Relationship between different types of obesity and metabolic index of cardiovascular disease in college students
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摘要:
目的 获得大学生不同肥胖类型与心血管疾病代谢指标之间的关联性，为有效控制青少年肥胖、预防心血管疾病提供科学依据。 方法 本次研究以芜湖市某高校2018级3 450名新生为研究对象，采用整群抽样的方法对其进行问卷调查和体格检测。使用BMI及腰围身高比(waist height ratio, WHtR)作为判断肥胖的指标。 结果 符合条件的3 349名调查对象中复合型肥胖、中心型肥胖和外周型肥胖的患病率分别为6.51%、4.93%、0.53%。除了载脂蛋白A(apolipoprotein A, APOA)外，各心血管疾病代谢异常检出率在不同肥胖类型之间差异均有统计学意义(均有P＜0.05)。除APOA外，复合型肥胖发生心血管疾病代谢异常的风险较非肥胖人群均有增加(均有P＜0.05)。与非肥胖人群相比，复合型肥胖的青少年出现指标异常数≥2的可能性是6.86倍(OR=6.86, 95% CI: 4.54~10.39)。 结论 复合型肥胖青少年发生心血管疾病代谢异常的风险较高，联合使用BMI和WHtR可提高对青少年心血管疾病的预测效应。 Abstract:Objective To investigate the correlation between different obesity types and metabolic indexes of cardiovascular disease in college students, and to provide scientific basis for the effective control of adolescent obesity and prevention of cardiovascular diseases. Methods In this study, 3 450 freshmen from Grade 2018 in a university of Wuhu City were selected as the research objects. Cluster sampling was used to conduct questionnaire survey and physical examination. Body Mass Index (BMI) and waist-to-height ratio (WHtR) were used as indicators to judge obesity. Results Among the 3 349 eligible subjects, the prevalence of compound obesity, central obesity and peripheral obesity were 6.51%、4.93% and 0.53%, respectively. Except for apolipoprotein A (APOA), there were statistically significant differences in the detection rates of metabolic abnormalities of cardiovascular diseases among different types of obesity (all P < 0.05). With the exception of APOA, the risk of cardiovascular metabolic abnormalities in compound obesity increased, compared with that in non-obese people (all P < 0.05). Compared with non-obese people, adolescents with compound obesity were 6.86 times more likely to have an abnormal number of indicators≥2 (OR=6.86, 95% CI: 4.54-10.39). Conclusions Adolescent with compound obesity are at higher risk of cardiovascular metabolic abnormalities. The combination of BMI and WHtR enhances the predictive effect of cardiovascular disease in adolescents. -
Key words:
- Obesity /
- Metabolic /
- Adolescent /
- Cardiovascular
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表 1 不同肥胖类型的心血管疾病代谢异常检出率比较[n(%)]
Table 1. Comparison of detection rates of metabolic abnormalities in cardiovascular diseases of different types of obesity [n(%)]
变量 外周型肥胖(n=18) 中心型肥胖(n=165) 复合型肥胖(n=218) 非肥胖人群(n=2948) χ2值 P值 FPG受损 1(0.02) 1(0.02) 0(0.00) 0(0.00) - ＜0.001 a 高TC 1(5.56) 10(6.06) 34(15.60) 124(4.21) 55.34 ＜0.001 高TG 1(5.56) 6(3.64) 42(19.27) 64(2.17) 182.26 ＜0.001 低HDL-C 1(5.56) 23(13.94) 58(26.61) 124(4.21) 194.62 ＜0.001 高LDL-C 1(5.56) 7(4.24) 25(11.47) 45(1.53) 56.71 ＜0.001 高血压 3(16.67) 18(10.09) 63(28.90) 190(6.44) 134.75 ＜0.001 APOA 2(11.11) 31(18.79) 47(21.56) 612(20.75) 1.48 0.691 APOB 2(11.11) 13(7.88) 40(18.35) 86(2.92) 127.91 ＜0.001 指标异常数≥2 3(16.67) 26(15.76) 88(40.38) 238(8.07) 229.03 ＜0.001 注：a Fisher确切概率法。 
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表 2 青少年肥胖类型与心血管疾病代谢异常发生率的关联性分析
Table 2. Analysis of association between type of obesity and incidence of metabolic abnormality of cardiovascular disease in adolescents
因变量 分类 单因素模型 多因素模型 OR(95%CI)值 P值 OR(95%CI)值 P值 高血压 非肥胖人群 1.00 1.00 外周型肥胖 2.90(0.83~10.12) 0.094 2.66(0.73~9.78) 0.140 中心型肥胖 1.78(1.07~2.96) 0.027 1.81(1.07~3.07) 0.028 复合型肥胖 5.90(4.25~8.19) ＜0.001 4.53(3.21~6.40) ＜0.001 高TC 非肥胖人群 1.00 1.00 外周型肥胖 1.34(0.18~10.15) 0.777 1.32(0.17~10.02) 0.789 中心型肥胖 1.47(0.76~2.86) 0.256 1.48(0.76~2.87) 0.249 复合型肥胖 4.21(2.80~6.33) ＜0.001 4.20(2.78~6.37) ＜0.001 高TG 非肥胖人群 1.00 1.00 外周型肥胖 2.65(0.35~20.22) 0.347 2.31(0.3~17.85) 0.424 中心型肥胖 1.70(0.73~3.99) 0.222 1.73(0.74~4.07) 0.210 复合型肥胖 10.75(7.08~16.33) ＜0.001 9.36(6.1~14.36) ＜0.001 低HDL-C 非肥胖人群 1.00 1.00 外周型肥胖 1.34(0.18~10.15) 0.777 1.19(0.15~9.24) 0.867 中心型肥胖 3.69(2.29~5.94) ＜0.001 3.87(2.37~6.31) ＜0.001 复合型肥胖 8.26(5.82~11.72) ＜0.001 6.76(4.70~9.71) ＜0.001 高LDL-C 非肥胖人群 1.00 1.00 外周型肥胖 3.8(0.49~29.13) 0.200 3.45(0.45~26.78) 0.236 中心型肥胖 2.86(1.27~6.44) 0.011 2.87(1.27~6.48) 0.011 复合型肥胖 8.36(5.02~13.92) ＜0.001 7.38(4.38~12.43) ＜0.001 APOA 非肥胖人群 1.00 1.00 外周型肥胖 0.76(0.22~2.65) 0.670 0.78(0.22~2.70) 0.691 中心型肥胖 0.88(0.59~1.32) 0.543 0.88(0.59~1.32) 0.544 复合型肥胖 1.05(0.75~1.47) 0.779 1.06(0.76~1.49) 0.736 APOB 非肥胖人群 1.00 1.00 外周型肥胖 4.16(0.94~18.38) 0.060 3.76(0.83~16.93) 0.085 中心型肥胖 2.85(1.55~5.22) 0.001 3.07(1.67~5.66) ＜0.001 复合型肥胖 7.48(4.99~11.21) ＜0.001 7.07(4.66~10.73) ＜0.001 指标异常数≥2 非肥胖人群 1.00 1.00 外周型肥胖 2.28(0.66~7.92) 0.196 3.65(0.81~16.46) 0.092 中心型肥胖 2.13(1.37~3.31) 0.001 2.97(1.61~5.47) ＜0.001 复合型肥胖 7.71(5.7~10.42) ＜0.001 6.86(4.54~10.39) ＜0.001 注：多因素分析校正了年龄、性别、家庭经济状况及运动情况等因素。
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