摘要
目的 探讨学龄期儿童超重和肥胖代谢异常的发病特点及影响因素,为降低肥胖儿童代谢并发症提供理论依据。方法 收集2020年7月至2022年7月在西安交通大学第一附属医院儿童保健门诊就诊的235例6岁以上超重和肥胖的儿童为研究对象,按照体质量指数(BMI)将其分为超重组(129例)与肥胖组(106例)。采用自制调查问卷获取儿童的一般信息;对血压、血脂、空腹血糖和腰围等代谢指标进行检测,依据检测结果将儿童分为代谢健康组(154例)与代谢异常组(81例),采用单因素分析和多因素Logistic回归分析代谢异常的影响因素。结果 超重组的腰围(t=7.142)、舒张压(t=2.307)、空腹血糖(Z=2.273)、高密度脂蛋白胆固醇(Z=2.513)、低密度脂蛋白胆固醇(t=2.734)、甘油三酯(Z=5.769)均优于肥胖组,差异均有统计学意义(P<0.05)。超重组和肥胖组的各项代谢指标异常检出率由高到低依次为:腹型肥胖、高/低密度脂蛋白胆固醇异常、高甘油三酯、高血压和高血糖,且肥胖组各项指标异常检出率均高于超重组(χ^(2)值分别为17.004、9.904、18.842、7.145、6.282,P<0.05),肥胖组和超重组儿童代谢综合征检出率分别为22.64%(24/106)、4.65%(6/129),经比较差异有统计学意义(χ^(2)=16.911,P<0.05)。多因素Logistic回归分析显示,肥胖(OR=2.823)、每周吃快餐>2次(OR=3.383)、吃饭速度过快(OR=3.272)和每天视频时间≥2h(OR=1.963)均为超重和肥胖儿童发生代谢异常的危险因素(P<0.05)。结论 学龄期超重和肥胖儿童代谢异常的并发症较多,不良的饮食习惯和长时间的视频与代谢异常相关。对学龄期儿童应做好定期体格检查,早发现并管理高BMI儿童可减少代谢异常并发症。
Objective To explore the pathogenesis and influencing factors of metabolic abnormalities of overweight or obesity in school-age children,and to provide a theoretical basis for reducing metabolic complications in obese children.Methods A total of 235 overweight or obese children over 6 years old who attended child health clinic in the Children's Health Care Clinic of the First Affiliated Hospital of Xi′an Jiaotong University from July 2020 to July 2022 were collected as subjects.According to their body mass index(BMI),they were divided into overweight group(129 cases) and obesity group(106 cases).General information of children was obtained by self-made questionnaire.The children were divided into healthy group(154 cases) and abnormal group(81 cases) according to the test results.Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors of abnormal metabolism.Results The values of the waist circumference(t=7.142),diastolic blood pressure(t=2.307),FPG(Z=2.273),HDL-C(Z=2.513),LDL-C(t=2.734) and TG(Z=5.769) of the overweight group were better than those of the obese group,all differences were statistically significant(P<0.05).The abnormal detection rates of metabolic indexes in obesity group and overweight children from high to low were:abdominal obesity,high/low density lipoprotein abnormality,high triglyceride,hypertension and hyperglycemia,and the abnormal detection rates of the above indexes were higher in obese group than those of overweight group(χ^(2) values were 9.904,18.842,7.145 and 6.282,respectively,all P<0.05).The prevalence of metabolic syndrome(MS) in obese and overweight children was 22.64%(24/106) and 4.65%(6/129),the difference was statistically significant(χ^(2)=16.911,P<0.05).Multivariate Logistic regression analysis showed that obesity(OR=2.823),eating fast food >2 times per week(OR=3.383),eating too fast(OR=3.272) and daily video time ≥2h(OR=1.963) were risk factors for metabolic abnormalities in overweight and obese children(P<0.05).Conclusion The complications of metabolic abnormalities in overweight and obese children of school age are high,and poor dietary habits and prolonged video are associated with metabolic abnormalities.Regular physical examinations should be done in school-aged children and early detection and management of children with high BMI can reduce the complications of metabolic abnormalities.
作者
史博慧
岳婕
吕敏
史晓薇
帖利军
刘黎明
SHI Bohui;YUE Jie;LV Min;SHI Xiaowei;Tie Lijun;Liu Liming(The First Affiliated Hospital of Xi′an Jiaotong University,Shaanxi Xi'an 710061,China)
出处
《中国妇幼健康研究》
2023年第8期8-13,共6页
Chinese Journal of Woman and Child Health Research
基金
国家自然科学基金项目(81273007)
陕西省重点研发计划项目(2022SF-104)。
关键词
体质量指数
学龄期儿童
代谢异常
影响因素
body mass index
school-age children
abnormal metabolism
influencing factors
