BMI是评价肥胖最常用的指标，但不能区分体成分及脂肪分布，尤其对处于生长发育期的儿童。研究发现，身体脂肪与肌肉及不同部位脂肪具有不同的心血管代谢功能。迄今，有关儿童体脂肪蓄积量及分布对心血管代谢异常发生风险的预测及机制的研究较少。本研究依托已建立的调查，采用前瞻性队列研究设计，基线选取4000名6-16岁儿童（体重正常2000人，超重1000人，肥胖1000人）。采用双能X线吸收测定法(DXA)评估体成分和体脂肪分布，检测血胰岛素、炎性因子及细胞因子的水平，并随访获得心血管代谢异常(高血压、血脂异常、高血糖等)的发病数据，以评估不同体重状态脂肪蓄积量及分布对心血管代谢异常发生风险的预测价值，探讨胰岛素、细胞因子及炎性因子在体脂肪致心血管代谢异常过程中的相关机制。另外，本项目拟基于心血管代谢异常风险预测研制体脂肪量及分布诊断儿童肥胖的标准，为儿童肥胖的精准评估和干预提供适宜技术。

Body mass index (BMI) is the most widely used measure to assess obesity, but it cannot distinguish body compositions and ignoring fat distribution within individuals, especially for children with rapid growth and development. Studies showed that body fat versus muscle tissues, as well as fat stored in different regions, have different metabolic functions. However, data are limited regarding the long-term influences of childhood body compositions and fat distributions on the development of cardiometabolic risk factors and related mechanisms. .In the present study, using longitudinal cohort study design, we plan to randomly select 4000 participants (2000 with normal weight, 1000 with overweight and 1000 with obesity) aged 6-16 years from School-based Cardio Vascular & Bone Health study. At baseline, all participants will undergo dual-energy X-ray absorptiometry scan to measure body composition and fat distribution and have insulin, adipokines and inflammatory biomarkers measured. Incident cardiometabolic risk factors (including hypertension, hyperlipidemia and type 2 diabetes) will be evaluated at follow-up. The primary aim of this study is to identify the predictive value of body total fat and fat distribution in predicting the risk of incident cardiometabolic abnormalities and to examine the underlying mechanisms involving insulin resistance, adipokines and inflammation response. In addition, the diagnostic criteria for body composition and fat distribution related indexes will be developed based on the prediction of incident cardio-metabolic abnormalities. These results from this study will provide strong evidence for precise prevention and intervention of childhood obesity.