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目的应用队列研究方法探讨超重／肥胖学龄儿童在青少年期体重指数(BMI)与血压、血脂、血糖、心脏结构及功能的相关关系。方法采用整群抽样横断面调查与追踪调查的流行病学方法调查北京市健康学龄儿童(7-11岁)与9年后同一观察对象(16-20岁)共193名,于基线时(9年前)及随访时(9年后)对每名学生均测量身高、体重、血压,并均应用生化法于空腹12小时后抽血检查血清总胆固醇、血糖和甘油三酯水平。应用超声心动图方法检测随访时16-20岁学生的心脏结构、血流及功能。根据儿童期BMI值分为儿童期肥胖组、超重组、正常体重组,比较同一观察对象儿童期与青少年期各项指标的变化。结果同一人群青少年期较儿童期血脂、血糖水平无明显差异。儿童期肥胖组较正常体重组于9年后随访时(青少年期)的BMI(24．71 kg／m2±4．57 kg/m2和20．54 kg／m2±2．84 kg／m2)及收缩压(117．22 mm Hg±17．44 mm Hg和102．20 mm Hg±11．68 mm Hg,1 mm Hg=0．133 kPa)明显增高(P<0．001和P<0 05),室间隔增厚(0．87 cm±0.12 cm和0．77 cm±0．12 cm)及左室后壁增厚(0．91 cm±0．13 cm和0．79 cm±0．31 cm)(P<0．01和P<0．05)、左室心肌质量(167．84 g±16．29 g和128．95 g±63．00 g)及左室心肌质量指数(88．12 g／m2±17．19 g／m2和79．35 g／m2±39．01g/m2)明显增加(P值均<0．05),差异有统计学意义;左室舒张末期容积及心输出量增加,射血分数及左室短轴缩短率下降(P值均<0．05),心脏舒张功能各项指标体重正常组与肥胖组及超重组间差异均无统计学意义。结论学龄肥胖儿童较学龄体重正常儿童在成长为青少年后,BMI及血压明显增高,左室壁增厚,左室心肌质量增加,提示儿童期单纯肥胖症是成年后心血管疾病的重要危险因素。
Objective To explore the relationship between body mass index (BMI) and blood pressure, blood lipids, blood glucose, cardiac structure and function in overweight / obese school-age children by cohort study. Methods A total of 193 healthy school-age children (aged 7-11 years) and the same subject (aged 16-20 years) of 9 years were enrolled in the epidemiological study of cluster sampling cross-sectional survey and follow-up survey. At baseline Years ago) and at follow-up (after 9 years). The height, weight and blood pressure were measured for each student. Blood samples were collected for blood total cholesterol, blood glucose and triglyceride levels 12 hours after fasting by biochemical methods. Echocardiographic methods were used to detect cardiac structure, blood flow, and function in students aged 16-20 years at follow-up. According to childhood BMI values are divided into childhood obesity group, overweight group, normal weight group, compare the same observation object changes in childhood and adolescent indicators. Results Compared with childhood, there was no significant difference in blood lipid and blood glucose among adolescents in the same population. In the childhood obesity group, BMI (24.71 kg / m2 ± 4.57 kg / m2 and 20.54 kg / m2 ± 2.84 kg / m2) at 9 years of follow-up (adolescence) and Systolic blood pressure (117.22 mm Hg ± 17.44 mm Hg and 102.20 mm Hg ± 11.68 mm Hg, 1 mm Hg = 0.133 kPa) were significantly higher (P <0.001 and P <0.05) , Interventricular septum thickening (0.87 cm ± 0.12 cm and 0.77 cm ± 0.12 cm) and left ventricular posterior wall thickening (0.91 cm ± 0.13 cm and 0.79 cm ± 0.31 (P <0.01 and P <0.05). Left ventricular myocardial mass (167.84 g ± 16.29 g and 128.95 g ± 63.00 g) and left ventricular mass index (88% 12 g / m2 ± 17.19 g / m2 and 79.35 g / m2 ± 39.01 g / m2) (P <0.05), with significant difference The increase of output, ejection fraction and shortening of left ventricular short axis (P <0.05). There was no significant difference between normal weight group and obesity group and overweight group in diastolic function indexes. Conclusions After school-aged obese children than normal school-age children with normal weight, BMI and blood pressure are significantly increased, left ventricular wall thickening and left ventricular mass are increased, suggesting that childhood obesity is an important risk factor for cardiovascular disease in adulthood.