Obesity and the metabolic syndrome in children and adolescents
Obesity and the metabolic syndrome in children and adolescents
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DOI：
10.1056/nejmoa031049
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发表时间：
2004-06-03
影响因子：
158.5
通讯作者：
Caprio, S
中科院分区：
文献类型：
--
作者：
Weiss, R;Dziura, J;Caprio, S
背景：儿童肥胖症的患病率和严重程度正在急剧增加。我们研究了不同程度肥胖对代谢综合征患病率的影响及其与胰岛素抵抗、C反应蛋白和脂联素水平的关系。方法：我们对439名肥胖、31名超重和20名非肥胖儿童和青少年进行了标准的糖耐量试验。基线测量包括血压、血脂、C反应蛋白和脂联素水平。甘油三酯、高密度脂蛋白胆固醇和血压的水平根据年龄和性别进行了调整。由于体重指数随年龄的变化而变化，我们将年龄和性别的值标准化，并将其换算为z分。结果：代谢综合征的患病率随着肥胖的严重程度而增加，在严重肥胖的青少年中达到50%。体重指数每增加半个单位，转换为z分数，超重和肥胖受试者患代谢综合征的风险就会增加(优势比为1.55；95%可信区间为1.16至2.08)，用稳态模型评估的胰岛素抵抗增加的单位也是如此(优势比为1.12；胰岛素抵抗每增加一个单位，95%可信区间为1.07至1.18)。代谢综合征的患病率随着胰岛素抵抗的增加而显著增加(P
Background: The prevalence and magnitude of childhood obesity are increasing dramatically. We examined the effect of varying degrees of obesity on the prevalence of the metabolic syndrome and its relation to insulin resistance and to C-reactive protein and adiponectin levels in a large, multiethnic, multiracial cohort of children and adolescents.Methods: We administered a standard glucose-tolerance test to 439 obese, 31 overweight, and 20 nonobese children and adolescents. Baseline measurements included blood pressure and plasma lipid, C-reactive protein, and adiponectin levels. Levels of triglycerides, high-density lipoprotein cholesterol, and blood pressure were adjusted for age and sex. Because the body-mass index varies according to age, we standardized the value for age and sex with the use of conversion to a z score.Results: The prevalence of the metabolic syndrome increased with the severity of obesity and reached 50 percent in severely obese youngsters. Each half-unit increase in the body-mass index, converted to a z score, was associated with an increase in the risk of the metabolic syndrome among overweight and obese subjects (odds ratio, 1.55; 95 percent confidence interval, 1.16 to 2.08), as was each unit of increase in insulin resistance as assessed with the homeostatic model (odds ratio, 1.12; 95 percent confidence interval, 1.07 to 1.18 for each additional unit of insulin resistance). The prevalence of the metabolic syndrome increased significantly with increasing insulin resistance (P for trend,