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Objective:To assess the predictive values of bioelectrical impedance analysis(BIA)-measured body fat indices to abnormal lipid profiles, and to preliminary propose optimal cut-off values of body fat in children and adolescents.Methods:Children and adolescents, aged 6-16 years, were selected from 30 schools (8 primary schools, 21 middle schools and one 12-year education school) in Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by adopting a stratified cluster sampling method from November 2017 to January 2018.Questionnaire survey, body mass index(BMI), body fat mass index (FMI), fat mass percentage (FMP) and four lipid profiles were conducted.Results:A total of 14 309 participants, aged (11.0±3.3) years, were enrolled in the analysis, with 49.9% boys.In boys and girls, the percentile values ( P60- P95) fitted by FMI and FMP with K-median-coefficient of variation(LMS) method were taken as the cutting points, and P75 values were selected as the cut-off points of excessive body fat for their better sensitivity, specificity, predictive value and area under curve (AUC) for identification of abnormal lipid profiles.Boys with FMI above P75 accounted for 28% of the total population, and controlling boys with FMI below P75 could prevent dyslipidemia of 8%-57%.FMI in girl population occupied about 26% of the above, and controlling FMI in girl population below this cut-off point may prevent dyslipidemia from 8%-42%.FMP observed similar results to FMI.Assessed by FMI or FMP with P75 cut-off values, adiposity performed better than BMI for recognizing abnormal lipid profiles in boys (AUC: 52.4%-69.6% vs.50.2%-67.1%, P<0.05) rather than in girls ( P>0.05). In addition, when FMI or FMP beyond P90, the specificity of each abnormal lipid profiles was around 90%. Conclusions:The recommend cut-off points for body fat may be to assess children′s adiposity, and can be applied in preventive activities.
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Objective@#To compare the power of dyslipidemia diagnosis by different sets of cut points in the prediction of cardiovascular metabolic risk factors and identify the appropriate cut points for the diagnosis of dyslipidemia in children and adolescents in China.@*Methods@#Data were obtained from the baseline survey of 'School-based Cardiovascular and Bone Health Promotion Program’ in Beijing in 2017. Dyslipidemia was diagnosed by using two set of cut points. Receiver operating characteristic curve analysis was conducted to assess the power of dyslipidemia diagnosis by the two set of cut points to predict the prevalence of hypertension, obesity, high fat mass percentage and impaired fasting glucose.@*Results@#A total of 14 390 children and adolescents were in included in the study. The prevalence rates of high TC, high LDL-C, low HDL-C, and high TG in the participants were 2.7%, 2.7%, 14.4%, and 3.7% according to 'Chinese Reference Standard’, and 5.0%, 3.7%, 13.3%, and 3.5% according to 'China Expert Consensus’. Low HDL-C and high TG defined by the 'Chinese Reference Standard’ had better performance for the prediction of high fat mass percentage and obesity in boys, but worse performance in girls (P<0.001).@*Conclusions@#Using 'China Reference Standard’ can increase the true positive rate in the prediction of obesity or high fat mass percentage in boys, and reduce the false positive rate in girls. The cut points for the diagnosis of dyslipidemia in Chinese children and adolescents need to be further validated by using national representative sample and in longitudinal study.
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Objective@#To investigate the association between blood lipid and calcaneus bone mineral density (BMD) in children and adolescents aged 6-16 years in Beijing.@*Methods@#Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method from November 2017 to January 2018. A total of 14 303 students in grade 1 to 4 of primary school, grade 1 of junior and senior middle school were enrolled after excluding subjects who were not able to participate into this study due to trauma or other uncomfortable physical conditions or with missing key values or with diabetes and kidney diseases. Questionnaire survey, blood lipid and calcaneus BMD were conducted. Multivariate linear regression was applied to quantify the association between calcaneal BMD as a dependent variable and blood lipid level as an independent variable after adjusting for the potential confounding factors. Furthermore, quantile regression was used to analyze the association between blood lipid level and different percentiles (P25, P50 and P75) of ultrasonic velocity values of bone mineral density, and parallel test was conducted for regression coefficients of different percentiles.@*Results@#A total of 14 303 participants aged (11.4±3.3) years (49.9% boys) were involved in the analysis. The mean age of 14 303 participants was (11.0±3.3) years. 7 142 boys accounted for 49.9%. The mean±SD of calcaneal BMD, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C) were (1 540.9±33.8) m/s, (3.90±0.76), (2.18±0.62), and (1.40±0.32) mmol/L, respectively. The P50 (P25, P75) of triglyceride (TG) was 0.69 (0.49-0.94) mmol/L. After the adjustment of age, height, smoking, drinking, vitamin D and calcium supplementation, dairy intake, physical activity, FMI, and MMI, a significantly inverse association (P<0.05) between TG level and calcaneus BMD was observed in both genders, which the regression coefficients (95%CI) in boys and girls were -0.064 (-0.085, -0.044) and -0.073 (-0.094, -0.053), respectively.@*Conclusion@#The level of BMD was associated with TG in boys and girls. Therefore, it is important to prevent children from hypertriglyceridemia for the bone health promotion.
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Objective@#To understand the association between body fat distribution and calcaneal bone mineral density (BMD) in children and adolescents aged 6-16 years in Beijing.@*Methods@#Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method from November 2017 to January 2018. A total of 15 030 students in grade 1 to 4 of primary school, grade 1 of junior and senior middle school were enrolled after excluding subjects who were not able to participate into this study due to trauma or other uncomfortable physical conditions or with missing key values or with diabetes and kidney diseases. Questionnaire survey, body composition and calcaneus bone mineral density were conducted. The relation of fat mass percentage (FMP), trunk to total fat ratio (TrTFR), trunk to limb fat ratio (TrLFR), limb to total fat ratio (LTFR) and viscera to total fat ratio (VTFR) with calcaneus BMD were assessed using the multivariate linear regression models after adjusting for possible confounding effects. The central fat distribution types were divided into 4 groups including type 1: both trunk fat and visceral fat greater than the sex-and age-specific internal P75; type 2: barely trunk fat greater than P75; type 3: barely visceral fat greater than P75; type 4: both trunk fat and visceral fat greater than P75. The central fat distribution types were included into the model in the form of dummy variables to analyze its relationship with calcaneal BMD. The sex-and age-specific z-scores of fat distribution indicators and BMD were calculated.@*Results@#A total of 15 030 participants aged (11.4±3.3) years (50.2% boys) were involved in the analysis. In both genders, after adjusting for age, height, lean mass index, smoking, drinking, physical activity, milk intake, vitamin D and calcium supplementation, FMP, TrTFR, TrLFR and VTFR were negatively correlated with calcaneal BMD (all P value<0.05), while LTFR was positively associated with calcaneal BMD (all P values<0.05). Compared to the central fat distribution type 1, the regression coefficients (95% CI) of type 2, 3 and 4 were -0.253 (-0.418, -0.087), -0.385 (-0.567, -0.204) and -0.428 (-0.487, -0.369) in boys, respectively; the regression coefficients (95% CI) of type 3 and 4 were -0.158 (-0.301, -0.015) and -0.226 (-0.290, -0.163), respectively.@*Conclusion@#Body fat distribution and central fat distribution in children and adolescents were correlated with calcaneus bone mineral density.
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Objective@#To investigate the influence of change in blood pressure status from childhood to adulthood on renal damage.@*Methods@#Data were obtained from Beijing Blood Pressure Cohort initiated from 1987. 3 198 children and adolescents aged 6-18 years from 6 primary and 6 middle schools in Chaoyang, Xicheng and Haidian Districts of Beijing were enrolled at baseline by using a cluster random sampling method, and 1 222 participants were followed up during 2010-2012. The measurements included weight, height, and blood pressure at baseline and microalbumin, serum creatinine, cystatin C and blood pressure at follow-up. Based on blood pressure status in childhood and adulthood, the participants were divided into four groups: participants with normal blood pressure in both childhood and adulthood, participants with elevated blood pressure in childhood but normal blood pressure in adulthood, participants with normal blood pressure in childhood but elevated blood pressure in adulthood, and participants with elevated blood pressure in both childhood and adulthood. Multivariate linear regression model was used to investigate the association of change in blood pressure from childhood to adulthood on renal dysfunction.@*Results@#The prevalence of elevated blood pressure in childhood and adulthood was 17.9% and 39.9%, respectively. The P50 (P25-P75) of microalbumin was 5.7(3.0-12.0) mg/L, and the concentration of eGFR and cystatin C were (118.0±19.8)% and (0.734±0.184)mg/L, respectively. With adjustment for sex, baseline age and follow-up years, compared with participants with persistently normal blood pressure from childhood to adulthood, participants with normal blood pressure in childhood but elevated blood pressure in adulthood had significantly higher levels of microalbumin (β=0.502, 95%CI: 0.320-0.684) and cystatin C (β=0.049, 95%CI: 0.025-0.073). After adjustment for sex, baseline age, follow-up duration, and adult BMI, smoking and drinking, participants with normal blood pressure in childhood and elevated blood pressure in adulthood had higher levels of adult urine microalbumin (β=0.322, 95%CI: 0.128-0.516) and cystatin C (β=0.032, 95%CI:0.007-0.057).@*Conclusion@#An increase in blood pressure during childhood and adulthood has an adverse impact on renal functional damage in adulthood. These findings underscore the importance of maintaining normal blood pressure during life course to prevent the development of chronic kidney disease.
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Objective@#To investigate the sleep status in children and adolescents and explore the relationship between the sleep and high blood pressure in them.@*Methods@#Data was from the Schoolbased Cardiovascular and Bone Health Promotiow Program (SCVBH) in Beijing. And 13 471 children and adolescents aged 6-16 years were selected from grades 1 to 4 in 8 primary schools, grade 1 in 21 middle schools and senior grade 1 in one twelve-year education school in Dongcheng, Fangshan, Miyun and Tongzhou Districts of Beijing during 2017-2018 by using a cluster sampling method. Self-reported questionnaires were used to collect the demographic characteristics, lifestyle habits of children and adolescents. The blood pressure was measured by electronic sphygmomanometer. Multiple logistic regression model was used to analyze the association between sleep and hypertension risk.@*Results@#The sleep duration was (8.4±1.1) hours. The prevalence of high blood pressure was 15.0%(2 021/13 471). The incidence of mouth breathing, slobber, snoring, and suffocate was 28.4%(3 823/13 471), 23.6%(3 184/13 471) and 18.7%(2 513/13 471), 2.8%(378/13 471) respectively. After adjusting for age, gender, snoring, mouth breaking, slobber, suffocate, the time for bed and sleep duration, we found that snoring and sleep duration (5.0-6.9 h) were both associated with high blood pressure (OR=1.49, 95%CI:1.32-1.69; OR=1.53, 95%CI: 1.28-1.81).@*Conclusion@#Snoring and sleep duration were positively associated with high blood pressure in this study. Interventions focusing on sleep status should be developed to reduce the incidence of high blood pressure in children and adolescents.
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Objective@#To describe the status of cardiovascular health (CVH) of children and adolescents aged 6-16 years in Beijing during 2017-2018.@*Methods@#The school-based Cardiovascular and Bone Health Promotion Program(SCVBH) was conducted from November 2017 to January 2018. 15 391 children and adolescents aged 6-16 years were selected from grade 1 to 4 in 8 primary schools, grade 1 in 21 middle schools and senior grade 1 in one twelve-year education school in Dongcheng, Fangshan, Miyun and Haidian Districts of Beijing by using a cluster sampling method. Seven cardiovascular health indicators, including smoking, body mass index, dietary intake, physical activity, blood pressure, blood glucose, and total cholesterol, were categorized as poor, intermediate, and ideal according to American Heart Association (AHA) criteria. The status of CVH was evaluated according to the criteria of the ideal CVH related behaviors and factors defined by AHA.@*Results@#The proportion of children and adolescents with an ideal smoking, dietary intake and physical activity indicators reached 99.2%(4 982/15 108), 19.7%(2 921/14 805), 17.8% (2 499/14 056), respectively. The proportion of children and adolescents with 7 and 4-5 ideal cardiovascular health indicators was 1.7%(209/12 560) and 65.1%(8 176/12 560). The proportion of children and adolescents with 4-7 ideal cardiovascular health indicators, 2-4 ideal health behavior indicators and 2-3 ideal health factors was significantly higher in urban than that in rural all P values<0.001. The proportion of females with 4-7 ideal cardiovascular health indicators, 2-4 ideal health behavior indicators and 2-3 ideal health factors was significantly higher than that in males (all P values<0.001).@*Conclusion@#The prevalence of ideal cardiovascular health of children and adolescents aged 6-16 years in Beijing during 2017-2018 was very low, particularly for healthy dietary intake and physical activity. Effective public health interventions should be implemented to improve the status of cardiovascular health of them.
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Objective@#To describe the baseline characteristics of School-based Cardiovascular and Bone Health Promotion Program(SCVBH) in Beijing.@*Methods@#Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method. 15 391 students in grade 1 to 4 from primary schools, grade 1 from junior and senior high schools were enrolled in the investigation with an exclusion of students who were not able to participate due to trauma or other uncomfortable physical conditions. The baseline survey including a questionnaire survey, physical examination and blood biochemical test was conducted from September 2017 to January 2018. Obesity, blood pressure, fasting blood glucose, lipid, bone density and grip were evaluated.@*Results@#The prevalence of obesity, hypertension, hyperglycemia (impaired fasting glucose and diabetes), dyslipidemia, lower bone density were 22.3%(3 394), 14.8%(2 248), 10.4%(1 490), 20.3%(2 919) and 2.1%(316) in total respectively, and 27.2%(2 081), 16.3%(1 244), 12.8%(922), 22.2%(1 595) and 1.2%(94) for boys, 17.3%(1 313), 13.3% (1 004), 7.9%(568), 18.4%(1 324) and 2.9%(229) for girls. Boys had higher prevalence of obesity, hypertension, hyperglycemia, and dyslipidemia and lower prevalence of low bone density than girls (all P values <0.05) The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05).The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05), the mean of fat mass percentage, total cholesterol, triglyceride, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol of boys were significantly lower than those of girls (all P values <0.05).@*Conclusion@#The prevalence of risk factors of chronic cardiovascular disease was high and the low bone density was appearing in children and adolescents in this study. The promotion of cardiovascular and bone health should be implemented in children and adolescents.
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Objective To examine the value of child and adolescent Korotkoff phase Ⅳ(K4)and Korotkoff phaseⅤ(K5)diastolic blood pressures for predicting subclinical cardiovascular disease(CVD)in adulthood.Methods The data was obtained from the Beijing Children Blood Pressure Study.A total of 3 198(1 700 males,53.2%)healthy children aged 6-18 years from 6 districts in Beijing in 1987 were selected.The physical examination process included measuring height,weight,and blood pressure.From a follow-up survey in 2010-2012,1 252 subjects were analyzed by the same measurements (height,weight and blood pressure)and also by using subclinical markers for vascular damage,including carotid intima-media thickness (cIMT)and carotid-femoral pulse wave velocity (cfPWV).Childhood hypertension at baseline and adulthood hypertension were diagnosed according to the China Guideline for Hypertension Prevention and Control issued in 2010.High cfPWV and high cIMT were defined in adults as having higher than age and gender-specific 75th percentile of cfPWV and cIMT.Pearson correlation coefficients were calculated to describe the association of K4 and K5 in childhood with systolic blood pressure(SBP),diastolic blood pressure(DBP),cfPWV, and cIMT in adulthood.Logistic regression was used to analyze the values of K4 and K5 to predict subclinical CVD in adulthood.Results The baseline mean value of K4 DBP was (66.4 ± 9.1)mmHg (1 mmHg＝0.133 kPa)and K5 DBP was (54.1 ± 11.1)mmHg.The prevalence rates of high-normal blood pressure were 9.4% with DBP measured by using K4,and 6.9% with DBP measured by using K5,respectively. The prevalence rates of hypertension were 11. 3% with DBP measured by using K4,and 8.4%with DBP measured by using K5.After adjustment for age and follow-up age,Pearson correlation analyses showed K4 DBP and K5 DBP in childhood were all significantly associated with adult SBP,DBP,cIMT,cfPWV in males and in females (all P＜0.05).K4 in childhood was better correlated with SBP,DBP,cIMT and cfPWV in adulthood than K5.With multi-factor logistic regression analysis,K4 was better than K5 in predicting CVD in adulthood after controlling gender and age.Further K4 was more effective in predicting cfPWV than cIMT.Conclusions There was a significant difference between K4 and K5 in Chinese children and adolescents. K4 in childhood was better correlated with CVD in adults than K5,and K4 is superior to K5 when using auscultator technique to measure DBP.
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<p><b>OBJECTIVE</b>To investigate the correlation between obesity in children and diabetes in adults from a cohort study, and further more to explore the necessity of preventing diabetes by controlling obesity in children.</p><p><b>METHODS</b>In 1987, 3 198 children and adolescents aged 6-18 were recruited from 6 elementary schools and 6 high schools located in 3 districts (Chaoyang, Haidian, and Xicheng) of Beijing using stratified cluster sampling design. The physical examination process included physical development test, blood pressure measurement, and questionnaire investigation. All children were invited to participate in the study, except for those who had history of congenital heart disease, chronic kidney disease, and limb disability. A total of 1,225 adults were enrolled in a prospective follow-up study from March 2010 to July 2012, anthropometric measures and blood sample were obtained. The obesity was defined by the following criteria: for children aged 6, the age-and the gender-specific 95th percentile of BMI from the US Centre for Disease Control and Prevention Growth charts 2000 as the baseline; for children age 7-18, recommendation from Working Group on Obesity in China (WGOC) as the standard; for adults, BMI≥28 kg/m(2) as the diagnosis standard. Diabetes was defined based on fasting plasma glucose(FPG) ≥7.0 mmol/L or 2 hours postprandial blood glucose (2 h PG) ≥11.1 mmol/L or glycosylated hemoglobin (HbA1c) ≥6.5% or current using blood glucose-lowering agents or current using insulin. Logistic regression was used to analyze the association obesity in children with diabetes in adults.</p><p><b>RESULTS</b>The prevalence of diabetes diagnosed by FPG and 2 h PG in adults who were obese children (16.2%, 18/111) was higher than those who were non-obese children (5.6%, 62/1,114)(χ(2)=18.76, P<0.001). The prevalence of diabetes diagnosed by HbA1c in adults who were obese children(18.1%,20/111) was higher than those who were non-obese children (6.9%, 77/1,114) (χ(2)=16.66, P<0.001). With multi-factor logistic regression analysis, we found that after controlling follow-up age, genders and lifestyle (smoking, alcohol consuming, dietary, and sleeping), in comparison with those non-obese from childhood to adulthood, those obese only in childhood or only in adulthood did not predict any risk of diabetes diagnosed by blood glucose in adults (OR(95%CI) were 1.90 (0.86-4.19), 1.71(0.50-5.79), respectively). Those obese both in childhood and in adulthood increased the risk of diabetes diagnosed by blood glucose in adults (OR(95%CI) was 4.50(2.22-9.14)). With multi-factor logistic regression analysis, we found that after controlling age, sex and lifestyle (smoking, alcohol consuming, dietary, and sleeping) in comparison with those non-obese from childhood to adulthood, those obese only in childhood or only in adulthood did not increase the risk of diabetes diagnosed by HbA1c in adults (OR(95%CI) were 1.42(0.71-2.86), 3.13(0.83-11.75), respectively). Those obese both in childhood and in adulthood increased the risk of diabetes diagnosed by HbA1c in adults (OR(95%CI) was 5.93(3.06- 11.49)).</p><p><b>CONCLUSION</b>Obesity in children even sustained to adulthood was a risk factor for diabetes in adulthood. It is necessary to control obesity in children to prevent diabetes in adults.</p>
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Adolescente , Adulto , Criança , Humanos , Pequim , Glicemia , Diabetes Mellitus , Epidemiologia , Dieta , Seguimentos , Insulina , Usos Terapêuticos , Estilo de Vida , Obesidade Infantil , Epidemiologia , Prevalência , Estudos Prospectivos , Fatores de RiscoRESUMO
<p><b>OBJECTIVE</b>To observe the effect of childhood excessive adiposity on long-term risk of adult carotid atherosclerosis and arterial stiffness.</p><p><b>METHODS</b>At baseline, in 1987, by using stratified cluster sampling design, 3 198 healthy children aged 6-18 were recruited from six primary schools and six middle schools from three districts (Chaoyang, Xicheng, and Haidian) in Beijing, with blood pressure, weight, height and left scapular skinfold thickness (LSSF) measured. From April 2010 to July 2012, 1 225 subjects were followed from childhood to adulthood. Questionnaire, biochemistry parameters, carotid-femoral pulse wave velocity (cfPWV), and carotid intima media thickness (cIMT) were measured at follow-up. Based on weight statuses in childhood and adulthood, subjects were classified into four groups (persistent non-overweight from childhood to adulthood, overweight in childhood but non-overweight in adulthood, non-overweight in childhood but overweight in adulthood, persistent overweight from childhood to adulthood). Multiple logistic regression model was used to analyze the association between weight statuses changing from childhood to adulthood and adult high cfPWV and high cIMT.</p><p><b>RESULTS</b>The prevalence of overweight (including obesity) at adulthood was 52.2% (639). Males had higher prevalence of smoking (62.5%(422/675) vs 29.4%(160/550), χ(2)=133.21, P<0.001), drinking (52.1%(353/675) vs 26.1%(140/550), χ(2)=87.13, P<0.001), overweight (including obesity) (69.3% (468/675) vs 31.1% (171/550), χ(2)=182.18, P< 0.001) than females. With adjusting for gender, age, and length of follow-up, the risk of high cfPWV and high cIMT increased by 26% and 58% for 1 units increase in BMI, and by 30% and 36% for 1 units increase in LSSF. Compared to subjects with persistent non-overweight from childhood to adulthood, subjects with overweight in childhood but non-overweight in adulthood had similar risks of high cfPWV (OR=1.59, 95%CI: 0.77-3.30)and high cIMT (OR=1.47, 95%CI:0.65-3.31). The risks of high cfPWV and high cIMT increased among subjects with non-overweight in childhood but overweight in adulthood (OR=1.92, 95%CI:1.37-2.68; OR=3.69, 95% CI:2.61- 5.23) and among subjects with persistent overweight from childhood to adulthood (OR=2.53, 95%CI:1.70-3.76; OR=5.37, 95%CI:3.62-7.97).</p><p><b>CONCLUSIONS</b>We concluded that a overweight children changed to a healthy weight adult, the risks of adult subclinical atherosclerosis and arterial stiffness would not be increased.</p>
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Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adiposidade , Aterosclerose , Epidemiologia , Pequim , Pressão Sanguínea , Índice de Massa Corporal , Doenças das Artérias Carótidas , Epidemiologia , Espessura Intima-Media Carotídea , Sobrepeso , Epidemiologia , Obesidade Infantil , Epidemiologia , Análise de Onda de Pulso , Fatores de Risco , Rigidez VascularRESUMO
<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>
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Adolescente , Criança , Feminino , Humanos , Masculino , Pequim , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , Peso Corporal , Doenças Cardiovasculares , Epidemiologia , HDL-Colesterol , Sangue , LDL-Colesterol , Sangue , Estudos Transversais , Dislipidemias , Epidemiologia , Hipertensão , Epidemiologia , Lipídeos , Sangue , Modelos Logísticos , Obesidade Abdominal , Epidemiologia , Obesidade Infantil , Epidemiologia , Fenótipo , Prevalência , Triglicerídeos , Sangue , Circunferência da CinturaRESUMO
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.
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Objective To explore the relationship between high-sensitivity C-reactive protein (hsCRP)and obesity/metabolic syndrome(MetS)related factors in children. Methods 403 children aged 10-14 and born in Beijing were involved in this study. Height,weight,waist circumference,fat mass percentage(Fat%),blood pressure(BP),hsCRP,triglyceride(TG),total cholesterol(TC), fasting plasma glucose(FPG),high and low density lipoprotein cholesterol(HDL-C,LDL-C)were observed among these children. hsCRP was transformed with base 10 logarithm(lgCRP). MetS was defined according to the International Diabetes Federation 2007 definition. Associations between MetS related components and hsCRP were tested using partial correlation analysis,analysis of covariance and linear regression models. Results 1) lgCRP was positively correlated with BMI,waist circumference,Fat%,BP,FPG,LDL-C and TC while negatively correlated with HDL-C. With BMI under control,the relationships disappeared,but LDL-C(r=0.102). 2)The distributions of lgCRP showed obvious differences in all the metabolic indices,in most groups,respectively. With BMI under control,close relationships between lgCRP and high blood pressure/high TG disappeared and the relationship with MetS weakened. 3) Through linear regression models, factors as waist circumference,BMI,Fat% were the strongest factors related to hsCRP,followed by systolic BP, HDL-C,diastolic BP,TG and LDL-C. With BMI under control,the relationships disappeared,but LDL-C (β=0.045). Conclusion hsCRP was correlated with child obesity,lipid metabolism and MetS. Waist circumference was the strongest factors related with hsCRP. Obesity was the strongest and the independent influencing factor of hsCRP.
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Objective To explore the relationship between high-sensitivity C-reactive protein (hsCRP)and obesity/metabolic syndrome(MetS)related factors in children. Methods 403 children aged 10-14 and born in Beijing were involved in this study. Height,weight,waist circumference,fat mass percentage(Fat%),blood pressure(BP),hsCRP,triglyceride(TG),total cholesterol(TC), fasting plasma glucose(FPG),high and low density lipoprotein cholesterol(HDL-C,LDL-C)were observed among these children. hsCRP was transformed with base 10 logarithm(lgCRP). MetS was defined according to the International Diabetes Federation 2007 definition. Associations between MetS related components and hsCRP were tested using partial correlation analysis,analysis of covariance and linear regression models. Results 1) lgCRP was positively correlated with BMI,waist circumference,Fat%,BP,FPG,LDL-C and TC while negatively correlated with HDL-C. With BMI under control,the relationships disappeared,but LDL-C(r=0.102). 2)The distributions of lgCRP showed obvious differences in all the metabolic indices,in most groups,respectively. With BMI under control,close relationships between lgCRP and high blood pressure/high TG disappeared and the relationship with MetS weakened. 3) Through linear regression models, factors as waist circumference,BMI,Fat% were the strongest factors related to hsCRP,followed by systolic BP, HDL-C,diastolic BP,TG and LDL-C. With BMI under control,the relationships disappeared,but LDL-C (β=0.045). Conclusion hsCRP was correlated with child obesity,lipid metabolism and MetS. Waist circumference was the strongest factors related with hsCRP. Obesity was the strongest and the independent influencing factor of hsCRP.
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Objective The aim of this paper was to analyze the association between different types of obesity and cardiovascular risk factors (CRFs) in school-aged children.Methods 3508children aged 6-18 years old including 2 054 non-obese and 1 454 obese children were chosen as the population under study,from Beijing Children and Adolescents Metabolic Syndrome Study.Demographic data was collected through questionnaires while height,weight,waist circumference,and blood pressure were measured through physical check-up.Fasting blood glucose and blood lipids were also tested.Children were divided into four groups:without obesity,with general obesity,with abdominal obesity and with combined obesity.CRFs including dyslipidemia,impaired fasting glucose (IFG),and hypertension were scored.Multiple linear regression and logistic regression analyses were performed to assess the association between different types of obesity and CRFs.Results From non-obese children,children under general-obesity,abdominal obesity and those with combined types of obesity,there appeared an increasing trend in the levels of blood pressure,blood glucose,and blood lipids,the prevalence dyslipidemia and hypertension (P＜0.001).There were no significant differences in the risks of IFG among four types of obesity.After controlling for age,sex,and puberty stage,when compared with non-obese children,those children with abdominal obesity or combined types of obesity had 1.54 and 2.51 times of risks to only one CRF,while generally obese children had similar risk of dyslipidemia.When compared to the non-obese ones,children with general obesity,abdominal obesity,or combined types of obesity showed 3.32,2.21 and 7.42 times of risks to ≥2CRFs and 3.10,3.67 and 10.75 times of risks to ≥3 CRFs.The cluster of CRFs increased with the levels of obesity (P＜0.001).Conclusion Levels and cluster of CRFs were increasing along with the levels of obesity in school-aged children in Beijing.Children with combined types of obesity had the highest risk of clustering CRFs,followed by those with abdominal obesity and general obesity.
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<p><b>OBJECTIVE</b>To study the dietary habits of school-age children in urban and rural districts and their association with blood pressure levels in Beijing, China.</p><p><b>METHODS</b>A stratified, randomly clustered sampling design was used, 29 primary and secondary schools from four urban districts and three rural districts in Beijing were randomly selected in 2004. 20 638 children aged 6-18 years old were surveyed, and 19 072 of them provided completed usable data. The weight, height and blood pressure of the subjects were measured according to standard method.10 food-groups' information was collected by a semi-quantitative food frequency questionnaire. The relationship between different dietary habits and the blood pressure levels in school children was analyzed by multiple linear regression model.</p><p><b>RESULTS</b>The prevalence of obesity among children in urban area (12.2%, 1 218/9 984) was higher than that in rural area (6.7%, 609/9 088) (χ(2) = 4.62, P < 0.05) , whereas the prevalence of hypertension among children in urban area (8.0%, 799/9 984) was lower than that in rural area (8.9%, 809/9 088) (χ(2) = 167.32, P < 0.05) . The diastolic blood pressure (DBP) among children was (65.7 ± 8.6) mmHg (1 mmHg = 0.133 kPa) in urban area and (67.0 ± 8.7) mmHg in rural area, respectively (F = 86.44, P < 0.05) , and the systolic blood pressure (SBP) among children was (103.4 ± 12.2) mmHg in urban area and (104.3 ± 11.6) mmHg in rural area, respectively (F = 11.33, P < 0.05) . Factor analysis revealed 4 dietary habits labeled prudent habit, protein habit, high-fat and high-calorie habit and vegetables and fruits habit. The 4 dietary habits' variance contribution rate respectively was 24.7%, 14.6%, 14.0%, 8.9%, and the 4 dietary habits totally reflect 62.2% characteristics of the 10 food-groups.In urban area, prudent habit was inversely associated with DBP (β' = -0.026, P < 0.05) , Protein habit was inversely associated with both children's SBP (β' = -0.018, P < 0.05) and DBP (β' = -0.030, P < 0.05) .In rural area, prudent habit was associated with children's SBP (β' = -0.050, P < 0.05) and DBP (β' = -0.039, P < 0.05) .</p><p><b>CONCLUSIONS</b>The dietary habits of school age children varied by sociodemographic characters in Beijing. The prudent habit and protein habit may decrease the children's blood pressure levels.</p>
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Adolescente , Criança , Humanos , Pressão Sanguínea , Peso Corporal , China , Comportamento Alimentar , Hipertensão , Obesidade , Prevalência , População Rural , Fatores Socioeconômicos , População UrbanaRESUMO
<p><b>OBJECTIVE</b>To examine the impact of single nucleotide polymorphisms in obesity-related genes on risk of obesity and metabolic disorder in childhood.</p><p><b>METHODS</b>A total of 3 503 Chinese children aged 6 to 18 years participated in the study, including 1 229 obese, 655 overweight and 1 619 normal weight children (diagnosed by the Chinese age- and sex- specific BMI cutoffs). Body size parameters were assessed and venipuncture blood samples were collected after a 12-hour overnight fast. Plasma glucose, insulin and serum lipid profiles were measured.Genomic DNA was isolated from peripheral blood white cells using the salt fractionation method. A total of 11 single nucleotide polymorphisms were genotyped by TaqMan allelic discrimination assays with the GeneAmp 7900 sequence detection system (Applied Biosystems, Foster City, CA, USA) (FTO rs9939609, MC4R rs17782313, GNPDA2 rs10938397, FAIM2 rs7138803, BDNF rs6265, NPC1 rs1805081, PCSK1 rs6235, KCTD15 rs29941, BAT2 rs2844479, SEC16B rs10913469 and SH2B1 rs4788102). Multiple factor analysis was performed to estimate the association between the variant and obesity-related traits. The false discovery rate (FDR) approach was used to correct for multiple comparisons.</p><p><b>RESULTS</b>After sex, age and pubertal stage adjustment and correction for multiple testing, the rs9939609-A, rs17782313-C, rs10938397-G, and rs7138803-A alleles were associated with higher BMI (β = 0.352-0.747), fat mass percentage(β = 0.568-1.113), waist circumference (β = 0.885-1.649) and waist-to-height ratio(β = 0.005-0.010) (all P values < 0.01) in Chinese children. The rs6265-G allele increased BMI(β = 0.251, P = 0.020). The rs9939609-A, rs17782313-C, and rs10938397-G and rs6265-G alleles were also associated with risk of obesity (OR = 1.386, 95%CI:1.171-1.642; OR = 1.367, 95%CI:1.196-1.563; OR = 1.242, 95%CI:1.102-1.400; OR = 1.156, 95%CI:1.031-1.296).Rs7138803 was associated with risk of obesity only in boys (OR = 1.234, 95%CI:1.043-1.460). GNPDA2 rs10938397-G allele was associated with risk of insulin resistance(OR = 1.205, 95%CI:1.069-1.359), but there was no significance after adjusting for BMI.</p><p><b>CONCLUSION</b>The association of FTO rs9939609-A, MC4R rs17782313-C, GNPDA2 rs10938397-G, and FAIM2 rs7138803-A with higher BMI, fat mass percentage, waist circumference, and waist-to height ratio and risk of obesity, and BDNF rs6265-G allele may increase BMI and obesity risk in Chinese children. GNPDA2 rs10938397-G may increase the risk of childhood insulin resistance depending on BMI.</p>
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Adolescente , Criança , Humanos , Masculino , Alelos , Povo Asiático , Índice de Massa Corporal , Predisposição Genética para Doença , Genótipo , Doenças Metabólicas , Obesidade , Sobrepeso , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Circunferência da CinturaRESUMO
<p><b>OBJECTIVE</b>To explore the relationship between high-sensitivity C-reactive protein (hsCRP) and obesity/metabolic syndrome (MetS) related factors in children.</p><p><b>METHODS</b>403 children aged 10-14 and born in Beijing were involved in this study. Height, weight, waist circumference, fat mass percentage (Fat%), blood pressure (BP), hsCRP, triglyceride (TG), total cholesterol (TC), fasting plasma glucose (FPG), high and low density lipoprotein cholesterol (HDL-C, LDL-C) were observed among these children. hsCRP was transformed with base 10 logarithm (lgCRP). MetS was defined according to the International Diabetes Federation 2007 definition. Associations between MetS related components and hsCRP were tested using partial correlation analysis, analysis of covariance and linear regression models.</p><p><b>RESULTS</b>1) lgCRP was positively correlated with BMI, waist circumference, Fat%,BP, FPG, LDL-C and TC while negatively correlated with HDL-C. With BMI under control, the relationships disappeared, but LDL-C (r = 0.102). 2) The distributions of lgCRP showed obvious differences in all the metabolic indices, in most groups, respectively. With BMI under control, close relationships between lgCRP and high blood pressure/high TG disappeared and the relationship with MetS weakened. 3) Through linear regression models, factors as waist circumference, BMI, Fat% were the strongest factors related to hsCRP, followed by systolic BP, HDL-C, diastolic BP, TG and LDL-C. With BMI under control, the relationships disappeared, but LDL-C(β = 0.045).</p><p><b>CONCLUSION</b>hsCRP was correlated with child obesity, lipid metabolism and MetS. Waist circumference was the strongest factors related with hsCRP. Obesity was the strongest and the independent influencing factor of hsCRP.</p>
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Criança , Feminino , Humanos , Masculino , Proteína C-Reativa , Metabolismo , Seguimentos , Síndrome Metabólica , Metabolismo , Obesidade , Metabolismo , Circunferência da CinturaRESUMO
<p><b>OBJECTIVE</b>To analyze the trends on the prevalence rates of obesity and cardiometabolic among children and adolescents in Beijing, during 2004-2013.</p><p><b>METHODS</b>Data was collected from three cross-sectional studies among children and adolescents, aged 7-17 years old in Beijing. Two studies in 2004 and 2013 were conducted in general population, and one was among obese children in 2007. Data on anthropometric measurements including weight, height, and age was collected from all the subjects. The obese children from all three studies underwent a clinic examination that containing blood pressure, fasting plasma glucose, lipid profile (TC, TG, LDL-C, HDL-C), and acanthosis nigricans. Liver transaminases detection (ALT and AST) and liver ultrasound examination were performed in obese children from surveys in 2007 and 2013.</p><p><b>RESULTS</b>The prevalence of severe obesity increased from 1.86% in 2004 to 4.17% in 2013, with an annual increase rate as 0.26%. The proportion of severe obesity in obesity increased from 18.92% in 2004 to 25.15% in 2013. After adjusting for age and gender, the prevalence of IFG, hypertriglyceridemia and low HDL-C in both obese children and adolescents increased during 2004-2013 (all P < 0.05). The prevalence rates of hypertension, dyslipidemia, hypertriglyceridemia, and acanthosis nigricans in severe obese children were higher than those in moderate obesity. The proportion of children with 2 or more cardiometabolic risk factors in severe obese children was higher than in moderate obese children.</p><p><b>CONCLUSION</b>The prevalence rates of obesity and cardiometabolic risk factors among children and adolescents in Beijing showed an increase during 2004-2013.</p>