维生素D缺乏和血脂异常交互作用与儿童青少年超重肥胖患病风险的关联

李婷婷; 罗晓燕; 田美娜; 刘长青

doi:10.16835/j.cnki.1000-9817.2024311

维生素D缺乏和血脂异常交互作用与儿童青少年超重肥胖患病风险的关联

doi: 10.16835/j.cnki.1000-9817.2024311

李婷婷¹,
罗晓燕²,
田美娜^2, ,,
刘长青^{1, 2, ,}

1.
河北医科大学公共卫生学院，石家庄 050017
2.
河北省疾病预防控制中心营养与食品安全所

基金项目:

河北省2019年度医学科学研究课题计划项目 20190143

详细信息

作者简介:
李婷婷(2000-)，女，河北衡水人，在读硕士，主要研究方向为营养与食品卫生

通讯作者:
田美娜，E-mail: tianmei78715@163.com

刘长青，E-mail: lcq93@126.com

中图分类号: R179 R723.14 R591.44
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- 文章访问数: 220
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- PDF下载量: 58
- 被引次数: 0
出版历程
- 收稿日期: 2024-05-06
- 修回日期: 2024-06-24
- 网络出版日期: 2024-11-02
- 刊出日期: 2024-10-25

Interaction between vitamin D deficiency and dyslipidemia with overweight and obesity in children and adolescents

LI Tingting¹,
LUO Xiaoyan²,
TIAN Meina^{2
, ,},
LIU Changqing^{1, 2
, ,}

1.
School of Public Health, Hebei Medical University, Shijiazhuang (050017), Hebei Province, China

摘要

摘要: 目的探讨维生素D缺乏和血脂异常交互作用与儿童青少年超重肥胖患病风险的关联，为儿童青少年超重肥胖防控提供理论依据。方法研究数据来源于2022—2023年中国居民营养与健康状况监测中的河北省6~17岁人群资料，采用分层整群随机抽样方法抽取2 118名儿童青少年进行问卷调查、体格测量和实验室检测。使用Logistic回归分析维生素D缺乏、血脂异常与超重肥胖的关联，以相乘和相加模型分析维生素D缺乏和血脂异常与超重肥胖的交互作用。结果儿童青少年维生素D缺乏检出率为67.80%，血脂异常率为24.46%，超重肥胖检出率为41.97%。多因素Logistic回归分析结果显示，调整混杂因素后，维生素D缺乏与血脂异常对儿童青少年超重肥胖的相乘交互作用无统计学意义(OR=0.90，95%CI=0.57~1.43，P>0.05)；但维生素D缺乏血脂异常的儿童青少年患超重肥胖风险是维生素D充足血脂正常儿童青少年的3.99倍(OR=3.99，95%CI=2.93~5.45，P < 0.01)。维生素D缺乏和血脂异常存在正向相加交互作用，交互作用超额相对危险度、交互作用归因比和交互作用指数分别为14.40，81.50%和7.35。结论儿童青少年维生素D缺乏与血脂异常存在协同作用，二者同时存在会增加超重肥胖的患病风险。应采取综合防控措施，及时补充维生素D、维持正常血脂水平，减少儿童青少年超重肥胖的发生。
- 维生素D缺乏 /
- 血脂异常 /
- 超重 /
- 肥胖症 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To explore the association of the interaction between vitamin D deficiency and dyslipidemia with the comorbidity risk of overweight and obesity in children and adolescents, so as to provide the theoretical basis for prevention and control of overweight and obesity in children and adolescents. Methods The data for the study was obtained from the population aged 6-17 in Hebei Province during the 2022-2023 monitoring of nutrition and health status of Chinese residents. A stratified cluster random sampling method was used to conduct questionnaire surveys, physical measurements, and laboratory tests on 2 118 children and adolescents. Logistic regression was used to analyze the association of vitamin D deficiency and dyslipidemia with overweight and obesity, and multiplication and addition models were used to analyze the interaction of vitamin D deficiency and dyslipidemia with overweight and obesit. Results The prevalence of vitamin D deficiency in the surveyed children and adolescents was 67.80%, the incidence of dyslipidemia was 24.46%, and the prevalence of overweight and obesity was 41.97%. After adjusting for confounding factors, the results of multivariate Logistic regression analysis showed that there was no multiplicative interaction of vitamin D deficiency and dyslipidemia with overweight and obesit (OR=0.90, 95%CI=0.57-1.43, P>0.05). However, the risk of overweight and obesity among children and adolescents with vitamin D deficiency and dyslipidemia was 3.99 times higher than that of those with sufficient vitamin D and normal blood lipids (OR=3.99, 95%CI=2.93-5.45, P < 0.01). There was a positive additive interaction between vitamin D deficiency and dyslipidemia, with relative excess risk of interaction, attributable proportion of interaction and synergy index of 14.40, 81.50% and 7.35, respectively. Conclusions For children and adolescents, there is a synergistic effect between vitamin D deficiency and dyslipidemia, and the coexistence of both increases the risk of overweight and obesity. Comprehensive prevention and control measures should be taken to timely supplement vitamin D and maintain normal blood lipid levels, to reduce the occurrence of overweight and obesity in children and adolescents.
- Vitamin D deficiency /
- Dyslipidemias /
- Overweight /
- Obesity /
- Regression analysis /
- Child /
- Adolescent

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表 1 不同组别儿童青少年超重肥胖检出率比较

Table 1. Comparison of overweight and obesity detection rates among different groups of children and adolescents

组别	选项	人数	超重肥胖人数	χ²值	P值
性别	男	1 075	499(46.42)	17.71	< 0.01
	女	1 043	390(37.39)
居住区域	城市	717	362(50.49)	32.27	< 0.01
	农村	1 401	527(37.62)
学段	小学	1 142	520(45.53)	12.92	< 0.01
	初中	542	206(38.01)
	高中	434	163(37.56)
维生素D缺乏	是	1 436	657(45.75)	26.14	< 0.01
	否	682	232(34.02)
血脂异常	是	518	302(58.30)	75.06	< 0.01
	否	1 600	587(36.69)
注：()内数字为检出率/%。

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表 2 正常组和超重肥胖组儿童青少年各指标比较[M(P₂₅，P₇₅)]

Table 2. Comparison of different indicators between normal group and overweight with obese group in children and adolescents[M(P₂₅，P₇₅)]

组别	人数	FBG/(mmol·L^-1)	维生素A/(mg·L^-1)	SBP/mmHg	DBP/mmHg	能量摄入量/(kcal·d^-1)
正常组	1 229	4.89(4.50, 5.24)	0.38(0.33, 0.44)	112.00(103.67, 119.00)	70.67(65.00, 76.00)	1 257.52(900.16, 1 666.92)
超重肥胖组	889	4.98(4.64, 5.31)	0.42(0.35, 0.48)	116.33(106.67, 124.67)	71.33(65.00, 76.67)	1 290.64(939.95, 1 685.99)
Z值		3.53	7.26	8.02	1.53	1.80
P值		< 0.01	< 0.01	< 0.01	0.13	0.28

组别	人数	蛋白质摄入量/(g·d^-1)	脂肪摄入量/(g·d^-1)	碳水化合物摄入量/(g·d^-1)	膳食纤维摄入量/(g·d^-1)
正常组	1 229	47.11(34.63, 62.82)	37.65(26.21, 52.73)	181.92(131.97, 254.97)	8.84(6.18, 12.50)
超重肥胖组	889	49.78(36.35, 65.48)	39.76(28.13, 54.52)	183.06(136.63, 250.53)	8.94(6.30, 12.62)
Z值		2.25	1.79	0.24	0.56
P值		0.03	0.07	0.81	0.57
注：1 mmHg=0.133 kPa，1 kcal=4.18 kJ。

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