6~7岁儿童颈动脉内中膜厚度与内脏脂肪面积的关联性  

Association between carotid intima-media thickness and visceral fat area in children aged 6-7 years

作　　者：李梦龙 赵瑞兰[2] 书文 段军伟[2] 赵芳芳[2] 李莉[2] 甄国新[2] 胡翼飞 LI Menglong;ZHAO Ruilan;SHU Wen;DUAN Junwei;ZHAO Fangfang;LI Li;ZHEN Guoxin;HU Yifei(Department of Child and Adolescent Health and Maternal Health,School of Public Health,Capital Medical University,Beijing(100069),China;不详)

机构地区：[1]首都医科大学公共卫生学院儿少卫生与妇幼保健学系,北京100069 [2]北京市顺义区疾病预防控制中心

出　　处：《中国学校卫生》2020年第3期413-415,419,共4页Chinese Journal of School Health

基　　金：北京市教委科技计划一般项目(KM201810025009);北京市自然科学基金资助项目(7202009);国家自然科学基金面上项目(81673232)。

摘　　要：目的探索儿童颈动脉内中膜厚度(c IMT)与内脏脂肪面积(VFA)的关系,为预防心血管疾病提供参考依据。方法采用基于人群普查的方法,纳入北京市顺义区6所公立非寄宿制小学一年级学生1 914名,建立儿童生长与健康队列(PROC),并进行社会人口学调查、身体测量、血液和尿液常规与生化指标的检测。采用单因素和多因素稳健线性回归分析c IMT与其他指标的关系。结果 1 711名被试中,正常、超重、肥胖儿童c IMT均值分别为(0.35±0.02)(0.36±0.02)(0.37±0.03) mm,差异有统计学意义(F=41.4,P<0.01);VFA中位数分别为16.2(13.6~19.3)、22.7(18.6~27.3)、51.5(33.9~73.0) cm2,差异有统计学意义(χ^2=854.5,P<0.01)。单因素稳健线性回归分析结果显示,总体模型校正年龄、性别后,c IMT与身高、收缩压(SBP)、舒张压(DBP)、高密度脂蛋白胆固醇(HDL-C)、VFA的相关均有统计学意义(P值均<0.05);与三酰甘油(TG)相关有边际统计学意义(P=0.055)。多因素稳健线性回归分析结果显示,在总体和男生模型中c IMT与VFA和SBP均呈正相关(β值分别为0.000 2,0.000 2;0.000 2,0.000 2,P值均<0.05),在女生模型中c IMT与VFA和TG均呈正相关(β值分别为0.000 2,0.006 2,P值均<0.05)。结论 VFA对c IMT的预测能力稳定,可利用VFA对儿童进行简化分类管理,进而开展有针对性的干预来早期预防成年期心血管疾病。Objective To identify the association of carotid intima-media thickness(c IMT) and visceral fat area( VFA to inform prevention of cardiovascular disease in later life. Methods All the grade one students of six non-boarding primary schools in Shunyi District,Beijing were enrolled,based on population-based survey design,to establish the child cohort on sensitization,puberty,obesity and cardiovascular risk( PROC). Socio-demographic information survey and anthropometric measure,blood and urine test were carried out. Robust linear regression was used to determine the relationship between c IMT and other factors. Results Among 1 711 participants,a significant difference were observed between normal,overweight and obesity children on c IMT [( 0.35±0.02)( 0.36±0.02)( 0.37±0.03) mm]( F = 41.4,P<0.01) and VFA [16.2( 13.6-19.3),22.7( 18.6-27.3),51.5( 33.9-73.0) cm2]( χ^2= 854.5,P< 0.01). After adjusting age and sex,univariate robust linear regression showed that c IMT was associated with height,SBP,DBP,HDL-C,VFA( P<0.05) and TG( P = 0.055). Multivariable robust linear regression indicated that in total and boys only included models,c IMT was associated with VFA and SBP( β = 0.000 2,0.000 2,0.000 2,0.000 2,P<0.05);while in girls only included model c IMT was associated with VFA and TG( β = 0.000 2,0.006 2,P<0.05). Conclusion VFA is stable to predict the increase of c IMT in children. We can use VFA to simplify the classification management of children and inform targeted early prevention of cardiovascular disease in adulthood.

关 键 词：颈动脉 血管中膜 内脏 脂肪组织 回归分析 儿童 

分 类 号：R725.4[医药卫生—儿科] R193[医药卫生—临床医学]