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

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 (P_trend < 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.