Association Between Body Fat Distribution And Cardiovascular Disease Risk Factors In School-age Children And Adolescents In Yinchuan

Objective:To understand the current status of body fat distribution among school-age children and adolescents in Yinchuan,and to analyze the association between body fat distribution and cardiovascular disease risk factors.So as to provide scientific basis for preventing the occurrence of obesity and related cardiovascular diseases in children and adolescents and reducing the incidence of chronic diseases in adulthood.Methods:Using the current survey design,a total of 1662 primary and secondary school students aged 6?18 in Yinchuan were selected by the method of stratified cluster sampling,and then conducted questionnaire surveys and physical measurements.The dual-energy X-ray absorptiometry was used to measure fat mass percentage?FMP?,total body fat mass?BFM?,trunk fat mass?TFM?,visceral fat tissue?VFT?,and abdominal cavity fat area?ACFA?.Subjects were tested in the laboratory for triglycerides?TG?,total cholesterol?TC?,high-density lipoprotein cholesterol?HDL-C?,low-density lipoprotein cholesterol?LDL-C?,and fasting blood glucose?FPG?.The 75th percentile(P₇₅)value and 90th percentile(P₉₀)value of the body fat distribution indicators of different ages and genders were used as the diagnostic threshold for overweight and obesity.Results:1.The body fat distribution index of school children and adolescents aged 6to 18 in Yinchuan generally increased with age,and the difference was statistically significant?all P<0.001?.The FMP of boys has little change with age?F=1.586,P>0.05?.After 11 years of age,the FMP tends to decrease slowly with age?F=7.030,P<0.001?.The FMP of girls increased with age?F=18.824,P<0.01?.The BFM,TFM,VFT,and ACFA of males and females generally increased with age,and the difference was statistically significant?F values of boys were 8.185,10.841,27.341,5.283,and girls were 44.855,34.343,43.423,12.045,respectively,all P<0.01?.With the change of age,BFM and TFM of boys and girls appear during the growth several crossings occurred,but neither VFT nor ACFA crossed.2.Each body fat distribution index is different between different genders,and the FMP,BFM,and TFM of girls are higher than that of boys,and the differences are statistically significant?t values were-17.585,-8.584,and-6.595,all P<0.001?.And the VFT and ACFA of boys were higher than that of girls?mean values of VFT and ACFA were 1771.90g and 44.3cm² for boys,and 1640.71g and31.11cm²for girls respectively,all P<0.001?.3.Except that FMP and DBP and FPG and VFT and TC are not related in boys,the body fat distribution indexes of boys and girls were positively correlated with SBP,DBP,TC,TG,LDL-C and FPG,and there was a negative correlation with HDL-C,and the difference is statistically significant?all P<0.01?.BFM,TFM,VFT and ACFA of all ages were positively correlated with SBP,DBP,TG,LDL-C,and HDL-C was negatively correlated,and the difference was statistically significant?all P<0.01?.4.The body fat distribution indexes of boys were higher in the abnormal blood pressure group than in the normal blood pressure group,and the difference was statistically significant?all P<0.01?.The BFM,TFM,VFT and ACFA of the blood pressure abnormal group of all ages were normal compared with blood pressure,and the difference between the two groups was statistically significant?all P<0.05?.The BFM,TFM,VFT and ACFA of boys,girls and all age groups with dyslipidemia were higher than those of the normal lipid group,and the FMP,TFM,VFT and ACFA of the hyperlipidemia group were higher than those of the normal group,and the differences were statistically significant?all P<0.05?.The TFM,VFT,and ACFA of boys,girls,and hyperglycemic groups of all ages were higher than those of the normal blood glucose group,and the differences were statistically significant?P<0.05?.And boys and girls body fat distribution index in CVDRF?1 group or CVDRF?2 group were higher than CVDRF<1 group or CVDRF<2 group,and the difference was statistically significant?all P<0.01?.The BFM,TFM,VFT and ACFA of primary school students in CVDRF?1 group or CVDRF?2 group were higher than those in CVDRF<1 group or CVDRF<2 group,and the difference was statistically significant?all P<0.01?.5.All body fat distribution indexes are risk factors that increase the incidence of CVDRF?1 or CVDRF?2 in children and adolescents?all P<0.001?,and ACFA has a greater degree of influence on CVDRF?1 or CVDRF?2 than others?OR values were 1.52 and 1.98?.The above phenomenon persisted after adjusting for age and gender.ROC curve analysis shows that ACFA has a stronger diagnostic effect on CVDRF?1 or CVDRF?2 than other body fat distribution indicators?AUC=0.60 and 0.70,all P<0.01?,which is the best prediction for evaluating cardiovascular disease risk factors.6.Adjusting age and gender,the effects of various body fat distribution indexes on CVDRF?1 or CVDRF?2 under overweight and obesity were 1.66?2.45times and 2.69?3.70 times their normal levels,respectively,and the differences were statistically significant?all P<0.001?.Adjusting the age and gender,the effect of the combination of overweight and obesity defined by BMI and overweight and obesity defined by each body fat distribution index on CVDRF?1or CVDRF?2 was higher than that of non-overweight obesity groups,and the differences were statistically significant?all OR>2.35,all P<0.001?.The effect of the combination of BMI overweight and obesity and ACFA overweight and obesity on CVDRF?1 or CVDRF?2 was 2.88?95%CI=2.21?3.74?times and 4.76?95%CI=3.30?6.86?times of their normal group,respectively,which is better than other body fat distribution index groupings in different weight states for evaluating cardiovascular disease risk factors.Conclusion:1.The BFM,TFM,VFT and ACFA of children and adolescents in Yinchuan increase with age with different genders.After entering puberty,boys'BFM and TFM are lower than girls,while VFT and ACFA are higher than girls.And the FMP of girls increases year by year.The FMP of boys does not change much with age before the age of 11,and decreases with the increase of age after the age of 11,and the boys are lower than the girls after the age of 11.2.Indexes of body fat distribution for boys and girls and age groups were correlated with cardiovascular risk factors,and children and adolescents with abnormal metabolism of cardiovascular disease risk factors had higher body fat distribution than normal children and adolescents.3.Each body fat distribution index is a risk factor that affects the occurrence of cardiovascular disease risk factors?CVDRF?in children and adolescents,and excessive body fat accumulation has a degree of influence on CVDRF that is1.66?3.70 times its normal,of which ACFA affects CVDRF to a large extent,it is the best predictor of evaluating cardiovascular disease risk factors.