胡霄, 姜红如, 张兵, 王惠君, 张继国, 贾小芳, 王柳森, 李惟怡, 王志宏. 中国十五省7~17岁儿童青少年心血管代谢性危险因素的流行特征[J]. 环境与职业医学, 2021, 38(8): 833-838. DOI: 10.13213/j.cnki.jeom.2021.21037
引用本文: 胡霄, 姜红如, 张兵, 王惠君, 张继国, 贾小芳, 王柳森, 李惟怡, 王志宏. 中国十五省7~17岁儿童青少年心血管代谢性危险因素的流行特征[J]. 环境与职业医学, 2021, 38(8): 833-838. DOI: 10.13213/j.cnki.jeom.2021.21037
HU Xiao, JIANG Hongru, ZHANG Bing, WANG Huijun, ZHANG Jiguo, JIA Xiaofang, WANG Liusen, LI Weiyi, WANG Zhihong. Epidemiological characteristics of cardio-metabolic risk factors among children and adolescents aged 7-17 years in 15 provinces of China[J]. Journal of Environmental and Occupational Medicine, 2021, 38(8): 833-838. DOI: 10.13213/j.cnki.jeom.2021.21037
Citation: HU Xiao, JIANG Hongru, ZHANG Bing, WANG Huijun, ZHANG Jiguo, JIA Xiaofang, WANG Liusen, LI Weiyi, WANG Zhihong. Epidemiological characteristics of cardio-metabolic risk factors among children and adolescents aged 7-17 years in 15 provinces of China[J]. Journal of Environmental and Occupational Medicine, 2021, 38(8): 833-838. DOI: 10.13213/j.cnki.jeom.2021.21037

中国十五省7~17岁儿童青少年心血管代谢性危险因素的流行特征

Epidemiological characteristics of cardio-metabolic risk factors among children and adolescents aged 7-17 years in 15 provinces of China

  • 摘要: 背景

    我国儿童青少年心血管代谢性危险因素的发生呈上升趋势,但流行状况及其影响因素的研究相对缺乏。

    目的

    分析我国十五省7~17岁儿童青少年心血管代谢性危险因素及其聚集性的检出状况和人口经济因素的差异。

    方法

    利用2015年“中国居民营养状况变迁的队列研究”数据,分析7~17岁儿童青少年中心性肥胖、血压升高、血糖升高、甘油三酯(TG)升高、高密度脂蛋白胆固醇(HDL-C)降低、总胆固醇(TC)升高、低密度脂蛋白胆固醇(LDL-C)升高和危险因素聚集的流行特征。采用多因素logistic回归模型分析社会经济因素与各心血管代谢性危险因素之间的关系,采用Cochran-Armitage趋势检验进行趋势性分析。

    结果

    共纳入1280名7~17岁儿童青少年。该人群中心性肥胖、血压升高、血糖升高、HDL-C降低、TG升高、TC升高和LDL-C升高的检出率分别为20.94%、10.78%、8.75%、15.16%、6.56%、7.50%和6.33%,18.75%的儿童青少年存在≥2项心血管代谢性危险因素。东部地区儿童青少年中心性肥胖和危险因素聚集的检出率高于中部地区(P < 0.05),东、西部地区TG升高、TC升高和LDL-C升高的检出率均高于中部地区(P < 0.05)。不同年龄组儿童青少年之间中心性肥胖和HDL-C降低的检出率均存在差异(P < 0.05)。男生血压升高、血糖升高和TC升高的检出率均高于女生(P < 0.05)。随着家庭人均年收入水平的提高,中心性肥胖的检出率逐渐增加(P趋势 < 0.05)。多因素logistic回归分析显示:女生血压升高、血糖升高和TC升高的风险均低于男生(OR=0.60,95%CI:0.42~0.87;OR=0.63,95%CI:0.42~0.94;OR=0.64,95%CI:0.42~0.99);12~17岁儿童青少年中心性肥胖和HDL-C降低的风险比7~11岁组分别高61%和92%,但TC升高的风险较低(OR=0.60,95%CI:0.38~0.95);东部地区儿童青少年中心性肥胖的风险比中部地区高57%;东、西部地区TG升高的风险分别是中部地区的2.94、3.21倍,TC升高的风险分别是其5.08、4.42倍,LDL-C升高的风险分别是其4.69、3.34倍;东部地区危险因素聚集的风险较中部地区高(OR=1.94,95%CI:1.23~3.06)。

    结论

    2015年中国十五省儿童青少年心血管代谢性危险因素中,中心性肥胖、HDL-C降低和血压升高的问题较为突出,男生、东部地区和12~17岁青少年检出心血管代谢性危险因素的风险较高。

     

    Abstract: Background

    Although the incidence of cardio-metabolic risk factors in children and adolescents in China is on the rise, the research on its prevalence and influencing factors is insufficient.

    Objective

    This study investigates the prevalence of cardio-metabolic risk factors and their co-prevalence, and the differences in demographic economics among children and adolescents aged 7-17 years in 15 provinces of China.

    Methods

    The data of the China Health and Nutrition Survey in 2015 were used to analyze the epidemiological characteristics of central obesity; elevated blood pressure, fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C); decreased high density lipoprotein cholesterol (HDL-C); and co-prevalence of the risk factors in children and adolescents aged 7-17 years. A multiple logistic regression model was used to analyze the relationship between socio-economic factors and selected cardio-metabolic risk factors, and Cochran-Armitage trend test was used for trend analysis.

    Results

    A total of 1 280 children and adolescents aged 7-17 years were included in the study. The prevalence rates of central obesity, elevated blood pressure, elevated FPG, decreased HDL-C, elevated TG, elevated TC, and elevated LDL-C were 20.94%, 10.78%, 8.75%, 15.16%, 6.56%, 7.50%, and 6.33%, respectively; the co-prevalence rate of cardio-metabolic risk factors was 18.75%. The prevalence rate of central obesity and co-prevalence rate of cardio-metabolic risk factors in eastern region were higher than those in central region (P < 0.05). The prevalence rates of elevated TG, elevated TC, and elevated LDL-C in eastern and western regions were higher than those in central region (P < 0.05). The prevalence rates of central obesity and decreased HDL-C were different among different age groups (P < 0.05). Boys showed higher prevalence rates of elevated blood pressure, elevated FPG, and elevated TC than girls (P < 0.05). With the improvement of annual household per capita income, the prevalence rates of central obesity was gradually increasing (Ptrend < 0.05). The results of multiple logistic regression analysis showed there were less risks of elevated blood pressure (OR=0.60, 95%CI: 0.42-0.87), elevated FPG (OR=0.63, 95%CI: 0.42-0.94), and elevated TC (OR=0.64, 95%CI: 0.42-0.99) in girls than in boys. The risks of central obesity and decreased HDL-C were 61% and 92% higher and the risk of elevated TC was lower (OR=0.60, 95%CI: 0.38-0.95) in children and adolescents aged 12-17 years than in those aged 7-11, respectively. The risk of central obesity in eastern region was 57% higher than that in central region. Taking central region as a reference, the risks of elevated TG, TC, and LDL-C in eastern and western regions were 2.94 and 3.21 times, 5.08 and 4.42 times, and 4.69 and 3.34 times higher, respectively. The co-prevalence of cardio-metabolic risk factors in eastern region was higher than that in central region (OR=1.94, 95%CI: 1.23-3.06).

    Conclusion

    Central obesity, lower HDL-C, and higher blood pressure are prominent cardio-metabolic risk factors among children and adolescents in 15 provinces of China in 2015. Higher risks of having cardio-metabolic risk factors are identified in boys, eastern region, and adolescents aged 12-17 years.

     

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