儿童超重肥胖和血脂异常联合作用与左心室肥厚的关联

安思莲; 刘姿琪; 张茜; 赵敏; 席波

doi:10.16835/j.cnki.1000-9817.2025110

儿童超重肥胖和血脂异常联合作用与左心室肥厚的关联

doi: 10.16835/j.cnki.1000-9817.2025110

安思莲^{1, 2},
刘姿琪^{1, 2},
张茜³,
赵敏⁴,
席波^{1, 2, ,}

1.
山东大学齐鲁医学院公共卫生学院流行病学系/儿少卫生与妇幼保健学系, 济南 250012
2.
山东大学儿童心血管研究中心
3.
淄博市疾病预防控制中心食品营养与学生保健所
4.
山东大学齐鲁医学院公共卫生学院营养与食品卫生学系

基金项目:

国家自然科学基金项目 81673195

国家自然科学基金项目 82173538

详细信息

作者简介:
安思莲(1998-), 女, 山西晋中人, 在读硕士, 主要研究方向为儿童心血管流行病学

通讯作者:
席波, E-mail: xibo2010@sdu.edu.cn

利益冲突声明所有作者声明无利益冲突。
中图分类号: R179 R723.14 R714.252
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- 被引次数: 0
出版历程
- 收稿日期: 2024-08-07
- 修回日期: 2024-09-19
- 网络出版日期: 2025-05-08
- 刊出日期: 2025-04-25

Association of joint effect of overweight and obesity with dyslipidemia on left ventricular hypertrophy in children

AN Silian^{1, 2},
LIU Ziqi^{1, 2},
ZHANG Qian³,
ZHAO Min⁴,
XI Bo^{1, 2
, ,}

1.
Department of Epidemiology/Department of Maternal, Child and Adolescent Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Ji'nan (250012), Shandong Province, China

摘要

摘要: 目的探讨儿童超重肥胖和血脂异常联合作用与左心室肥厚(LVH)的关联, 为预防儿童早期心血管损害提供科学依据。方法研究对象来自"桓台儿童心血管健康随访队列"2021年第2次随访横断面调查数据, 共纳入1 047名信息完整的10~15岁儿童。根据超重肥胖和血脂异常状态, 将研究对象分为正常体重且血脂正常组、正常体重且血脂异常组、超重肥胖且血脂正常组、超重肥胖且血脂异常组4组, 比较4组左心室质量指数(LVMI)水平及LVH检出率的差异, 采用多因素Logistic回归模型探讨超重肥胖和血脂异常的联合效应对LVH的影响。结果 4组儿童LVMI水平[(28.66±7.10, 29.63±4.71, 31.49±5.86, 32.65±4.80)g/m^2.7]及LVH检出率(4.28%, 12.50%, 22.74%, 31.30%)差异均有统计学意义(F/χ²值分别为50.76, 90.92, P值均<0.05)。调整性别、年龄、视屏时间、睡眠时间、果蔬摄入、碳酸饮料摄入、体力活动以及血压偏高等协变量后, 相较于正常体重且血脂正常组, 正常体重且血脂异常组、超重肥胖且血脂正常组的LVH风险均增加(OR=3.27, 95%CI=1.57~6.82;OR=6.33, 95%CI=3.76~10.66), 超重肥胖且血脂异常组的LVH风险达到最高(OR=9.66, 95%CI=5.35~17.43)(P值均<0.05)。结论儿童期超重肥胖与血脂异常的联合效应与LVH呈正相关。预防儿童LVH应该同时关注儿童超重肥胖和血脂异常。
- 超重 /
- 肥胖症 /
- 血脂异常 /
- 心肌病 /
- 肥厚性 /
- 回归分析 /
- 儿童
Abstract: Objective To examine the association of joint effect of overweight and obesity with dyslipidemia on left ventricular hypertrophy (LVH) in children, so as to provide scientific evidence for the prevention of early cardiovascular damage in children. Methods Data were obtained from the second follow-up cross-sectional survey of Huantai Childhood Cardiovascular Health Cohort study in 2021, comprising 1 047 children aged 10-15 years with complete information. Based on overweight and obesity status and dyslipidemia status, all participants were divided into four groups: normal weight with normal lipid levels, normal weight with dyslipidemia, overweight and obesity with normal lipid levels, and overweight and obesity with dyslipidemia. Left ventricular mass index (LVMI) levels and prevalence of LVH across four groups were compared. Multivariate Logistic regression model was used to examine the association of joint effect of overweight and obesity with dyslipidemia on LVH in children. Results There were significant differences in LVMI levels [(28.66±7.10, 29.63±4.71, 31.49±5.86, 32.65±4.80)g/m^2.7] and prevalence of LVH (4.28%, 12.50%, 22.74%, 31.30%) across four groups (F/χ²=50.76, 90.92, P<0.05). After adjustment for confounding variables such as gender, age, screen time, sleep duration, fruit and vegetable intake, carbonated beverage consumption, physical activity and elevated blood pressure, compared to children with both normal weight and normal lipid levels, the risk of LVH in children with dyslipidemia alone increased (OR=3.27, 95%CI=1.57-6.82, P<0.05). Children with overweight and obesity alone also had a significantly increased risk of LVH (OR=6.33, 95%CI=3.76-10.66), and the highest risk was observed in those with both overweight and obesity with dyslipidemia (OR=9.66, 95%CI=5.35-17.43) (P<0.05). Conclusions The joint effect of overweight and obesity with dyslipidemia is positively correlated with LVH in children. To prevent LVH in children, both overweight and obesity with dyslipidemia should be paid attention to.
- Overweight /
- Obesity /
- Dyslipidemias /
- Cardiomyopathy /
- hypertrophic /
- Regression analysis /
- Child
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 正常组与LVH组儿童基本情况比较

Table 1. Comparison of basic characteristics between LVH group and normal group children

组别	人数	果蔬摄入充足	碳酸饮料摄入过多	体力活动充足	血压偏高	超重肥胖	高TC	高TG	低HDL-C	高LDL-C	血脂异常
正常组	899	126(14.02)	149(16.57)	803(89.32)	155(17.24)	338(37.60)	109(12.12)	52(5.78)	52(5.78)	45(5.01)	181(20.13)
LVH组	148	21(14.19)	26(17.57)	133(89.86)	49(33.11)	114(77.03)	26(17.57)	17(11.49)	20(13.51)	12(8.11)	54(36.49)
χ²值		0.00	0.09	0.04	20.39	80.53	3.35	6.71	11.86	2.38	19.52
P值		0.96	0.76	0.84	<0.01	<0.01	0.07	0.01	<0.01	0.12	<0.01
注：()内数字为检出率/%。

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表 2 不同超重肥胖和血脂异常联合组别LVMI水平[(X±S )，g/m^2.7]

Table 2. LVMI levels in different combination groups of overweight and obesity with dyslipidemia[(X±S ), g/m^2.7]

组别	人数	性别		年龄/岁
组别	人数	男生	女生	10~12	13~15
正常体重且血脂正常	491	28.78±7.47	28.67±7.02	28.86±5.97	28.59±7.77
正常体重且血脂异常	104	29.35±4.61	29.93±4.90	29.73±4.10	28.62±5.00
超重肥胖且血脂正常	321	31.80±6.27	31.31±5.59	30.03±5.09	33.37±6.25
超重肥胖且血脂异常	131	33.13±5.04	32.27±4.65	31.42±4.07	34.59±5.25

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表 3 不同超重肥胖和血脂异常联合组别LVH检出率

Table 3. LVH detection rates in different combination groups of overweight and obesity with dyslipidemia

组别	人数	性别		年龄/岁
组别	人数	男生	女生	10~12	13~15
正常体重且血脂正常	491	10(3.95)	11(4.62)	13(5.31)	8(3.25)
正常体重且血脂异常	104	4(10.26)	9(13.85)	10(14.93)	3(8.11)
超重肥胖且血脂正常	321	34(18.89)	39(27.66)	32(17.30)	41(30.15)
超重肥胖且血脂异常	131	26(31.71)	15(30.61)	24(30.77)	17(32.08)
注：()内数字为检出率/%。4组人数男生分别为253，39，180，82；女生分别为238，65，141，49；10~12岁分别为245，67，185，78；13~15岁分别为246，37，136，53。

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表 4 超重肥胖和血脂异常联合效应与男女童LVH的关联

Table 4. Association of combined effects of overweight and obesity with dyslipidemia with LVH in boys and girls

性别	自变量	模型1		模型2
性别	自变量	OR值(95%CI)	P值	OR值(95%CI)	P值
男生(n=554)	正常体重且血脂正常	1.00		1.00
	正常体重且血脂异常	2.91(0.86~9.85)	0.09	2.89(0.85~9.85)	0.09
	超重肥胖且血脂正常	5.77(2.76~12.06)	<0.01	5.59(2.63~11.86)	<0.01
	超重肥胖且血脂异常	11.38(5.19~24.97)	<0.01	10.65(4.71~24.08)	<0.01
女生(n=493)	正常体重且血脂正常	1.00		1.00
	正常体重且血脂异常	3.34(1.32~8.48)	0.01	3.93(1.52~10.14)	<0.01
	超重肥胖且血脂正常	7.93(3.90~16.13)	<0.01	7.22(3.51~14.88)	<0.01
	超重肥胖且血脂异常	9.15(3.88~21.60)	<0.01	8.50(3.53~20.45)	<0.01

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表 5 超重肥胖和血脂异常联合效应与不同年龄组儿童LVH的关联

Table 5. Association of combined effects of overweight and obesity with dyslipidemia with LVH in children of different age groups

年龄/岁	自变量	模型1		模型2
年龄/岁	自变量	OR值(95%CI)	P值	OR值(95%CI)	P值
10~12(n=575)	正常体重且血脂正常	1.00		1.00
	正常体重且血脂异常	3.10(1.29~7.43)	0.01	3.15(1.31~7.56)	0.01
	超重肥胖且血脂正常	3.81(1.93~7.50)	<0.01	3.92(1.97~7.80)	<0.01
	超重肥胖且血脂异常	8.17(3.89~17.12)	<0.01	8.32(3.90~17.76)	<0.01
13~15(n=472)	正常体重且血脂正常	1.00		1.00
	正常体重且血脂异常	2.37(0.60~9.46)	0.22	2.67(0.66~10.81)	0.17
	超重肥胖且血脂正常	13.09(5.91~29.02)	<0.01	12.28(5.38~28.07)	<0.01
	超重肥胖且血脂异常	15.05(6.00~37.76)	<0.01	12.76(4.85~33.54)	<0.01

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