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目的探讨延边地区汉族和朝鲜族小学生血清游离脂肪酸(FFA)与体质量指数(BMI)对代谢综合征(MS)患病危险的关联性,为早期筛选儿童青少年MS高危人群提供依据。方法分别于2012年7月15—18日和2013年7月16—21日,在吉林省延边朝鲜族自治州选择5所小学校,采用整群抽样的方法,共抽取5 747名小学生(汉族3 736名,朝鲜族2 011名)作为研究对象,全部测量身高、体重、腰围和血压,并检测清晨空腹血清三酰甘油、高密度脂蛋白胆固醇、血糖、FFA。结果调整年龄和性别的协方差分析结果显示,汉族学生MS组和正常组FFA平均水平分别为(22.72±2.72)和(21.09±2.60)μmol/L,朝鲜族学生分别为(23.49±1.64)和(21.95±1.63)μmol/L;汉族学生MS组和正常组BMI平均水平分别为(25.68±3.58)和(16.98±2.89)kg/m~2,朝鲜族学生分别为(23.11±3.63)和(17.86±3.05)kg/m~2,汉族和朝鲜族学生MS组FFA和BMI平均水平均高于正常组学生(P值均<0.01),且不同民族学生MS患病水平均随着FFA和BMI水平的增加而增加(P值均<0.01)。调整了年龄和性别因素后,Logistic回归分析显示,汉族学生FFA水平第四分位组MS患病危险是第一分位组的2.693倍,朝鲜族学生为12.132倍;汉族学生超重组和肥胖组的MS患病危险是正常组的19.646和223.666倍,朝鲜族学生分别为4.860和19.204倍。FFA>P_(75)且BMI超重及肥胖组的汉族(OR=172.524,95%CI=60.288~493.705)和朝鲜族(OR=79.188,95%CI=35.728~175.513)学生MS患病危险升高,且均高于单纯FFA>P_(75)组和BMI超重及肥胖组。结论延边地区学生FFA和BMI均与MS患病密切相关,FFA升高合并超重及肥胖学生MS患病危险性较高。FFA水平升高可以预测MS的患病危险,并且对于朝鲜族学生的预测作用强于汉族学生。
Objective To investigate the association of serum free fatty acid (FFA) and body mass index (BMI) with the risk of metabolic syndrome (MS) among Han and Korean pupils in Yanbian area, and to provide basis for early screening of MS high risk population in children and adolescents. Methods Five primary schools were selected in Yanbian Korean Autonomous Prefecture, Jilin Province on July 15-18, 2012 and July 16-21, 2013 respectively. A total of 5 747 primary school children (Han 3 736 2,111 Korean nationals) were included in the study. Height, weight, waist circumference and blood pressure were measured. Fasting serum triglyceride, high density lipoprotein cholesterol, blood glucose and FFA were measured. Results The results of covariance analysis adjusted age and sex showed that the mean level of FFA in Han students was (22.72 ± 2.72) and (21.09 ± 2.60) μmol / L respectively in MS group and normal group, while that in Korean students was (23.49 ± 1.64) and (21.95 ± 1.63) μmol / L respectively. The mean BMI of MS students in Han nationality group and normal group were (25.68 ± 3.58) and (16.98 ± 2.89) kg / m 2 respectively, while that of Korean students was (23.11 ± 3.63) and 17.86 ± 3.05) kg / m ~ 2. The mean levels of FFA and BMI in Han and Korean MS students were significantly higher than those in normal subjects (P <0.01) Increased levels of the increase (P values were <0.01). After adjustment for age and gender, Logistic regression analysis showed that MS prevalence of Han nationality students in FFA level 4 was 2.693 times that of the first quintile and 12.132 times higher than that of Korean students; Han students were overweight and obese The risk of MS was 19.646 and 223.666 times that of normal group, and Korean students were 4.860 and 19.204 times respectively. The prevalences of MS were higher in FFA> P_ (75) and Han (OR = 172.524,95% CI = 60.288 ~ 493.705) and Korean (OR = 79.188,95% CI = 35.728 ~ 175.513) in BMI overweight and obesity group , Which were higher than that of simple FFA> P_ (75) group and BMI overweight and obesity group. Conclusion Both FFA and BMI in Yanbian area are closely related to MS. The higher the risk of MS with FFA in overweight and obese students. The increase of FFA can predict the risk of MS, and the prediction of Korean students is stronger than that of Han students.