超重肥胖与维生素D营养状况的交互作用对儿童肌肉减少症的影响  

Interaction between overweight/obesity and vitamin D status and its impact on sarcopenia in children

作　　者：黄杰 黄诗婷 李艳艳 李妍 熊静帆[2] 姚平 HUANG Jie;HUANG Shi-ting;LI Yan-yan;LI Yan;XIONG Jing-fan;YAO Ping(Department of Preventive Medicine,Shihezi University School of Medicine,Shihezi,Xinjiang 832000,China;不详)

机构地区：[1]石河子大学医学院预防医学系,新疆石河子832000 [2]深圳市慢性病防治中心儿童青少年慢性病防控科 [3]华中科技大学同济医学院公共卫生学院营养与食品卫生学系,湖北武汉430030

出　　处：《现代预防医学》2024年第17期3123-3127,共5页Modern Preventive Medicine

基　　金：广东省医学科学技术研究基金项目(A2024150);深圳市基础研究资助项目(KCXFZ20201221173400002);深圳医学重点学科建设经费资助项目(SZXK065);深圳市“医疗卫生三名工程”项目资助。

摘　　要：目的探讨儿童青少年超重肥胖及维生素D不足与肌肉减少症的关系。方法2021年采用多阶段分层整群随机抽样对深圳市中小学生进行调查,包括问卷调查、体格检查和实验室检查,并采用生物电阻抗法测定其身体成分。通过logistic回归分析模型分析超重肥胖与维生素D不足对儿童肌肉减少症的影响,并进一步分析其交互作用。结果4931名6~17岁儿童中肌肉减少症占10.3%,超重肥胖占23.0%,维生素D不足率为41.2%。多因素logistic回归分析模型调整混杂因素后超重肥胖合并维生素D不足的肌肉减少症的发病风险是无超重肥胖无维生素D不足儿童的118.107倍(95%CI:73.035~190.995)。超重肥胖与维生素D不足对其存在相乘交互作用(OR=2.436,95%CI:1.009~5.882)。相加交互结果也提示超重肥胖与维生素不足存在协同作用,交互作用指数(S)、交互作用相对超额危险度比(RERI)、交互作用归因比(AP)分别为1.684(95%CI:1.250~2.270)、47.591(95%CI:10.098~85.083)、40.280%(95%CI:22.650~57.910)。按年龄层交互作用分析也显示,超重肥胖与维生素D不足两者之间存在交互作用。结论在儿童青少年中超重肥胖与维生素D不足是肌肉减少症的危险因素且二者可能存在协同作用。Objective To investigate the relationship between overweight/obesity,vitamin D deficiency,and sarcopenia in children and adolescents.Methods In 2021,a multi-stage stratified cluster random sampling survey was conducted among primary and secondary school students in Shenzhen,which included questionnaire surveys,physical examinations,and laboratory tests.Body composition was assessed using bioelectrical impedance analysis.Logistic regression analysis was employed to evaluate the effects of overweight/obesity and vitamin D deficiency on sarcopenia in children,followed by interaction analysis.Results Among 4931 children aged 6 to 17 years,the prevalence of sarcopenia was 10.3%,overweight obesity was 23.0%,and the rate of vitamin D deficiency was 41.2%.After adjusting for confounding factors in a multivariable logistic regression model,the risk of sarcopenia in children with overweight/obesity and vitamin D deficiency was found to be 118.107 times higher(95%CI:73.035-190.995)than that in children without either condition.There was a multiplicative interaction between overweight/obesity and vitamin D deficiency(OR=2.436,95%CI:1.009-5.882).The additive interaction results also suggested a synergistic effect between overweight obesity and vitamin D deficiency,with interaction indices(S),relative excess risk due to interaction(RERI),and attributable proportion(AP)being 1.684(95%CI:1.250-2.270),47.591(95%CI:10.098-85.083),and 40.280%(95%CI:22.650-57.910),respectively.Interaction analysis by age group further confirmed the presence of an interaction between overweight/obesity and vitamin D deficiency.Conclusion Overweight obesity and vitamin D deficiency are risk factors for sarcopenia in children and adolescents,and there may be a synergistic effect between the two.

关 键 词：儿童青少年 超重肥胖 维生素D 肌肉减少症 交互作用 

分 类 号：R685[医药卫生—骨科学] R726.8[医药卫生—外科学]