Frequency of obesity and related risk factors among school children and adolescents in a low-income community. A cross-sectional study

CONTEXT AND OBJECTIVE: The frequency of obesity at an early age may contribute to atherosclerosis and cardiovascular disease (CVD) in adults. This study measured the frequency of obesity and cardiovascular risk factors in children and adolescents aged 6 to 17 years.DESIGN AND SETTING: Cross-sectional study in a school located in a region of low income and socioeconomic status in Santa Rita do Sapucai, Minas Gerais, Brazil.METHODS: A total of 175 students were classified using body mass index (BMI) and their waist circumference, blood pressure, number of hours of sedentary behavior and school meals were evaluated. Serum concentrations of fasting blood glucose, total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C) were analyzed.RESULTS: 37.2% of the students had BMI above the 85th percentile and had significantly lower age, higher prevalence of hypertension, higher serum TC, LDL-C and TG, and greater waist circumference than those with BMI below the 85th percentile. Hypertension was observed in 2.9% of the students; 5.1% presented impaired glucose tolerance, 40% had two risk factors for atherosclerosis and 26.9% had three risk factors. A sedentary lifestyle was significantly less prevalent among subjects with BMI above the 85thpercentile and was significantly correlated with serum TC and LDL-C. The school meals were hypoglycemic, hyperproteic and hyperlipidemic.CONCLUSION: One third of the children and adolescents had weights greater than or equal to the age-adjusted weight, and this was associated with greater waist circumference, hypertension and prevalence of dyslipidemia.

研究背景与研究目的：儿童早期肥胖的发生频率可能会增加成人动脉粥样硬化与心血管疾病（CVD）的发病风险。本研究针对巴西米纳斯吉拉斯州圣丽塔-杜萨普卡伊市一处低收入社会经济水平区域内的学校，对6至17岁儿童及青少年的肥胖发生率与心血管危险因素展开调研。
研究设计与研究地点：本研究为横断面研究（cross-sectional study），实施地点位于巴西米纳斯吉拉斯州圣丽塔-杜萨普卡伊市一处低收入社会经济水平区域内的一所学校。
研究方法：本研究共纳入175名学生，通过体质指数（BMI）进行分组，并对其腰围、血压、久坐行为时长与学校供餐情况开展评估。同时检测了空腹血糖、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C）的血清浓度。
研究结果：37.2%的学生体质指数高于第85百分位数，与体质指数低于第85百分位数的学生相比，该组学生年龄显著更低，高血压患病率、血清总胆固醇、低密度脂蛋白胆固醇与甘油三酯水平，以及腰围均显著更高。本次调研中共检出2.9%的学生存在高血压；5.1%的学生存在糖耐量受损，40%的学生存在2项动脉粥样硬化危险因素，26.9%的学生存在3项危险因素。体质指数高于第85百分位数的学生中，久坐生活方式的患病率显著更低，且久坐行为与血清总胆固醇、低密度脂蛋白胆固醇水平呈显著相关性。本次调研的学校供餐为低糖、高蛋白、高脂膳食。
研究结论：三分之一的儿童及青少年体重达到或超过年龄校正后的标准体重，该情况与更大的腰围、更高的高血压患病率及血脂异常发生率显著相关。