1.The association between uric acid levels and cardiovascular metabolic disorders and non - alcohol fatty liver disease among obese children
Yinkun YAN ; Dongqing HOU ; Jiali DUAN ; Ying SUN ; Hong CHENG ; Xiaoyuan ZHAO ; Guimin HUANG ; Wenqing DING ; Qin LIU ; Jie MI
Chinese Journal of Applied Clinical Pediatrics 2015;(13):1000-1003
Objective To observe the prevalence of hyperuricemia(HUA)among obese children,and to ex-plore the association between uric acid(UA)levels and cardiometabolic risk factors,acanthosis nigricans and non - al-cohol fatty liver disease(NAFLD). Methods By using representative sampling method,1 753 obese children aged 6 -17 years old from 18 schools in 3 districts of Beijing(Xicheng,Haidian,Miyun)were selected to participate in the clini-cal examinations,including anthropometric measurements(height,weight)and blood pressure. Serum biochemical pa-rameters were assessed,including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high - densi-ty lipoprotein cholesterol(HDL - C),low - density lipoprotein cholesterol(LDL - C)and UA. Acanthosis nigricans and B - model ultrasonography of the liver were conducted. Results The prevalence of hypertension,impaired fasting glu-cose,dyslipidemia,acanthosis nigricans,and NAFLD among these 1 753 obese children was 33. 6%(589 cases), 66. 5%(1 156 cases),54. 3%(943 cases),23. 3%(408 cases),and 17. 0%(298 cases),respectively. The preva-lence of HUA was 40. 70%(714 / 1 753 cases),with 50. 17%(581 / 1 158 cases)in boys and 22. 34%(133 / 595 ca-ses)in girls. There was a significant increase in body mass index,systolic blood pressure,diastolic blood pressure, FPG,TG and LDL - C with the increase of UA,but there was a decrease in HLD - C with the increase of UA(all P ﹤0. 05). In boys,the adjusted odds ratios( OR)and 95% CI of the highest quartile of UA for hypertension,impaired fasting glucose,dyslipidemia,acanthosis nigricans,and NAFLD were 1. 16(0. 77 - 1. 74),1. 34(0. 90 - 1. 99),1. 29 (0. 89 - 1. 87),1. 89(1. 17 - 3. 04),and 1. 71(1. 03 - 2. 84),respectively;in girls,the adjusted OR and 95% CI of the highest quartile of UA for hypertension,impaired fas-ting glucose,dyslipidemia,acanthosis nigricans,and NAFLD was 0. 70(0. 40 - 1. 24),0. 60(0. 40 - 1. 00),1. 69(1. 04 - 2. 70),1. 67(0. 80 - 3. 49),and 1. 33(0. 48 - 3. 66),re-spectively. Conclusions The prevalence of HUA is relatively high in obese children and there is a strong association between UA and some car-diovascular metabolic disorders,acanthosis nigricans and NAFLD.
2. Influence of change in blood pressure status from childhood to adulthood on renal dysfunction: a cohort study
Yinkun YAN ; Dongqing HOU ; Junting LIU ; Hong CHENG ; Xiaoyuan ZHAO ; Jie MI
Chinese Journal of Preventive Medicine 2018;52(11):1140-1145
Objective:
To investigate the influence of change in blood pressure status from childhood to adulthood on renal damage.
Methods:
Data were obtained from Beijing Blood Pressure Cohort initiated from 1987. 3 198 children and adolescents aged 6-18 years from 6 primary and 6 middle schools in Chaoyang, Xicheng and Haidian Districts of Beijing were enrolled at baseline by using a cluster random sampling method, and 1 222 participants were followed up during 2010-2012. The measurements included weight, height, and blood pressure at baseline and microalbumin, serum creatinine, cystatin C and blood pressure at follow-up. Based on blood pressure status in childhood and adulthood, the participants were divided into four groups: participants with normal blood pressure in both childhood and adulthood, participants with elevated blood pressure in childhood but normal blood pressure in adulthood, participants with normal blood pressure in childhood but elevated blood pressure in adulthood, and participants with elevated blood pressure in both childhood and adulthood. Multivariate linear regression model was used to investigate the association of change in blood pressure from childhood to adulthood on renal dysfunction.
Results:
The prevalence of elevated blood pressure in childhood and adulthood was 17.9% and 39.9%, respectively. The
3. Effect of genetic polymorphisms on change in body mass index and obesity status during childhood
Meixian ZHANG ; Hong CHENG ; Xiaoyuan ZHAO ; Lijun WU ; Yinkun YAN ; Jie MI
Chinese Journal of Preventive Medicine 2017;51(7):635-641
Objective:
The present study aimed to prospectively validate whether the single nucleotide polymorphisms (SNPs) in obesity-related genes were associated with change in body mass index (BMI) and obesity status during childhood.
Methods:
Based on the Beijing Child and Adolescent Metabolic Syndrome study (BCAMS), which was initiated between April and October in 2004, we conducted a follow-up study among 1 624 children aged 6 to 11 years old with genetic data in December 2010. A total of 777 children (246 obese and 531 non-obese) were reassessed for BMI.
4.Change in the prevalence of obesity phenotypes and cardiometabolic disorders among children aged 6- 17 in Beijing during 2004- 2013.
Yinkun YAN ; Hong CHENG ; Xiaoyuan ZHAO ; Junting LIU ; Dongqing HOU ; Zhongjian SU ; Guimin HUANG ; Wenqing DING ; Qin LIU ; Jie MI
Chinese Journal of Preventive Medicine 2016;50(1):34-39
OBJECTIVETo examine the prevalence of obesity phenotypes and cardiometablic disorders (CDs) among children aged 6- 17 in Beijing from 2004 to 2013.
METHODSData were obtained from two cross-section surveys, which were conducted in 2004 and 2013. In 2004, by using stratified cluster sampling design, 20 primary or middle schools were selected from 7 districts (Xicheng, Dongcheng, Chaoyang, Haidian, Daxing, Pinggu, and Yanqing) in Beijing, and 20 554 school children aged 6-17 were recruited, with weight, height, waist circumference and blood pressure measured. Fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were measured in 962 subjects from one school. In 2013, by using the same sampling design, 7 211 students from two districts (Haidian and Dongcheng) were surveyed with weight, height, waist circumference and blood pressure measured, and fasting plasma glucose and lipid profile (TC, TG, HDL-C, LDL-C) were measured for 1 344 subjects in the same school measured in 2004. Student's-t test was used to analyze the difference in body mass index(BMI), WC, and waist to height ratio (WHtR) among children between 2004 and 2010. Chi-square test was used to analyze the difference of hypertension, impaired fasting glucose(IFG), dyslipidemia, and metabolic disorders clustering between 2004 and 2010, and among different types of obesity; logistic regression model was used to analyze the association between three types of obesity and risks of cardiovascular metabolic disorders.
RESULTSIn boys, BMI ((20.3 ± 4.4) vs (19.4 ± 4.2) kg/m(2), t=11.18, P<0.001), WC ((70.6 ± 12.8) vs (66.7 ± 11.8) cm, t=17.20, P<0.001) and WHtR (0.451 ± 0.064 vs 0.437 ± 0.059, t=11.64, P<0.001) were significantly higher in 2013 than those in 2004. Similarly in girls, BMI ((18.9 ± 3.6) vs (18.7 ± 3.7) kg/m(2), t=12.21, P<0.001), WC ((64.5 ± 9.6) vs (63.0 ± 9.3) cm, t=8.15, P<0.001) and WHtR (0.430 ± 0.047 vs 0.423 ± 0.047, t=14.13, P<0.001) were also significantly higher in 2013 than those in 2004. The prevalence of combined obesity rose from 8.27% (1 697/20 526) in 2004 to 10.74% (774/7 209) in 2013, and central obesity from 3.08% (632/20 526) to 4.44% (320/7 209). The prevalence of hypertension (10.78%(313/1 344) vs 4.29% (42/962), χ(2)=36.76, P<0.001), IFG(49.54%(664/1 344) vs 6.45%(63/962), χ(2)=506.61, P<0.001), high TC(11.53%(155/1 344) vs 5.03%(49/962), χ(2)=28.31, P< 0.001), high TG(7.51%(101/1 344) vs 3.59%(35/962), χ(2)=29.59, P<0.001) were significantly higher in 2013 than those in 2004. Subjects with combined obesity had higher risks of hypertension (OR=5.88, 95% CI: 4.42-7.82), high TG (OR=7.12, 95%CI: 4.35-11.64), low HDL-C (OR=3.04, 95%CI: 1.55-5.95), high LDL-C (OR=2.27, 95% CI: 1.22-4.02), CDs≥2 (OR=3.07, 95% CI: 2.09-4.50), comparing to children without obesity.
CONCLUSIONThe prevalence of types of obesity and obesity-related metabolic disorders, except for low HDL-C and high HDL-C, were significantly higher in 2013 than those 2004 among chlildren aged 6-17 year in Beijing. Children with combined obesity had higher prevalence of metabolic disorders.
Adolescent ; Beijing ; Blood Glucose ; analysis ; Blood Pressure ; Body Mass Index ; Body Weight ; Cardiovascular Diseases ; epidemiology ; Child ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Cross-Sectional Studies ; Dyslipidemias ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; Lipids ; blood ; Logistic Models ; Male ; Obesity, Abdominal ; epidemiology ; Pediatric Obesity ; epidemiology ; Phenotype ; Prevalence ; Triglycerides ; blood ; Waist Circumference
5.Effect of childhood adiposity on long-term risks of carotid atherosclerosis and arterial stiffness in adulthood.
Yinkun YAN ; Dongqing HOU ; Junting LIU ; Xiaoyuan ZHAO ; Hong CHENG ; Ping YANG ; Xinying SHAN ; Jie MI
Chinese Journal of Preventive Medicine 2016;50(1):28-33
OBJECTIVETo observe the effect of childhood excessive adiposity on long-term risk of adult carotid atherosclerosis and arterial stiffness.
METHODSAt baseline, in 1987, by using stratified cluster sampling design, 3 198 healthy children aged 6-18 were recruited from six primary schools and six middle schools from three districts (Chaoyang, Xicheng, and Haidian) in Beijing, with blood pressure, weight, height and left scapular skinfold thickness (LSSF) measured. From April 2010 to July 2012, 1 225 subjects were followed from childhood to adulthood. Questionnaire, biochemistry parameters, carotid-femoral pulse wave velocity (cfPWV), and carotid intima media thickness (cIMT) were measured at follow-up. Based on weight statuses in childhood and adulthood, subjects were classified into four groups (persistent non-overweight from childhood to adulthood, overweight in childhood but non-overweight in adulthood, non-overweight in childhood but overweight in adulthood, persistent overweight from childhood to adulthood). Multiple logistic regression model was used to analyze the association between weight statuses changing from childhood to adulthood and adult high cfPWV and high cIMT.
RESULTSThe prevalence of overweight (including obesity) at adulthood was 52.2% (639). Males had higher prevalence of smoking (62.5%(422/675) vs 29.4%(160/550), χ(2)=133.21, P<0.001), drinking (52.1%(353/675) vs 26.1%(140/550), χ(2)=87.13, P<0.001), overweight (including obesity) (69.3% (468/675) vs 31.1% (171/550), χ(2)=182.18, P< 0.001) than females. With adjusting for gender, age, and length of follow-up, the risk of high cfPWV and high cIMT increased by 26% and 58% for 1 units increase in BMI, and by 30% and 36% for 1 units increase in LSSF. Compared to subjects with persistent non-overweight from childhood to adulthood, subjects with overweight in childhood but non-overweight in adulthood had similar risks of high cfPWV (OR=1.59, 95%CI: 0.77-3.30)and high cIMT (OR=1.47, 95%CI:0.65-3.31). The risks of high cfPWV and high cIMT increased among subjects with non-overweight in childhood but overweight in adulthood (OR=1.92, 95%CI:1.37-2.68; OR=3.69, 95% CI:2.61- 5.23) and among subjects with persistent overweight from childhood to adulthood (OR=2.53, 95%CI:1.70-3.76; OR=5.37, 95%CI:3.62-7.97).
CONCLUSIONSWe concluded that a overweight children changed to a healthy weight adult, the risks of adult subclinical atherosclerosis and arterial stiffness would not be increased.
Adiposity ; Adolescent ; Adult ; Atherosclerosis ; epidemiology ; Beijing ; Blood Pressure ; Body Mass Index ; Carotid Artery Diseases ; epidemiology ; Carotid Intima-Media Thickness ; Child ; Female ; Humans ; Male ; Overweight ; epidemiology ; Pediatric Obesity ; epidemiology ; Pulse Wave Analysis ; Risk Factors ; Vascular Stiffness
6.Association of childhood and adolescents obesity with adult diabetes.
Dongqing HOU ; Xiaoyuan ZHAO ; Junting LIU ; Fangfang CHEN ; Yinkun YAN ; Hong CHENG ; Ping YANG ; Xinying SHAN ; Jie MI
Chinese Journal of Preventive Medicine 2016;50(1):23-27
OBJECTIVETo investigate the correlation between obesity in children and diabetes in adults from a cohort study, and further more to explore the necessity of preventing diabetes by controlling obesity in children.
METHODSIn 1987, 3 198 children and adolescents aged 6-18 were recruited from 6 elementary schools and 6 high schools located in 3 districts (Chaoyang, Haidian, and Xicheng) of Beijing using stratified cluster sampling design. The physical examination process included physical development test, blood pressure measurement, and questionnaire investigation. All children were invited to participate in the study, except for those who had history of congenital heart disease, chronic kidney disease, and limb disability. A total of 1,225 adults were enrolled in a prospective follow-up study from March 2010 to July 2012, anthropometric measures and blood sample were obtained. The obesity was defined by the following criteria: for children aged 6, the age-and the gender-specific 95th percentile of BMI from the US Centre for Disease Control and Prevention Growth charts 2000 as the baseline; for children age 7-18, recommendation from Working Group on Obesity in China (WGOC) as the standard; for adults, BMI≥28 kg/m(2) as the diagnosis standard. Diabetes was defined based on fasting plasma glucose(FPG) ≥7.0 mmol/L or 2 hours postprandial blood glucose (2 h PG) ≥11.1 mmol/L or glycosylated hemoglobin (HbA1c) ≥6.5% or current using blood glucose-lowering agents or current using insulin. Logistic regression was used to analyze the association obesity in children with diabetes in adults.
RESULTSThe prevalence of diabetes diagnosed by FPG and 2 h PG in adults who were obese children (16.2%, 18/111) was higher than those who were non-obese children (5.6%, 62/1,114)(χ(2)=18.76, P<0.001). The prevalence of diabetes diagnosed by HbA1c in adults who were obese children(18.1%,20/111) was higher than those who were non-obese children (6.9%, 77/1,114) (χ(2)=16.66, P<0.001). With multi-factor logistic regression analysis, we found that after controlling follow-up age, genders and lifestyle (smoking, alcohol consuming, dietary, and sleeping), in comparison with those non-obese from childhood to adulthood, those obese only in childhood or only in adulthood did not predict any risk of diabetes diagnosed by blood glucose in adults (OR(95%CI) were 1.90 (0.86-4.19), 1.71(0.50-5.79), respectively). Those obese both in childhood and in adulthood increased the risk of diabetes diagnosed by blood glucose in adults (OR(95%CI) was 4.50(2.22-9.14)). With multi-factor logistic regression analysis, we found that after controlling age, sex and lifestyle (smoking, alcohol consuming, dietary, and sleeping) in comparison with those non-obese from childhood to adulthood, those obese only in childhood or only in adulthood did not increase the risk of diabetes diagnosed by HbA1c in adults (OR(95%CI) were 1.42(0.71-2.86), 3.13(0.83-11.75), respectively). Those obese both in childhood and in adulthood increased the risk of diabetes diagnosed by HbA1c in adults (OR(95%CI) was 5.93(3.06- 11.49)).
CONCLUSIONObesity in children even sustained to adulthood was a risk factor for diabetes in adulthood. It is necessary to control obesity in children to prevent diabetes in adults.
Adolescent ; Adult ; Beijing ; Blood Glucose ; analysis ; Child ; Diabetes Mellitus ; epidemiology ; Diet ; Follow-Up Studies ; Humans ; Insulin ; therapeutic use ; Life Style ; Pediatric Obesity ; epidemiology ; Prevalence ; Prospective Studies ; Risk Factors
7.Joint effect of birth weight and obesity measures on abnormal glucose metabolism at adulthood.
Bo XI ; Hong CHENG ; Fangfang CHEN ; Xiaoyuan ZHAO ; Jie MI
Chinese Journal of Preventive Medicine 2016;50(1):17-22
OBJECTIVETo investigate the joint effect of birth weight and each of obesity measures (body mass index (BMI) and waist circumference (WC)) on abnormal glucose metabolism (including diabetes) at adulthood.
METHODSUsing the historical cohort study design and the convenience sampling method, 1 921 infants who were born in Beijing Union Medical College Hospital from June 1948 to December 1954 were selected to do the follow-up in 1995 and 2001 respectively. Through Beijing Household Registration and Management System, they were invited to participate in this study. A total of 972 subjects (627 were followed up in 1995 and 345 were followed up in 2001) with complete information on genders, age, birth weight, family history of diabetes, BMI, WC, fasting plasma glucose (FPG) and 2-hour plasma glucose (2 h PG) met the study inclusion criteria at the follow-up visits. In the data analysis, they were divided into low, normal, and high birth weight, respectively. The ANOVA and Chi-squared tests were used to compare the differences in their characteristics by birth weight group. In addition, multiple binary Logistic regression model was used to investigate the single effect of birth weight, BMI, and waist circumference on abnormal glucose metabolism at adulthood. Stratification analysis was used to investigate the joint effect of birth weight and each of obesity measures (BMI and WC) on abnormal glucose metabolism.
RESULTSThere were 972 subjects (males: 50.7%, mean age: (46.0±2.2) years) included in the final data analysis. The 2 h PG in low birth weight group was (7.6±3.2) mmol/L , which was higher than that in normal birth weight group (6.9±2.1) mmol/L and high birth weight group (6.4±1.3) mmol/L (F=3.88, P=0.021). After adjustment for genders, age, body length, gestation age, family history of diabetes, physical activity, smoking and alcohol consumption, and duration of follow-up, subjects with overweight and obesity at adulthood had 2.73 (95% confidence interval (CI) =2.06- 3.62) times risk to develop abnormal glucose metabolism when compared with norm weight ones. Likewise, subjects with central obesity were more likely to develop abnormal glucose metabolism than ones with normal waist (odds ratio (OR)=3.35, 95%CI=2.49-4.50). In addition, compared to subjects with normal birth weight and normal BMI at adulthood, ones with normal birth weight and overweight (including obesity) at adulthood were more likely to have abnormal glucose metabolism (OR= 2.60, 95%CI=1.94-3.49); subjects with low birth weight and overweight (including obesity) at adulthood had the highest risk for abnormal glucose metabolism (OR=4.70, 95% CI=1.84- 11.99). The attributable proportion of interaction between low birth weight and overweight (including obesity) at adulthood was 48.5%. In addition, compared to subjects with normal birth weight and normal WC at adulthood, one with normal birth weight and central obesity at adulthood were more likely to have abnormal glucose metabolism (OR=3.18, 95% CI=2.33- 4.32); subjects with low birth weight and central obesity at adulthood had the highest risk for abnormal glucose metabolism (OR=4.78, 95% CI=2.01- 11.38); subjects with high birth weight and central at adulthood also had high risk for abnormal glucose metabolism (OR=4.35, 95%CI=1.38- 13.65). We found that the attributable proportion of interaction between low birth weight and central obesity at adulthood was 38.5% , and was 28.3% for interaction between high weight and central obesity.
CONCLUSIONThere was strong interaction effect between birth weight and overweight (especially central obesity) at adulthood on abnormal glucose metabolism at adulthood. Effective measures should be adopted to prevent and control adult obesity in order to offset the adverse effect of birth weight on long-term health risk.
Adult ; Birth Weight ; Blood Glucose ; analysis ; Body Height ; Body Mass Index ; Cohort Studies ; Female ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Obesity ; epidemiology ; Obesity, Abdominal ; epidemiology ; Odds Ratio ; Overweight ; epidemiology ; Waist Circumference
8.Abnormal adipokines associated with various types of obesity in Chinese children and adolescents.
Meixian ZHANG ; Xiaoyuan ZHAO ; Ming LI ; Hong CHENG ; Dongqing HOU ; Yu WEN ; Cianflone KATHERINE ; Jie MI
Biomedical and Environmental Sciences 2011;24(1):12-21
OBJECTIVETo explore the role of adipokines including insulin, resistin, leptin, adiponectin, acylation stimulating protein (ASP) and complement C3 (C3) in various types of obesity (peripheral obesity, abdominal obesity and mixed obesity) in Chinese children and adolescents, and their relationships with body size and pubertal development.
METHODSChildren and adolescents (n=3 508) aged 6 to 18 years, with 1 788 boys and 1 720 girls were assessed for body mass index, waist circumference, pubertal development, blood insulin, resistin, leptin, adiponectin, ASP and C3 levels. Three types of obesity [peripheral obesity (n=43), abdominal obesity (n=473), mixed obesity (n=1 187)] and non-obese control (n=1 805) were defined with combined use of Chinese body mass index and waist circumference criteria.
RESULTSSerum resistin, leptin and adiponectin levels were higher in girls than those in boys (all P<0.01). Insulin and leptin increased and adiponectin decreased across five Tanner stages in both girls and boys (all P<0.001), while ASP changed only in girls (P<0.001) and C3 only in boys (P<0.001). Insulin, leptin and ASP were higher, but adiponectin was lower in all three types of obesity vs. the non-obese control (all P<0.05). The greatest abnormalities of all six adipokines were found in the mixed obesity group. With inclusion of body mass index and waist circumference in simultaneous regression analyses, both body size indices were independently and significantly correlated with insulin, leptin and adiponectin after age and gender adjustment. Compared with waist circumference, the body mass index was stronger in interpreting insulin, leptin, adiponectin and ASP levels, whereas it was weaker in explaining variance of plasma C3.
CONCLUSIONObese children have a worse metabolic profile with high insulin, resistin, leptin, ASP and C3, and low adiponectin levels. The adipokine profile in mixed obesity is worse than that in peripheral or abdominal obesity. Identification of obese subjects with a malignant adipokine profile using a combination of body mass index and waist circumference is important for the prevention of obesity-related disease.
Adipokines ; blood ; Adolescent ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; Obesity ; blood
9.Tyrosinase inhibition of Potentilla bifurca.
Xianglan PIAO ; Yanze TIAN ; Xiaoyuan MI ; Jian CUI
China Journal of Chinese Materia Medica 2009;34(15):1952-1954
OBJECTIVETo identify the tyrosinase inhibitory constituent quickly from Potentilla bifurca.
METHODThe active constituent was found through fraction collecting and tyrosinase inhibitory activity by bioassay-linked HPLC method.
RESULTThe methanol extracts and BuOH fraction of Potentilla bifurca showed strong tyrosinase inhibitory activities. From BuOH fraction of Potentilla bifurca, the tyrosinase inhibitory constituent was isolated and identified as flavonoid, quercetin-4'-O-beta-D-glucoside. It express stronger tyrosinase inhibition than the known tyrosinase inhibitor, kojic acid (IC50 = 0.28 mmol x L(-1)) with IC50 value of 0.001 9 mmol x L(-1).
CONCLUSIONBioassay-linked HPLC fractionation method was provided for determination the active constituents quickly from herbal medicines.
Enzyme Inhibitors ; chemistry ; isolation & purification ; Kinetics ; Peptides ; chemistry ; isolation & purification ; Plant Extracts ; chemistry ; isolation & purification ; Potentilla ; chemistry
10.Association between different types of obesity and cardiovascular risk factors in school-aged children
Junting LIU ; Xiaoyuan ZHAO ; Hong CHENG ; Dongqing HOU ; Jie MI
Chinese Journal of Epidemiology 2014;35(1):3-8
Objective The aim of this paper was to analyze the association between different types of obesity and cardiovascular risk factors (CRFs) in school-aged children.Methods 3508children aged 6-18 years old including 2 054 non-obese and 1 454 obese children were chosen as the population under study,from Beijing Children and Adolescents Metabolic Syndrome Study.Demographic data was collected through questionnaires while height,weight,waist circumference,and blood pressure were measured through physical check-up.Fasting blood glucose and blood lipids were also tested.Children were divided into four groups:without obesity,with general obesity,with abdominal obesity and with combined obesity.CRFs including dyslipidemia,impaired fasting glucose (IFG),and hypertension were scored.Multiple linear regression and logistic regression analyses were performed to assess the association between different types of obesity and CRFs.Results From non-obese children,children under general-obesity,abdominal obesity and those with combined types of obesity,there appeared an increasing trend in the levels of blood pressure,blood glucose,and blood lipids,the prevalence dyslipidemia and hypertension (P<0.001).There were no significant differences in the risks of IFG among four types of obesity.After controlling for age,sex,and puberty stage,when compared with non-obese children,those children with abdominal obesity or combined types of obesity had 1.54 and 2.51 times of risks to only one CRF,while generally obese children had similar risk of dyslipidemia.When compared to the non-obese ones,children with general obesity,abdominal obesity,or combined types of obesity showed 3.32,2.21 and 7.42 times of risks to ≥2CRFs and 3.10,3.67 and 10.75 times of risks to ≥3 CRFs.The cluster of CRFs increased with the levels of obesity (P<0.001).Conclusion Levels and cluster of CRFs were increasing along with the levels of obesity in school-aged children in Beijing.Children with combined types of obesity had the highest risk of clustering CRFs,followed by those with abdominal obesity and general obesity.