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儿童青少年脂肪体重、去脂体重和肺通气功能的关系

王丹阳, 冯逵, 陈莉, 祖淑玉, 韩少梅, 朱广瑾

中国医学科学院基础医学研究所，北京协和医学院基础学院 生理与病理生理学系；流行病学与统计学系，北京 100005

摘要

本文旨在研究儿童青少年去脂体重(fat free mass, FFM)、脂肪体重(fat mass, FM)和肺通气功能的关系。随机抽取黑龙江省10~18 岁健康儿童青少年1 174 人(男性583 人，女性591 人)，测量身高、体重和腰臀比(waist to hip ratio, WHR)，使用身体成分测量仪和肺功能仪分别测量FFM、FM 和肺通气功能，采用独立样本t 检验、偏相关和多元逐步回归分析FFM、FM 和肺通气功能的关系。结果显示，无论性别，受试者年龄与去脂体重指数(FFM index, FFMI)呈正相关(P<0.001)。男性年龄和脂肪体重指数(FM index, FMI)呈负相关(P<0.001)，女性年龄和FMI 呈正相关(P<0.001)。无论性别，受试者FFMI 与用力呼气肺活量(forced vital capacity, FVC)、用力呼气一秒量(forced expiratory volume in one second, FEV1)、最大呼气流量(peak expiratory flow, PEF)、用力呼出25%肺活量时呼气流量(forced expiratory flow at 25% of forced vital capacity,FEF25%)、FEF50% 和最大呼气中段流量(maximum mid-expiratory flow, MMEF)都呈正相关(P<0.05)，与FEV1/FVC 呈负相关(P<0.01)。男性FFMI 与FEF75% 正相关(P<0.05)，女性FFMI 与FEF75% 不相关。男性FMI 与FEV1、FEV1/FVC、PEF、FEF25%、FEF50%、FEF75% 和MMEF 呈负相关(P<0.05)，而与FVC 不相关。女性FMI 与肺通气功能的指标均不相关。除男性FEV1/FVC 和FEF75% 外，无论性别，FFMI 对肺通气功能指标的预测作用大于FMI。FFMI 对男性肺通气功能预测作用大于女性。男性肺功能突增发生在12~15 岁：FVC 较前一个年龄段分别增加10.05%、20.41%、11.75% 和9.00%，FEV1 分别较前一年龄段增加11.38%、20.07%、12.01% 和9.14%。女性肺功能突增发生在12、13 和18 岁：FVC较前一年龄段分别增加13.73%、9.07% 和9.76%，FEV1 较前一年龄段分别增加13.17%、11.12% 和10.62%。在肺功能突增期，无论性别，FFMI 对肺功能的预测作用大于年龄的预测作用。综上所述，无论性别，反映骨骼肌力的FFM 与肺通气功能呈正相关，对男性肺通气功能的预测作用大于女性。FM 与男性肺通气功能呈负相关，而与女性肺通气功能不相关。在肺功能突增期，身高和FFM 的快速增长可能是造成肺功能快速增长的主要原因。

关键词： 儿童; 青少年; 身体成分; 用力呼气流量; 用力肺活量; 生长突增

分类号：R33 2

[Relation between fat mass, fat free mass and ventilatory function in children and adolescents.] [Ariticle in Chinese]

WANG Dan-Yang, FENG Kui, CHEN Li, ZU Shu-Yu, HAN Shao-Mei, ZHU Guang-Jin

Department of Physiology and Pathophysiology； Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China

Abstract

The aim of the present study was to evaluate the relation between fat mass (FM), fat free mass (FFM) and ventilatoryfunction in children and adolescents. 1 174 healthy children and adolescents (583 males and 591 females) aged 10-18 years were selectedfrom Heilongjiang Province through random sampling by means of questionnaire and physical examination, and measured for height,weight, waist to hip ratio (WHR), FM, FFM and ventilatory function. The data were analyzed by means of independent-samples t test,Pearson correlation analysis and multi-factors regression analysis. Regardless of sex, an independent positive correlation was found(P<0.001) between age and FFM index (FFMI). FM index (FMI) correlated negatively with age in males (P<0.001), but positively with age in females (P<0.001). Regardless of sex, FFMI correlated positively with forced vital capacity (FVC), forced expiratoryvolume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow at 25% of forced vital capacity (FEF25%), FEF50%,and maximal mid-expiratory flow (MMEF) (P<0.05), while negatively with FEV1/FVC (P<0.01). FFMI was correlated positivelywith FEF75% in males (P<0.05), but not correlated in females. In males, FMI correlated negatively with FEV1, FEV1/FVC, PEF,FEF25%, FEF50%, FEF75% and MMEF (P<0.05), but not correlated with FVC. No correlation was found between the ventilatoryfunction indices and FMI in females. Except FEV1/FVC and FEF75% in males, the effect of FFMI in predicting ventilatory functionwas higher than FMI regardless of sex. Moreover, the predicting effect of FFMI was higher in males than that in females. Growth spurtof lung function occurred in the ages of 12-15 years in males, while in the ages of 12, 13 and 18 years in females. During the period ofgrowth spurt of lung function, regardless of sex, the effect of FFMI in predicting the lung function was higher than that of age. Inconclusion, regardless of sex, FFMI correlates positively with ventilatory function, as a reflection of muscle mass. The effect of FFMin predicting ventilatory function is higher in males than that in females. FM correlates negatively with ventilatory function in males,but not in females. The rapid growth of height and FFM are possibly the main reasons for growth spurt of lung function.

Key words: child; adolescent; body composition; forced expiratory flow rates; forced vital capacity; growth spurt

收稿日期：2010-06-07　　录用日期：2010-08-13

通讯作者：冯逵　　E-mail: fengkui@sina.com

引用本文：

王丹阳, 冯逵, 陈莉, 祖淑玉, 韩少梅, 朱广瑾. 儿童青少年脂肪体重、去脂体重和肺通气功能的关系[J]. 生理学报 2010; 62 (5): 455-464.

WANG Dan-Yang, FENG Kui, CHEN Li, ZU Shu-Yu, HAN Shao-Mei, ZHU Guang-Jin. [Relation between fat mass, fat free mass and ventilatory function in children and adolescents.] [Ariticle in Chinese] . Acta Physiol Sin 2010; 62 (5): 455-464 (in Chinese with English abstract).