儿童期超重肥胖对成年期动脉粥样硬化及动脉僵硬的长期影响  

作　　者：闫银坤[1] 侯冬青[1] 刘军廷[1] 赵小元[1] 程红[1] 杨平[1] 单鑫影 米杰[1] 

机构地区：[1]首都儿科研究所流行病学研究室,北京100020

出　　处：《中华预防医学杂志》2016年第1期28-33,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金（81172746）;北京市科技计划重大项目（D111100000611002）

摘　　要：目的分析儿童期超重肥胖对成年期动脉粥样硬化及动脉僵硬的长期影响。方法于1987年采用分层整群抽样方法，在北京市朝阳、西城及海淀区的所有学校中各抽取6所小学和6所中学，对其中的3198名6—18岁学生进行血压、身高、体重及左肩胛下皮褶厚度（LSSF）等指标的测量。调查对象均排除患有先天性心脏病、慢性。肾病及肢体残疾者。于2010年3月至2012年7月对基线调查对象进行随访体检，共随访到1225名，对其进行问卷调查，同时进行血生化指标检测、颈．股脉搏波传导速度（cfPwV）及颈动脉内膜中层厚度（cIMT）检测。根据儿童期及成年期体重状态变化，将调查对象分为4组（儿童期至成年期持续非超重组、仅儿童期超重组、仅成年期超重组、儿童期至成年期持续超重组）并作为自变量，以成年期高cfPWV及高cIMT为因变量，进行多因素非条件logistic回归模型分析。结果1225名随访对象超重肥胖患病率为52．2％（639例）；男性吸烟率、饮酒率、超重肥胖患病率分别为62．5％（422／675）、52．1％（353／675）和69．3％（468／675），均高于女性[29．4％（160／550）、26．1％（140／550）和31．1％（171／550）]（X2值分别为133．21、87．13、182．18，P值均〈0．001）。调整性别、基线年龄及随访年限后，儿童期BMI每增加1个单位，成年期高cfPWV及高clMT的发生风险分别增加26％、58％；儿童期LSSF每增加1个单位，则成年期高cfPWV及高clMT的发生风险分别增加30％、36％。另外，仅儿童期超重不会增加成年期高cfPWV及高cIMT的发生风险[（OR=1．59，95％CI：0．77～3．30）、（OR=I．47，95％CI：0．65～3-31）1，但仅成年期超重可增加成年期高cfPWV及高clMT的发生风险[（OR=I．92，95％CI：1．37～2．68）、（OR=3．69，95％CI：2．61～5．23）]；儿童期至成年期持续超重也可增加成年期�Objective To observe the effect of childhood excessive adiposity on long-term risk of adult carotid atherosclerosis and arterial stiffness. Methods At baseline, in 1987, by using stratified cluster sampling design, 3 198 healthy children aged 6-18 were recruited from six primary schools and six middle schools from three districts (Chaoyang, Xicheng, and Haidian) in Beijing, with blood pressure, weight, height and left scapular skinfold thickness (LSSF) measured. From April 2010 to July 2012, 1 225 subjects were followed from childhood to adulthood. Questionnaire, biochemistry parameters, carotid-femoral pulse wave velocity (cfPWV), and carotid intima media thickness (cIMT) were measured at follow-up. Based on weight statuses in childhood and adulthood, subjects were classified into four groups (persistent non-overweight from childhood to adulthood, overweight in childhood but non-overweight in adulthood, non-overweight in childhood but overweight in adulthood, persistent overweight from childhood to adulthood). Multiple logistic regression model was used to analyze the association between weight statuses changing from childhood to adulthood and adult high cfPWV and high cIMT. Results The prevalence of overweight (including obesity) at adulthood was 52.2% (639). Males had higher prevalence of smoking&nbsp;(62.5%(422/675) vs 29.4%(160/550), χ2=133.21, P<0.001), drinking (52.1%(353/675) vs 26.1%(140/550),χ2=87.13, P<0.001), overweight (including obesity) (69.3%(468/675) vs 31.1%(171/550), χ2=182.18, P<0.001) than females. With adjusting for gender, age, and length of follow-up, the risk of high cfPWV and high cIMT increased by 26%and 58%for 1 units increase in BMI, and by 30%and 36%for 1 units increase in LSSF. Compared to subjects with persistent non-overweight from childhood to adulthood, subjects with overweight in childhood but non-overweight in adulthood had similar risks of high cfPWV (OR=1.59, 95%CI:0.77-3.30)and high cIMT (OR=1.47, 95%CI:0.65-3.31). The risks of high cfPWV and high cIMT increased among su

关 键 词：儿童 人体质量指数 动脉粥样硬化 左肩胛下皮褶厚度 动脉僵硬 

分 类 号：R723.14[医药卫生—儿科]