Objective: To examine the association of abdominal obesity assessed by waist circumference (WC) with carotid intima-media thickness (cIMT) in children. Methods: The study participants were from the "Huantai Childhood Cardiovascular Health Cohort Study" conducted in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to select a primary school in Huantai County to conduct the baseline survey from November 2017 to January 2018. A total of 1 515 children aged 6-11 years old were included. The first follow-up survey was conducted from November to December 2019, and a total of 981 children aged 8-13 years old were finally included after exclusion of those with high cIMT at baseline. Questionnaire survey, physical examination and ultrasonic examination were used to collect general demographic characteristics, WC and cIMT information. According to the status of WC at baseline, the participants were divided into normal WC group and abdominal obesity group. Covariance analysis was used to compare the cIMT levels of children between normal WC group and abdominal obesity group. Multivariable logistic regression models were used to evaluate the association between baseline abdominal obesity and high cIMT during the follow-up. Results: The age of 981 children was (8.5±1.5) years at the baseline. The follow-up age was (10.5±1.5) years, and 520 boys accounted for 53.0%. The cIMT of children in the abdominal obesity group was 0.54 mm, which was higher than that in the normal WC group (0.51 mm) (P<0.001). Similarly, the prevalence of high cIMT in children with abdominal obesity (23.9%) was higher than that of normal WC group (3.9%) (P<0.001). After adjusting for potential covariates at the baseline and during the follow-up period, compared with the normal WC group, abdominal obesity was significantly associated with high cIMT (OR=5.78, 95%CI:3.43-9.74). Conclusion: The abdominal obesity in children could increase the risk of high cIMT.
目的： 探讨儿童期腹型肥胖与颈动脉内中膜厚度（cIMT）的关联。 方法： 研究对象来源于山东省淄博市桓台县开展的“桓台儿童心血管健康随访队列”。采用方便整群抽样的方法，于2017年11月至2018年1月在桓台县某所小学选取1 515名6~11岁儿童进行基线调查，并于2019年11至12月对其进行随访，剔除基线cIMT异常者之后，最终纳入981名8~13岁儿童为研究对象。通过问卷调查、体格检查、超声检查的方法收集一般人口学特征、腰围和cIMT等信息。依据基线期儿童的腰围状态将研究对象划分为正常腰围组和腹型肥胖组，采用协方差分析比较正常腰围组和腹型肥胖组儿童的cIMT水平，采用多因素logistic回归模型分析基线期儿童腹型肥胖与随访期cIMT增厚的关联。 结果： 981名研究对象基线年龄为（8.5±1.5）岁，随访年龄为（10.5±1.5）岁，男生占53.0%（520名）。基线期腹型肥胖组儿童的随访期cIMT（0.54 mm）高于正常腰围组儿童（0.51 mm）（P<0.001）。腹型肥胖组cIMT增厚检出率（23.9%）高于正常腰围组（3.9%）（P<0.001）。调整相关混杂因素后，与基线期正常腰围儿童相比，腹型肥胖儿童与随访期cIMT增厚存在关联（OR=5.78，95%CI：3.43~9.74）。 结论： 儿童期腹型肥胖增加cIMT增厚的发病风险。.
Keywords: Carotid intima-media thickness; Child; Cohort studies; Obesity, abdominal.