年超重、肥胖筛查BMI分类标准,按照性别、民族、年龄相差≤1岁,进行肥胖、超重、正常1∶1∶1配对,各321例,采用"全国青少年体质调研统一测量方法"对研究对象进行体格测量,并采集空腹静脉血进行血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)生化指标的测定。结果三组间体重、腰围、臀围、收缩压(SBP)、舒张压(DBP)、TG、TC、LDL-C差异均有统计学意义(均P<0.01或0.05),肥胖组明显高于正常组;随BMI的增加,血TG、TC异常率呈上升趋势,肥胖组明显高于正常组,差异均有统计学意义(均P<0.01或0.05);控制性别、民族和年龄因素后,TG与BMI、腰围、臀围、腰高比值(WHtR)呈正相关(均P<0.01或0.05),HDL-C与BMI、腰围、臀围、WHtR呈负相关(均P<0.01或0.05);调整性别、民族、年龄因素后,随BMI的增加,高脂血症发病风险显著增加,肥胖组患高脂血症的风险是正常组的1.593倍(95%CI为1.144².220),差异有统计学意义(P<0.01);回族儿童青少年的TC、LDL-C、HDL-C水平均高于汉族,TG水平均低于汉族(P>0.05);而回族儿童青少年TC、LDL-C异常率明显高于汉族(P<0.01)。结论肥胖显著增加了儿童青少年高脂血症的发病风险;回族儿童青少年TC、LDL-C的异常率均显著高于汉族,是否与民族遗传有关,有待于进一步研究。

Objective Discuss the relationship between obesity and hyperlipidemia in children and adolescent. Methods According to the BMI classification criteria of overweight and obesity screening in Chinese school-age child and adolescent,and the gender and nationality,age( ≤1 year-old),we performed the 1∶ 1∶ 1 match of the obesity,overweight,and normal,there were 321 subjects in each group. Using "national unified measurement method of youth physical fitness research",we did physical measurements on the subjects,and collected fasting venous blood to do biochemical detections,including blood glucose( FPG),triglyceride( TG),total cholesterol( TC),high density lipoprotein cholesterol( HDL-C), low density lipoprotein cholesterol( LDL-C). Results The differences of weight,waist circumference,hip circumference,SBP,DBP,TG,TC,LDLC were statistically significant among the three groups( all P < 0. 01 or 0. 05),the obese group was significantly higher than the normal group. With the increase of BMI,the abnormal rate of TG and TC were all upward trend,the obese group was significantly higher than the normal group,the differences were statistically significant( all P < 0. 01 or 0. 05).After controlling factors of gender,nationality and age,TG was positively correlated with BMI,waist circumference,hip circumference and waist-high ratio( WHtR)( all P < 0. 01 or 0. 05),HDL-C was negatively correlated with and BMI,waist circumference,hip circumference and WHtR( all P < 0. 01 or 0. 05). After adjusting gender,nationality and age,with the increase of BMI,the risk for hyperlipidemia increased significantly,the risk of the obese group for hyperlipidemia was 1. 593 times than the normal group( 95% CI 为1. 144 ~ 2. 220),it was statistically significance( P < 0. 01). The level of TC,LDL-C and HDL-C in Muslim children and adolescents were higher than in Han,the level of TG were lower than in Han,but the differences were not statistically significant( All P > 0. 05)). The abnormal rates of TC,LDL-C in Muslim children and adolescents were higher than in Han,the differences were statistically significant. Conclusions Conclusions: The blood lipids levels of obese children and adolescents were obviously higher than that of normal one,especially TG and TC; obesity significantly increased the risk for hyperlipidemia in children and adolescents; the abnormal rates of TC,LDL-C in Muslim children and adolescents were significantly higher than in Han; Whether it is associated with ethnic genetic,remains to be further research.