银川市12~17岁儿童青少年肌肉质量指数和心血管危险因素聚集的关系

白玲; 蔡蓉蓉; 周金玉; 董洋洋; 丁文清

doi:10.16835/j.cnki.1000-9817.2022.03.030

银川市12~17岁儿童青少年肌肉质量指数和心血管危险因素聚集的关系

doi: 10.16835/j.cnki.1000-9817.2022.03.030

宁夏医科大学公共卫生与管理学院/宁夏环境因素与慢性病控制重点实验室, 银川 750004

基金项目:

国家自然科学基金项目 82160641

详细信息

作者简介:
白玲(1997-), 女, 宁夏银川人, 在读硕士, 主要研究方向为儿童青少年慢性流行病学

通讯作者:
丁文清, E-mail: dwqdz@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 G804.49 R54
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- 被引次数: 0
出版历程
- 收稿日期: 2021-09-15
- 修回日期: 2022-01-07
- 网络出版日期: 2022-03-29
- 刊出日期: 2022-03-25

Relationship between the muscle mass index and the aggregation of cardiovascular risk factors in children and adolescents aged 12-17 years in Yinchuan City

School of Public Health and Management, Ningxia Medical University/Key Laboratory of Environmental Factors and Chronic Disease Control in Ningxia, Yinchuan (750004), China

摘要

摘要: 目的探索儿童青少年肌肉质量指数(muscle mass index, MMI)与心血管危险因素(cardiovascular risk factors, CVRFs)聚集的关系, 为儿童青少年心血管疾病的防治提供科学依据。方法采用现况研究设计, 以整群随机抽样的方法抽取银川市12~17岁1 622名儿童青少年, 运用问卷调查、体格检查、体成分测定和实验室指标检测进行调查分析。结果未调整其他变量时, MMI与心血管危险因素聚集呈正相关(P值均 < 0.01), 调整年龄、性别和体质量指数(BMI)后, MMI与CVRFs≥1呈负相关(OR=0.74, 95%CI=0.62~0.89)。总人群中, 相比于MMI不足, MMI良好及充足与CVRFs≥1的发生风险呈负相关(OR=0.60, 95%CI=0.46~0.79;OR=0.56, 95%CI=0.37~0.85), 与CVRFs≥2的发生风险呈负相关(OR=0.54, 95%CI=0.37~0.79;OR=0.51, 95%CI=0.30~0.87), 男生中也有相似的结果(P值均 < 0.05)。结论相同BMI水平下, 肌肉质量指数是儿童青少年心血管危险因素聚集的保护因素。应重视儿童青少年体育锻炼, 保持最佳肌肉质量和体重。
- 心血管系统 /
- 危险因素 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To explore the relationship between the muscle mass index (MMI) and the aggregation of cardiovascular risk factors (CVRFs) in children and adolescents, and to provide a scientific basis for the prevention and treatment of cardiovascular diseases in children and adolescents. Methods The current situation study design was adopted, and 1 622 children and adolescents aged 12-17 years old in Yinchuan City were selected by a cluster random sampling method. All subjects were subjected to questionnaire survey, physical examination, body composition determination and laboratory index testing. Results When other variables were not adjusted, MMI was a risk factor for the aggregation of cardiovascular risk factors (P < 0.01). After adjusting for age, gender and BMI, MMI became a protective factor for CVRFs≥1 (OR=0.74, 95%CI=0.62-0.89), compared with insufficient MMI, the risk of developing CVRFs≥1 with good MMI and sufficient MMI was 0.60(95%CI=0.46-0.79), 0.56(95%CI=0.37-0.85) times. The risk of CVRFs≥2 was 0.54(95%CI=0.37-0.79), 0.51(95%CI=0.30-0.87) times, and similar results were found in boys (P < 0.05). Conclusion Under the same BMI level, muscle mass index is a protective factor for cardiovascular risk factor aggregation in children and adolescents. Physical exercise of children and adolescents should be emphasized to maintain the best muscle mass and weight.
- Cardiovascular system /
- Risk factors /
- Regression analysis /
- Child /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 不同肌肉质量指数研究对象基本特征比较(x±s)

Table 1. Comparison of basic characteristics of subjects with different muscle mass index(x±s)

组别	人数	年龄/岁	身高/cm	身高-Z分	体重/kg	体重-Z分	BMI(kg·m^-2)	BMI-Z分	腰围/cm	腰围-Z分
MMI严重不足	71	15.1±1.3	166.9±8.7	-0.28±0.95	45.4±5.2	-1.10±0.32	16.2±1.0	-1.17±0.25	66.0±4.0	-0.84±0.33
MMI不足	411	15.0±1.2	167.9±8.4	-0.16±1.03	50.5±6.9	-0.69±0.49	17.9±1.6	-0.73±0.43	68.4±5.4	-0.59±0.52
MMI良好	714	14.7±1.4	167.7±8.5	-0.04±0.99	56.8±9.3	-0.14±0.64	20.1±2.4	-0.13±0.63	72.5±7.4	-0.17±0.71
MMI充足	426	14.4±1.4	168.6±8.2	0.27±0.92	71.0±14.1	1.08±0.98	24.8±3.7	1.12±0.96	83.9±11.4	0.98±1.09
F值		16.90	1.55	16.79	325.82	528.85	633.15	617.30	260.12	342.78
P值		< 0.01	0.20	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01

组别	人数	MM/kg	MM-Z分	收缩压/mm Hg	舒张压/mm Hg	总胆固醇/(mmol·L^-1)	三酰甘油/(mmol·L^-1)^*	高密度脂蛋白胆固醇/(mmol·L^-1)	低密度脂蛋白胆固醇/(mmol·L^-1)	空腹血糖/(mmol·L^-1)
MMI严重不足	71	34.99±5.82	-1.43±0.49	106.6±8.7	69.2±8.2	4.07±1.04	1.01(0.93~1.10)	1.54±0.48	2.14±0.74	5.00±0.74
MMI不足	411	39.16±6.18	-0.77±0.55	107.8±10.4	67.2±7.6	4.09±0.98	0.96(0.92~0.99)	1.53±0.41	2.19±0.77	4.81±0.80
MMI良好	714	42.69±7.40	-0.05±0.63	111.2±10.6	66.8±7.8	3.85±0.90	0.96(0.93~0.99)	1.42±0.35	2.08±0.74	4.74±0.65
MMI充足	426	48.22±8.92	1.06±0.85	118.4±11.3	67.0±8.4	3.95±0.95	1.17(1.11~1.23)	1.34±0.35	2.19±0.81	4.79±0.59
F/H值		133.55	637.83	79.35	15.76	5.77	24.15	20.52	2.39	3.35
P值		< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	0.07	0.02
注：*为M(P₂₅~P₇₅)；1 mm Hg=0.133 kPa。

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表 2 不同性别、年龄研究对象MMI分级分布

Table 2. Distribution of MMI classifications of study participants by gender and age

性别	年龄/岁	人数	严重不足	不足	良好	充足
男	12~14	290	11(3.79)	54(18.60)	125(43.10)	100(34.50)
	15~17	710	39(5.49)	228(32.10)	315(44.40)	128(18.00)
	小计	1 000	50(5.00)	282(28.20)	440(44.00)	228(22.80)
女	12~14	278	5(1.80)	50(18.00)	133(47.80)	90(32.40)
	15~17	344	16(4.65)	79(23.00)	141(41.00)	108(31.40)
	小计	622	21(3.40)	129(20.70)	274(44.10)	198(31.80)
注：()内数字为构成比/%。

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表 3 儿童青少年MMI与心血管危险因素聚集的Logistic回归分析[OR值(OR值95%CI)，n=1 622]

Table 3. Logistic regression analysis of MMI and the aggregation of cardiovascular risk factors in children and adolescents s [OR(OR 95%CI)，n=1 622]

模型	自变量	CVRFs≥1	CVRFs≥2
1	MMI	1.38(1.24~1.53)^**	1.58(1.39~1.81)^**
2	MMI	0.74(0.62~0.89)^**	0.85(0.68~1.07)
	BMI	2.14(1.78~2.58)^**	2.02(1.63~2.52)^**
3	正常体重、低MMI	1.00	1.00
	正常体重、高MMI	0.88(0.70~1.12)	0.85(0.60~1.20)
	超重肥胖、低MMI	6.73(0.74~61.31)	5.58(0.86~36.17)
	超重肥胖、高MMI	2.89(2.17~3.85)^**	3.04(2.13~4.34)^**
注：连续性变量均计算Z值后纳入分析；**P < 0.01。

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表 4 不同性别儿童青少年MMI分级与心血管危险因素聚集的关系[OR值(OR值95%CI)]

Table 4. Association between MMI classification and the aggregation of cardiovascular risk factors in children and adolescents by gender [OR(OR 95%CI)]

性别	MMI	人数	CVRFs≥1	CVRFs≥2
男	不足	332	1.00	1.00
	良好	440	0.61(0.43~0.84)^**	0.49(0.30~0.81)^**
	充足	228	0.56(0.33~0.96)^*	0.58(0.29~1.18)
女	不足	150	1.00	1.00
	良好	274	0.59(0.38~0.91)^*	0.62(0.35~1.11)
	充足	198	0.58(0.31~1.07)	0.46(0.21~1.02)
合计	不足	482	1.00	1.00
	良好	714	0.60(0.46~0.79)^**	0.54(0.37~0.79)^**
	充足	426	0.56(0.37~0.85)^**	0.51(0.30~0.87)^*
注：*P < 0.01，P < 0.05。

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