Construction And Application Of A Novel Indicator Of Relative Children’s Lipid Accumulation Product

ObjectiveTo construct a novel indicator to reflect the status of lipid accumulation in children and adolescents,and apply it to predict metabolic syndrome（MS）,hypertension and impaired fasting glucose（IFG）in children and adolescents,thus providing theoretical basis for promoting children and adolescents’health.MethodsIn this study,a total of 683 students aged 8-15 years（including 317 girls（46.4%）and 366 boys（53.6%））were effectively recruited from two nine-year-system schools using a stratified cluster sampling method from Bengbu,Anhui Province.Investigate age,diet and physical activity factors,measure height,weight,sitting high,waist circumference（WC）,abdominal skinfold fat thickness（AST）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,fasting blood glucose（FBG）,low density lipoprotein（LDL-C）,high density Lipoprotein（HDL-C）and triacylglycerol（TG）.A novel indicator of relative child lipid accumulation index（RCLAP）was constructed based on the Childhood Lipid Accumulation product（CLAP）combined with height,sitting height and weight.The independent sample t test and rank-sum test were used to compare the differences between groups of quantitative data,qualitative data was expressed as rate or proportion（%）.The chi-square test was used to compare the differences in qualitative data between comparison groups,and the Logistic regression model was used for multivariate analysis.Receiver operating characteristic（ROC）and area under the curve（AUC）was used to analyze the predictive value of each index on the occurrence of MS,hypertension and IFG in children and adolescents.The Med Calc 20.0 software was used to analysis the joint prediction of indicators.Different percentiles of RCLAP were calculated by gender to explore their optimal cutoffs for predicting MS,hypertension,and IFG in children and adolescents.Results1.The sitting height,AST,TG,VAI,Ty G,TG/HDL-C and Ln CLAP of girls were higher than those of boys（P<0.05）,and the WHt R,SBP and FBG of boys were higher than those of girls（P<0.05）.The age-standardized RCLAP-H,RCLAP-SH and RCLAP-W of girls were higher than boys（P<0.05）.The rate of unhealthy eating behavior≥P₇₅ in boys was higher than that in girls,the proportion of boys with moderate-to-vigorous physical activity time≥60 min per day was higher than that in girls,and the proportion of girls with sedentary physical activity≥120 min per day was higher than that in boys,the differences were statistically significant（P<0.05）.2.The ability of RCLAP-H and RCLAP-SH to predict MS in boys and girls（AUC for boys were 0.952,0.952,respectively;AUC for girls were 0.950,0.948,respectively）were better than weight,BMI,WHt R,WC,AST,VAI,Ty G,TG/HDL-C and CLAP,and the optimal cutoff of RCLAP-H and RCLAP-SH were P₈₅for predicted MS in boys and girls.RCLAP-H combined with TG/HDL-C,RCLAP-SH combined with TG/HDL-C or VAI had the highest and equal AUC values for predicted MS in girls(AUC _girls=0.956);RCLAP-SH combined with BMI had the highest AUC value for predicted MS in boys(AUC _boys=0.962).3.The ability of RCLAP-H and RCLAP-SH to predict hypertension in boys（AUC for boys were 0.713,0.712,respectively）were better than weight,BMI,WHt R,WC,AST,VAI,Ty G and TG/HDL-C,and the optimal cutoff of RCLAP-H and RCLAP-SH were P₈₅ for predicted hypertension in boys.RCLAP-H combined with TG/HDL-C had the highest AUC value for predicted hypertension in girls(AUC _girls=0.712),and RCLAP-W combined with SH had the highest AUC value for predicted hypertension in boys(AUC _boys=0.775).4.The ability of RCLAP-H and RCLAP-SH to predict boys IFG（AUC for boys were 0.633,0.634,respectively）were better than weight,BMI,WHt R,WC and AST,and the optimal cutoff of RCLAP-H and RCLAP-SH were P₇₅ for predicted IFG in boys.RCLAP-SH combined with VAI had the highest and equal AUC values for predicted IFG in girls(AUC _girls=0.621),and RCLAP-H or RCLAP-SH combined with VAI predicted the highest AUC value of IFG in boys(AUC _boys=0.656).Conclusions1.The relative children’s lipid accumulation product（RCLAP-H,RCLAP-SH）could reflect the degree of lipid accumulation in children was constructed using WC,AST,TG,height and sitting height.2.RCLAP-H and RCLAP-SH have a better ability to predict MS in boys and girls,hypertension in boys and IFG in boys,and the prediction effect was better than weight,BMI,WC,WHt R and AST.3.The combined ability of RCLAP-H,RCLAP-SH and traditional indexes to predict MS,hypertension and IFG was better than that of single index.