Study On The Relationship Between Body Composition And Cardiovascular Risk Factors In Obese Children And Adolescents

Objective To understand the status quo of overweight and obesity,body composition,blood pressure and blood lipids in children and adolescents in Ningxia,analyze the distribution characteristics of body composition,blood pressure,blood lipids and subclinical indicators of cardiovascular disease in overweight and obese children and adolescents,and further study the relationship between body composition and cardiovascular disease risk factors and subclinical indicators,so as to provide a theoretical basis for preventing the occurrence of cardiovascular disease in children and adolescents.Methods A total of 5047 children and adolescents were randomly selected from primary and middle schools in Ningxia by stratified cluster sampling.Laboratory and clinical subjects were recruited from the baseline subjects,and 1034 subjects(523 boys and 511 girls)were finally included in the laboratory study.182 subjects(68 males and 114 females)were examined clinically.The laboratory examination included basic examination,blood biochemistry,body composition and vascular endothelial function.This study has been approved by the Ethics Committee of Ningxia Medical University,and all subjects and their guardians have signed the informed consent form.Results(1)The prevalence rates of overweight,obesity and abdominal obesity in children and adolescents aged 6～18 years in Ningxia were 11.04%,8.92% and 21.72%respectively.The prevalence rates of overweight,obesity and abdominal obesity were 16.00%,13.64% and 28.88% in boys and 6.19%,4.31% and 14.72% in girls,respectively.The prevalence rates of overweight,obesity and abdominal obesity in boys were higher than those in girls(P<0.01).(2)The detection rate of high normal blood pressure,high blood pressure and dyslipidemia in children and adolescents aged 6～18 years in Ningxia was 14.86%,24.01% and39.4% respectively.The detection rates of normal high blood pressure and high blood pressure in boys were 15.88% and 24.63%,respectively.The prevalence rates of high normal blood pressure and high blood pressure in female students were 13.86% and 23.41% respectively,which were higher in male students than in female students(P<0.05).(3)There were significant differences in BMI,total body water,muscle mass,lean body mass,body fat percentage,SDP,BDP,c IMT,RWT and baPWV between sexes(all P<0.05).There were significant differences in BMI,total body water,muscle mass,body fat,lean body weight,body fat percentage,waist-hip ratio,TC,TG,HDL,LDL,SDP,BDP,c IMT,RWT,baPWV between normal and overweight children and adolescents(all P<0.05).(4)The correlation factors of each index of CVD risk factors are different.The correlation factors of TC were BMI,body fat,body fat percentage and WHR,and the correlation coefficients were 0.261,0.251,0.292 and 0.222 respectively.The correlation factors of TG were BMI,body fat,body fat percentage and waist-hip ratio,the correlation coefficients were 0.246,0.203,0.191 and 0.239 respectively.The correlative factors of LDL were BMI,body fat,body fat percentage and WHR,the correlative coefficient were 0.226,0.376,0.354,0.341,0.369 respectively.The related factors of HDL were BMI,total body water,muscle mass,body fat,lean body weight,body fat percentage and waist-hip ratio,and the correlation coefficients were-0.294,-0.383,-0.283,-0.279,-0.343,-0.284,-0.240,-0.402,respectively.BMI,total body water,muscle mass,body fat,lean body weight,body fat percentage and waist-hip ratio were the related factors of SDP,and the correlation coefficients were 0.593,0.335,0.586,0.590,0.392,0.589,0.160 and 0.464,respectively.The correlation factors of BDP were BMI,total body water,muscle mass,body fat,lean body weight,body fat percentage and waist-hip ratio,and the correlation coefficients were 0.378,0.300,0.388,0.386,0.286,0.387,0.219 respectively.(5)The effects of body composition and CVD risk factors on CVD subclinical indexes are also different.c IMT was correlated with BMI,total body water,muscle mass,body fat,TC,TG,HDL,LDL,DBP and FGP,and the correlation coefficients were 0.308,0.369,0.310,0.300,0.248,0.306,0.208,0.355,-0.172,0.246,0.177 and-0.272,respectively.LVMI was correlated with total body water,muscle mass,lean body weight and SBP(r = 0.217,0.220,0.215,0.189,respectively).The correlation factors of RWT were DBP and SBP,and the correlation coefficients were 0.148 and 0.230;The correlation factors of baPWV were BMI,HDL,SBP and DBP,and the correlation coefficients were-0.150,0.154,0.236 and-0.191,respectively.Logistic regression analysis showed that SLM and PBF were protective factors for high c IMT values before adjusting for age and gender,while BMI and WHR were risk factors for high c IMT values;BMI is a protective factor for high baPWV values,while SLM and PBF are risk factors for high baPWV values;Adjusted PBF is a protective factor for high c IMT values;BMI is a risk factor for high LVMI values;Adjusted BMI is a protective factor for high baPWV values,while PBF is a risk factor for high baPWV values.Conclusion(1)The prevalence of overweight,obesity and abdominal obesity among children and adolescents aged 6～18 years in Ningxia region showed an upward trend,and the prevalence of blood pressure was higher than the national average.(2)BMI,WHR and body fat were positively correlated with TC,TG,LDL,SBP,DBP,and negatively correlated with HDL.Total body water,muscle mass and lean body weight were positively correlated with SBP and DBP,and negatively correlated with HDL.Body fat percentage was positively correlated with TC,TG,LDL,SBP,and negatively correlated with HDL.(3)c IMT was positively correlated with BMI,total body water,muscle mass,body fat,lean body weight,TC,TG,LDL,DBP,and negatively correlated with HDL,FGP.Lvmi was positively correlated with total body water,muscle mass,lean body weight and SBPRWT was positively correlated with SBP and negatively correlated with DBP.baPWV was positively correlated with HDL and SBP,and negatively correlated with BMI and DBP.(4)BMI is a risk factor for high LVMI values and a protective factor for high baPWV values;SLM is a risk factor for abnormal blood pressure;PBF is a protective factor for high c IMT values and a risk factor for high baPWV values;WHR is a risk factor for dyslipidemia.