银川市6～18岁儿童青少年血脂异常流行现状调查

摘要

目的 了解银川市学龄儿童青少年血脂异常流行现状.方法 采用分层整群随机抽样的方法,抽取银川市城区生活水平中等的小学、初中及高中学校,按年级分层,以教学班为单位整群随机抽取调查对象共1 939人,年龄6 ～18岁,性别、民族不限,检测血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)及低密度脂蛋白-胆固醇(LDL-C)水平.结果 1 939名学龄儿童青少年血脂异常总检出率为15.5％(300/1 939例),高TG、高TC、高LDL-C、低HDL-C、高non-HDL-C及高脂血症的检出率分别为5.8％(113/1 939例)、0.8％(18/1 939例)、1.1％(21/1 939例)、10.6％(205/1 939例)、0.9％(18/1 939例)、6.4％(124/1 939例).男童血脂异常总检出率(17.7％)及低HDL-C异常检出率(13.1％)均高于女童(13.3％,8.2％),差异均有统计学意义(x2 =7.178,P=0.007;x2=12.337,P＜0.001).16 ～18岁组血脂异常总检出率[19.1％(89/466例)]高于低年龄组,差异有统计学意义(x2=11.393,P＜0.01).肥胖、超重及正常体质量血脂异常检出率分别为39.7％(69/174例)、20.8％(60/289例)与11.6％(171/1 469例),随着肥胖程度的增加,血脂异常检出率增高,差异有统计学意义(x2=100.180,P＜0.01).腹型肥胖儿童血脂异常总检出率高于非腹型肥胖组[31.5％(92/292例)比12.6％(207/1 640例)],差异有统计学意义(x2=67.578,P＜0.01),肥胖组与腹型肥胖组中分别有39.7％(67/174例)与31.5％(92/292例)的血脂异常儿童青少年应采取营养咨询与以学校为基础的生活方式干预等措施.结论 应重视银川市学龄儿童青少年血脂异常的筛查与防治,尤其是男生和高年龄组儿童应作为重点人群,对其血脂水平进行监测与干预.%Objective To assess the prevalence of dyslipidemia among children and adolescents aged 6-18 years in Yinchuan.Methods A stratified,random cluster sampling was used to select a target samples (1 939 cases) of children from elementary schools,middle schools and high schools in different age groups,with medium economic status.The levels of serum total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),and triglycerides (TG) were measured.Results The prevalence of total dyslipidemia was 15.5 ％ (300/1 939 cases).The prevalence of high TG,high TC,high LDL-C,low HDL-C,high non-HDL-C and hyperlipemia were 5.8％ (113/1 939 cases),0.8％ (18/1 939 cases),1.1％ (21/1 939 cases),10.6％ (205/1 939 cases),0.9％ (18/1 939 cases) and 6.4％ (124/1 939 cases),respectively.Boys were more likely to have dyslipidemia than girls (17.7％ vs.13.3％) and a low HDL-C level (13.1％ vs.8.2％),and the differences between 2 groups were statistically significant (x2 =7.178,P =0.007;x2 =12.337,P ＜ 0.001).Individuals aged 16-18 years had the highest prevalence of total dyslipidemia [19.1％ (89/466 cases)] than other age groups,and the difference was statistically significant(x2 =11.393,P ＜ 0.01).Prevalence of dyslipidemia among the obese,the overweight and the normal weight individuals were 39.7％ (69/174 cases),20.8％ (60/289 cases) and 11.6％ (171/1 469 cases),respectively.Moreover,prevalence of dyslipidemia increased significantly with gravity of obesity,and the difference was statistically significant(x2 =100.180,P ＜ 0.01).Individuals with abdominal obesity had higher prevalence rates of dyslipidemia than that of the non-abdominal obese individuals [31.5％ (92/292 cases) vs.12.6％ (207/1 064 cases)],and the difference was statistically significant (x2 =67.578,P ＜ 0.01).Approximately 39.7％ (69/174 cases) and 31.5 ％ (92/292 cases) obese individuals and abdominal obesity were candidates for taking intervention measures including nutritional counseling,school-based lifestyle as well as community fitness programs.Conclusions Screening and prevention should be regarded for dyslipidemia among children and adolescents,especially for boys and teenagers in Yinchuan.