Relationship between different obesity phenotypes and abnormal blood pressure in children and adolescents in Yinchuan city / 中华实用儿科临床杂志

Objective:To investigate the relationship between different obesity phenotypes and abnormal blood pressure in children and adolescents in Yinchuan city, and to provide appropriate treatment and intervention measures for obese children and adolescents.Methods:The current research design was adopted to facilitate the cluster sampling.A total of 1 047 children and adolescents aged 12 to 18 in Yinchuan were enrolled in this study from September 2017 to September 2018.There were 530 males and 517 females, with an average age of (13.93±1.24) years old.The questionnaire survey, physical examination and laboratory testing were carried out.Statistical analysis was performed by using SPSS 19.0 software.Results:Among the children and adolescents with normal weight, the composition ratio of the metabolically unhealthy normal-weight (MUNW) phenotype was 7.6%.In the obese cases, the composition ratio of the metabolically healthy obesity (MHO) phenotype was 20.2%.The blood pressure of MUNW [systolic pressure SBP: (119±13) mmHg(1 mmHg=0.133 kPa); diastolic pressure(DBP)(74±10) mmHg] and metabolically unhealthy obesity (MUO) [SBP (127±10) mmHg; DBP(74±7) mmHg] phenotypes were significantly higher than those of the metabolically healthy normal-weight (MHNW) phenotype (all P<0.05). The blood pressure of the MUO [SBP(127±10) mmHg; DBP(74±7) mmHg] phenotype was significantly higher than that of the MHO phenotype ( P<0.05). After adjusting for age, gender, and family history of hypertension, MUNW and MUO phenotypes were 5.93 (95% CI: 3.10-11.36) and 11.63 (95% CI: 6.37-21.24) times more likely to develop blood pressure abnormalities than MHNW phenotypes, respectively ( P<0.001). The MHO phenotype was 0.63 (95% CI: 0.08-4.93) times more likely to develop blood pressure abnormalities than the MHNW phenotype ( P=0.66). Conclusions:The MHO phenotype does not increase the risk of abnormal blood pressure, while the MUNW phenotype does.Therefore, it is recommended to identify the MHO phenotype and MUNW phenotype in order to provide appropriate obesity treatment and interventions for children and adolescents.

Survey on prevalence of dyslipidemia among children and adolescents aged 6-18 years old in Yinchuan / 中华实用儿科临床杂志

Objective To assess the prevalence of dyslipidemia among children and adolescents aged 6-18 years in Yinchuan.Methods A stratified,random cluster sampling was used to select a target samples (1 939 cases) of children from elementary schools,middle schools and high schools in different age groups,with medium economic status.The levels of serum total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),and triglycerides (TG) were measured.Results The prevalence of total dyslipidemia was 15.5 ％ (300/1 939 cases).The prevalence of high TG,high TC,high LDL-C,low HDL-C,high non-HDL-C and hyperlipemia were 5.8％ (113/1 939 cases),0.8％ (18/1 939 cases),1.1％ (21/1 939 cases),10.6％ (205/1 939 cases),0.9％ (18/1 939 cases) and 6.4％ (124/1 939 cases),respectively.Boys were more likely to have dyslipidemia than girls (17.7％ vs.13.3％) and a low HDL-C level (13.1％ vs.8.2％),and the differences between 2 groups were statistically significant (x2 =7.178,P =0.007;x2 =12.337,P ＜ 0.001).Individuals aged 16-18 years had the highest prevalence of total dyslipidemia [19.1％ (89/466 cases)] than other age groups,and the difference was statistically significant(x2 =11.393,P ＜ 0.01).Prevalence of dyslipidemia among the obese,the overweight and the normal weight individuals were 39.7％ (69/174 cases),20.8％ (60/289 cases) and 11.6％ (171/1 469 cases),respectively.Moreover,prevalence of dyslipidemia increased significantly with gravity of obesity,and the difference was statistically significant(x2 =100.180,P ＜ 0.01).Individuals with abdominal obesity had higher prevalence rates of dyslipidemia than that of the non-abdominal obese individuals [31.5％ (92/292 cases) vs.12.6％ (207/1 064 cases)],and the difference was statistically significant (x2 =67.578,P ＜ 0.01).Approximately 39.7％ (69/174 cases) and 31.5 ％ (92/292 cases) obese individuals and abdominal obesity were candidates for taking intervention measures including nutritional counseling,school-based lifestyle as well as community fitness programs.Conclusions Screening and prevention should be regarded for dyslipidemia among children and adolescents,especially for boys and teenagers in Yinchuan.

Change in the prevalence of obesity phenotypes and cardiometabolic disorders among children aged 6- 17 in Beijing during 2004- 2013 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To examine the prevalence of obesity phenotypes and cardiometablic disorders (CDs) among children aged 6- 17 in Beijing from 2004 to 2013.</p><p><b>METHODS</b>Data were obtained from two cross-section surveys, which were conducted in 2004 and 2013. In 2004, by using stratified cluster sampling design, 20 primary or middle schools were selected from 7 districts (Xicheng, Dongcheng, Chaoyang, Haidian, Daxing, Pinggu, and Yanqing) in Beijing, and 20 554 school children aged 6-17 were recruited, with weight, height, waist circumference and blood pressure measured. Fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were measured in 962 subjects from one school. In 2013, by using the same sampling design, 7 211 students from two districts (Haidian and Dongcheng) were surveyed with weight, height, waist circumference and blood pressure measured, and fasting plasma glucose and lipid profile (TC, TG, HDL-C, LDL-C) were measured for 1 344 subjects in the same school measured in 2004. Student's-t test was used to analyze the difference in body mass index(BMI), WC, and waist to height ratio (WHtR) among children between 2004 and 2010. Chi-square test was used to analyze the difference of hypertension, impaired fasting glucose(IFG), dyslipidemia, and metabolic disorders clustering between 2004 and 2010, and among different types of obesity; logistic regression model was used to analyze the association between three types of obesity and risks of cardiovascular metabolic disorders.</p><p><b>RESULTS</b>In boys, BMI ((20.3 ± 4.4) vs (19.4 ± 4.2) kg/m(2), t=11.18, P<0.001), WC ((70.6 ± 12.8) vs (66.7 ± 11.8) cm, t=17.20, P<0.001) and WHtR (0.451 ± 0.064 vs 0.437 ± 0.059, t=11.64, P<0.001) were significantly higher in 2013 than those in 2004. Similarly in girls, BMI ((18.9 ± 3.6) vs (18.7 ± 3.7) kg/m(2), t=12.21, P<0.001), WC ((64.5 ± 9.6) vs (63.0 ± 9.3) cm, t=8.15, P<0.001) and WHtR (0.430 ± 0.047 vs 0.423 ± 0.047, t=14.13, P<0.001) were also significantly higher in 2013 than those in 2004. The prevalence of combined obesity rose from 8.27% (1 697/20 526) in 2004 to 10.74% (774/7 209) in 2013, and central obesity from 3.08% (632/20 526) to 4.44% (320/7 209). The prevalence of hypertension (10.78%(313/1 344) vs 4.29% (42/962), χ(2)=36.76, P<0.001), IFG(49.54%(664/1 344) vs 6.45%(63/962), χ(2)=506.61, P<0.001), high TC(11.53%(155/1 344) vs 5.03%(49/962), χ(2)=28.31, P< 0.001), high TG(7.51%(101/1 344) vs 3.59%(35/962), χ(2)=29.59, P<0.001) were significantly higher in 2013 than those in 2004. Subjects with combined obesity had higher risks of hypertension (OR=5.88, 95% CI: 4.42-7.82), high TG (OR=7.12, 95%CI: 4.35-11.64), low HDL-C (OR=3.04, 95%CI: 1.55-5.95), high LDL-C (OR=2.27, 95% CI: 1.22-4.02), CDs≥2 (OR=3.07, 95% CI: 2.09-4.50), comparing to children without obesity.</p><p><b>CONCLUSION</b>The prevalence of types of obesity and obesity-related metabolic disorders, except for low HDL-C and high HDL-C, were significantly higher in 2013 than those 2004 among chlildren aged 6-17 year in Beijing. Children with combined obesity had higher prevalence of metabolic disorders.</p>

Prevalence of dyslipidemia in Chinese children and adolescents: a Meta-analysis / 中华流行病学杂志

Objective To quantify the prevalence of dyslipidemia among children and adolescents in China.Methods Chinese Biomedical Database (CBM),Wanfang Databases,China National Knowledge Infrastructme (CNKI) and PubMed were comprehensively searched.Original reports were selected if data on prevalence estimates of dyslipdemia among children and adolescents in China,was provided under cross-sectional epidemiological studies.Quality of the literature was evaluated through the STROBE statement.The prevalence through Meta was estimated using the Strata 11.0 software.Subgroup analysis was undertaken on gender,age,regions and secular trends issues.Sensitivity analysis was performed to evaluate the impact of quality or standard of diagnosis.Results A total of 24 papers were included in this Meta-analysis,with the whole sample size as 129 426.The overall pooled-prevalence of total dsylipidemia was estimated at 25.3％ (95％ CI:12.7％-37.8％).Prevalence rates of high TC,LDL-C,TG,low HDL-C and hyperlipemia were 4.1％ (95％ CI:3.4％-4.9％),5.3％ (95％ CI:3.9％-6.7％),8.5％ (95％ CI:6.3％-10.7％),6.8％ (95％ CI:3.7％-9.9％),4.8％ (95％CI:0.6％-9.1％),respectively.Girls (3.4％) had lower prevalence of high TG than boys (5.6％),but having higher prevalence of other different types dyslipidemia.Children aged 7-18 years had higher overall prevalence of dyslipidemia (31.6％)when compared to children aged 2-6 years (9.0％).There were no statistically significant differences for subgroups of age,region and period regarding the prevalence rates of high TG,TC and low HDL-C (P＞0.05).Conclusion Prevalence of dyslipidemia was high and with increasing trend among children and adolescents in China.Early screening and prevention programs on abnormal serum lipids should be emphasized and promoted.

Prevalence of metabolic syndrome in Chinese children and adolescents: a Meta-analysis / 中华流行病学杂志

Objective To evaluate the prevalence of metabolic syndrome (MS) in Chinese children and adolescents to provide scientific basis for early prevention of MS in the related populations.Methods Studies on CNKI,Wanfangdata,VIP and PubMed databases on related prevalence of metabolic syndrome in Chinese children and adolescents between 2004-2014 were searched.Quality of literatures was evaluated according to the cross-sectional study standard in Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.Stata 12.0 software was used to estimate the prevalence of MS,as well as on gender,weight and other factors to make subgroup analysis.According to funnel plot and Egger assess publication bias,sensitivity analysis performed by excluding the impact of any article was generated by the combined effect of the value of literature.Results This study included 19 papers from the literature (5 in English,14 in Chinese).According to International Diabetes Federation (IDF),National Cholesterol Education Program Ⅲ (NCEP Ⅲ) and The definition and prevention recommends of metabolic syndrome in Chinese children and adolescents (CHN2012),the prevalence rates of MS in Chinese children were seen as 1.8％,2.6％ and 2.0％.According to IDF,the prevalence rates of MS appeared 2.9％ in boys and 1.8％ in girls,0.2％ in children with normal weight,4.7％ in overweight and 17.3％ in obesity.Both the results from NCEP Ⅲ and CHN2012 showed that the prevalence rates of MS as boys＞girls,obesity＞overweight＞normal weight.Conclusion Prevalence of MS in Chinese children and adolescents showed a general trend.Data under different standards showed different prevalence rates.Obesity appeared an important risk factor of MS,suggesting that in order to control obesity in children,attention should be paid to identifying and carrying out effective interventions on children under overweight or obesity.

The association between uric acid levels and cardiovascular metabolic disorders and non - alcohol fatty liver disease among obese children / 中华实用儿科临床杂志

Objective To observe the prevalence of hyperuricemia(HUA)among obese children,and to ex-plore the association between uric acid(UA)levels and cardiometabolic risk factors,acanthosis nigricans and non - al-cohol fatty liver disease(NAFLD). Methods By using representative sampling method,1 753 obese children aged 6 -17 years old from 18 schools in 3 districts of Beijing(Xicheng,Haidian,Miyun)were selected to participate in the clini-cal examinations,including anthropometric measurements(height,weight)and blood pressure. Serum biochemical pa-rameters were assessed,including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high - densi-ty lipoprotein cholesterol(HDL - C),low - density lipoprotein cholesterol(LDL - C)and UA. Acanthosis nigricans and B - model ultrasonography of the liver were conducted. Results The prevalence of hypertension,impaired fasting glu-cose,dyslipidemia,acanthosis nigricans,and NAFLD among these 1 753 obese children was 33. 6%(589 cases), 66. 5%(1 156 cases),54. 3%(943 cases),23. 3%(408 cases),and 17. 0%(298 cases),respectively. The preva-lence of HUA was 40. 70%(714 / 1 753 cases),with 50. 17%(581 / 1 158 cases)in boys and 22. 34%(133 / 595 ca-ses)in girls. There was a significant increase in body mass index,systolic blood pressure,diastolic blood pressure, FPG,TG and LDL - C with the increase of UA,but there was a decrease in HLD - C with the increase of UA(all P ﹤0. 05). In boys,the adjusted odds ratios( OR)and 95% CI of the highest quartile of UA for hypertension,impaired fasting glucose,dyslipidemia,acanthosis nigricans,and NAFLD were 1. 16(0. 77 - 1. 74),1. 34(0. 90 - 1. 99),1. 29 (0. 89 - 1. 87),1. 89(1. 17 - 3. 04),and 1. 71(1. 03 - 2. 84),respectively;in girls,the adjusted OR and 95% CI of the highest quartile of UA for hypertension,impaired fas-ting glucose,dyslipidemia,acanthosis nigricans,and NAFLD was 0. 70(0. 40 - 1. 24),0. 60(0. 40 - 1. 00),1. 69(1. 04 - 2. 70),1. 67(0. 80 - 3. 49),and 1. 33(0. 48 - 3. 66),re-spectively. Conclusions The prevalence of HUA is relatively high in obese children and there is a strong association between UA and some car-diovascular metabolic disorders,acanthosis nigricans and NAFLD.

Characteristic analysis for change in health for Han primary and secondary school students from 1985 to 2010 in Ningxia / 中华实用儿科临床杂志

Objective To analyze the dynamic trends of physical development,constitutional fitness,and prevalence of obesity among Han children and adolescents in Ningxia aged 7-18 years from 1985 to 2010.Methods Data were collected from the National Survey on Students Constitution and Health in 1985,1991,1995,2000,2005 and 2010,respectively.Height,weight and chest circumference were used to evaluate physical development,vital capacity,50-meter running and vital capacity versus weight ratio for the evaluation of constitutional fitness.Results 1.Weight and chest circumference increased faster than height.The average annual increase of weight among the urban girls was significantly faster than those in rural areas.2.The tempo per year of vital capacity in both boys and girls decreased during 25 years,especially after 2005.The rural students had a faster tempo than those in the urban students,and the rate in boys was higher than those in girls.Vital capacity to weight ratio in boys decreased from 2005 much more than before,and had a decreasing trend in each age group except for a few groups in girls.There was a decrease in the mean time of 50-meter running in both boys and girls from 1985 to 2005,whereas the decrease became slow during 1995-2005.The prolonged trend in 50-meter-run time existed during 2005-2010.The average prolonged speeds per decade in boys and urban students was higher than that in girls and rural areas.3.From 1985 to 2010 year,the increasing prevalence of overweight and obesity among boys and girls was 15.0％,25.0％ and 28.1％,12.4％,respectively.The average increasing rate was much higher in the obese than in the over-weighted children,and there were more in boys than in girls.There was a similar positive trend of increasing prevalence of overweight and obesity with the increased gross domestic product.Conclusions The physical growth and development among students in Ningxia increased rapidly,along with the descending trend of average annual rate of physical fitness as well as the rising trend of prevalence obesity.Some measures should be taken by the government to tackle with the situation,and the healthy intervention should be applied to the high risk population.

Indoor Environment and Childhood Asthma in Ningxia:a Case-Control Study / 环境与健康杂志

Objective To know the risk factors of indoor environment associated with childhood asthmas. Methods Using 1∶1 matched case-control study design,140 cases and 140 age-sex-matched controls from the Affiliated Hospital of Ningxia Medical University were investigated for the indoor environment risk factors,from July 2004 to May 2008. Conditional Logistic regression model was used for data analysis. Results It was revealed in univariate and multivariate conditional Logistic regression analysis that there was significant correlation between using coal for cooking,newly indoor decoration,raising pets and the childhood asthma with odds ratios of 1.67,6.46 and 3.06 respectively(P

Environmental Risk Factors for Child Leukemia in Ningxia:a Case-Control Study / 环境与健康杂志

Objective To explore environmental hazards of childhood leukemia and to determine hazardous suspects on childhood leukemia. Methods Using 1∶2 matched case-control study design,50 patients of leukemia and 100 controls selected from the Affiliated Hospital of Ningxia Medical College were investigated during Feb.2005-May 2007. Information was obtained by questionnaires, which included the general social demographic characteristics, disease history, the history of exposure to the materials during the child's mother pregnancy, indoor and outdoor environmental situation and the history of the families. Results The data showed that hazards for childhood leukemia were significantly associated with the history of infection(OR=0.452),diagnostic X-ray exposure (OR=0.157), the history of exposure to the chemical fertilizer and the pesticide during the pregnancy of mother(OR=3.150), the house type(OR=5.162), the nearest distance to the high voltage electricity (OR=2.383) and the radioactive source to the dwelling environment (OR=2.793) were important hazardous factors of the childhood leukemia. Conclusion The history of infection, diagnostic X-ray exposure, the history of exposure to the chemical fertilizer and the pesticide during the pregnancy of mother,the house type, the nearest distance to the high voltage electricity and the radioactive source to the dwelling environment might be the hazardous factors of the childhood leukemia.

Indoor Environmental Factors and Adults Asthma in Ningxia,China:a Case-Control Study / 环境与健康杂志

Objective To determine indoor environmental risk factors for adults asthma.Methods A hospital-based case-control study included 122 adult patients with asthma and 205 community controls was carried out to investigate indoor environmental factors for adult asthma.The data were analyzed by univariate and multivariate unconditional Logistic regression.Results It was revealed in univariate analysis that one-story house,newly decorated house,short of breath hard in newly decorated house,drying the beddings in the sun regularly,no leakage of smoke in kitchen,using coke for heating and using firewood for cooking.Results of the multivariate conditional logistic regressive analysis showed that one-story house and newly decorated house had significant negative correlation with asthma(P

The Risk Factors for Adult Leukemia: a Case-Control Study / 环境与健康杂志

Objective To explore risk factors for adult leukemia. Methods 192 patients with leukemia and 241 community controls were chosen to carry out a case-control study for finding the indoor environmental factors and the other risk factors for leukemia. The data was statistically analyzed by unconditional logistic regression. Results It was demonstrated as the risk factors for leukemia that the occupation (OR=7.06, P