Cardiometabolic Risks and Severity of Obesity in Children and Young Adults
Cardiometabolic Risks and Severity of Obesity in Children and Young Adults
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DOI：
10.1056/nejmoa1502821
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发表时间：
2015-10-01
影响因子：
158.5
通讯作者：
Skelton, Joseph A.
中科院分区：
文献类型：
--
作者：
Skinner, Asheley C.;Perrin, Eliana M.;Skelton, Joseph A.
在过去的十年中，儿童和年轻人严重肥胖的患病率有所增加。虽然超重或肥胖的儿童和年轻人中心脏代谢危险因素的患病率相对较低，那些有更严重形式的肥胖可能是在更大的风险。对1999年至2012年国家健康和营养检查调查中纳入的超重或肥胖儿童和3至19岁年轻人的数据进行了截面分析，根据肥胖的严重程度评估多种心脏代谢危险因素的患病率。根据测量的身高和体重对体重状况进行分类。我们使用总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白胆固醇、甘油三酯、血压、糖化血红蛋白、对8579名体重指数在第85百分位或更高的儿童和年轻人进行了TSAmong分析，（根据疾病控制和预防中心的生长图表），46.9%的人超重，36.4%的人患有I级肥胖症，11.9%的人患有II级肥胖症，4.8%的人患有III级肥胖症。在男性和女性受试者中，部分（但不是全部）心脏代谢变量的平均值随肥胖严重程度的增加而升高，男性受试者的值高于女性受试者;对于HDL胆固醇，平均值随肥胖严重程度的增加而降低。控制年龄，种族或民族，性别的多变量模型显示，肥胖的严重程度越大，高密度脂蛋白胆固醇水平低，高收缩压和舒张压，高甘油三酯和糖化血红蛋白level.CONCLUSIONSSevere的风险越高，在儿童和年轻人严重肥胖与心脏代谢危险因素的患病率增加，特别是在男孩和年轻人。
BACKGROUNDThe prevalence of severe obesity among children and young adults has increased over the past decade. Although the prevalence of cardiometabolic risk factors is relatively low among children and young adults who are overweight or obese, those with more severe forms of obesity may be at greater risk.METHODSWe performed a cross-sectional analysis of data from overweight or obese children and young adults 3 to 19 years of age who were included in the National Health and Nutrition Examination Survey from 1999 through 2012 to assess the prevalence of multiple cardiometabolic risk factors according to the severity of obesity. Weight status was classified on the basis of measured height and weight. We used standard definitions of abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, glycated hemoglobin, and fasting glucose and report the prevalence of abnormal values in children and young adults according to weight status.RESULTSAmong 8579 children and young adults with a body-mass index at the 85th percentile or higher (according to the Centers for Disease Control and Prevention growth charts), 46.9% were overweight, 36.4% had class I obesity, 11.9% had class II obesity, and 4.8% had class III obesity. Mean values for some, but not all, cardiometabolic variables were higher with greater severity of obesity in both male and female participants, and the values were higher in male participants than in female participants; for HDL cholesterol, the mean values were lower with greater severity of obesity. Multivariable models that controlled for age, race or ethnic group, and sex showed that the greater the severity of obesity, the higher the risks of a low HDL cholesterol level, high systolic and diastolic blood pressures, and high triglyceride and glycated hemoglobin levels.CONCLUSIONSSevere obesity in children and young adults was associated with an increased prevalence of cardiometabolic risk factors, particularly among boys and young men.