ABSTRACT
Objective@#To examine the association between the visceral adiposity index (VAI) and nonalcoholic fatty liver disease (NAFLD) in the pediatric population in order to improve risk stratification and prevention systems for chronic liver disease.@*Methods@#A total of 510 overweight/obese children aged 6-8 years old were enrolled from the child cohort which was designed to study puberty, obesity, and cardiovascular risk (PROC), and complete data from liver ultrasounds and the VAI were obtained. Used Spearman s rank correlation coefficient, Chi-square tests, and Logistic regression analyses to explore the association between the VAI and NAFLD.@*Results@#The detection rates of NAFLD for boys and girls were 25.9% and 11.1%, respectively. VAI for normal group and the NAFLD group were 0.43(0.31, 0.61) and 0.61(0.44, 0.87) in boys, and 0.74(0.56, 1.07) and 1.08(0.67, 1.51) in girls, respectively. Spearman s correlation coefficient analysis showed that triglycerides(TG), VAI, and the third quintile VAI group were positively correlated with NAFLD in both boys and girls(r=0.19,0.26,0.29;0.16,0.16,1.18,P<0.05), and high-density lipoprotein-cholesterol (HDL-C) was negatively correlated with NAFLD in boys (r=-0.21, P<0.05). With advancing tertiles of VAI, the increasing trend in the NAFLD detection rate was statistically significant in boys and girls(Chi-square for trend were 21.77,7.66, P<0.01). The results of univariate and multivariable Logistic regression showed that, by taking the first tertile of VAI as a reference, the risk of NAFLD among boys was higher in the second tertile (cOR=2.59, 95%CI=1.15-5.86; aOR=2.33, 95%CI=1.01-5.36) and in the third tertile(cOR=5.73, 95%CI=2.62-12.53; aOR=4.87, 95%CI=2.15-11.03), where as the risk among girls was higher in the third tertile(cOR=4.43, 95%CI=1.40-14.00).@*Conclusion@#VAI is positively correlated with pediatric NAFLD. Higher tertiles of VAI were associated with an increased risk of NAFLD in overweight and obese children, which indicates that VAI can be used as an early predictor of NAFLD.
ABSTRACT
Objective To study the determinants of exercise behavior among the overweight and obese residents, so as to provide reference for policy-making and health promotion in the future. Methods The study only enrolled overweight and obese residents to conduct a questionnaire survey and physical examination including height, weight and waist circumference. The self-designed questionnaire based on Health Belief Model had acceptable validity and reliability. Structural Equation Modeling was used to analyze the determinants of exercise behavior after univariate analysis and correlation analysis. Result Totally 2 489 overweight and obese residents(1 182 male and 1 307 female)were included in this study. Their average age was 45.3±14.2 years and their median amount of exercise was 4 thousand-step equivalent with quartile of (0.5, 10.0); 22.9% of these residents never took any exercise. Males with high school and equivalent level of education and an income of 5 000 to 10 000 yuan, took more exercise than other demographic groups. Amount of exercise had a positive correlation with perceived benefits of exercise, perceived severity of disadvantage of low exercise and self-efficacy, while it had a negative correlation with subjective barriers and objective barriers. Structural Equation Modeling showed that perceived subjective barriers, objective barriers and self-efficacy were determinants of exercise behavior. Their total standardized effects on exercise behavior were-0.085 (P=0.020),-0.242 (P<0.001) and 0.184 (P<0.001) respectively.Those with higher self-efficacy and less barriers preferred to do more exercise. Indirect effect widely existed in the SEM and self-efficacy were the most important mediating variables of all the other significant determinants. Conclusion The overweight and obese residents are seriously lack of exercise, which need some targeted intervention, especially by improving their self-efficacy and reducing their objective barriers.