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身高增长与超重肥胖联合作用对儿童血压的影响

高迪 李艳辉 董彦会 王西婕 杨招庚 宋逸 马军

高迪, 李艳辉, 董彦会, 王西婕, 杨招庚, 宋逸, 马军. 身高增长与超重肥胖联合作用对儿童血压的影响[J]. 中国学校卫生, 2021, 42(4): 515-518, 523. doi: 10.16835/j.cnki.1000-9817.2021.04.009
引用本文: 高迪, 李艳辉, 董彦会, 王西婕, 杨招庚, 宋逸, 马军. 身高增长与超重肥胖联合作用对儿童血压的影响[J]. 中国学校卫生, 2021, 42(4): 515-518, 523. doi: 10.16835/j.cnki.1000-9817.2021.04.009
GAO Di, LI Yanhui, DONG Yanhui, WANG Xijie, YANG Zhaogeng, SONG Yi, MA Jun. Combined effect of height growth and overweight/obesity on blood pressure in children[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(4): 515-518, 523. doi: 10.16835/j.cnki.1000-9817.2021.04.009
Citation: GAO Di, LI Yanhui, DONG Yanhui, WANG Xijie, YANG Zhaogeng, SONG Yi, MA Jun. Combined effect of height growth and overweight/obesity on blood pressure in children[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2021, 42(4): 515-518, 523. doi: 10.16835/j.cnki.1000-9817.2021.04.009

身高增长与超重肥胖联合作用对儿童血压的影响

doi: 10.16835/j.cnki.1000-9817.2021.04.009
基金项目: 

国家自然科学基金项目 81673192

详细信息
    作者简介:

    高迪(1993-),女,吉林省人,在读博士,主要研究方向为儿童青少年生长发育及影响因素

    通讯作者:

    宋逸,E-mail:songyi@bjmu.edu.cn

  • 中图分类号: R  723.14  R  544.1  R  179

Combined effect of height growth and overweight/obesity on blood pressure in children

  • 摘要:   目的  分析不同身高增长幅度与超重肥胖联合作用对儿童新发血压偏高的影响,为探索防控儿童血压偏高的策略提供科学依据。  方法  基于厦门市青春期发育队列研究,采用整群抽样方法,选取2017年基线和2019年随访时身高、体重和血压数据完整的1 313名小学生作为研究对象。采用多因素Logistic回归模型分析不同身高增长幅度与超重肥胖的联合作用对儿童血压偏高的影响。  结果  1 313名小学生基线时(2017年)血压偏高检出率为25.2%;随访2年后,未发生血压偏高的人群中有19.7%的儿童新发了血压偏高,男生血压偏高新发率为23.4%,女生为16.6%。多因素Logistic回归模型分析显示,在调整年龄、性别、高血压家族史、睡眠时间、水果、蔬菜、含糖饮料及肉制品摄入情况后,总体及男生身高增长高水平超重肥胖组血压偏高新发的风险高于身高增长低水平非超重肥胖组(总体:RR=2.41,95%CI=1.44~4.04;男生:RR=2.69,95%CI=1.45~5.02);女生身高增长低水平联合超重肥胖组血压偏高检出率也显著增加(RR=4.47,95%CI=1.45~13.75)。  结论  身高增长幅度较高和超重肥胖是儿童血压偏高发病的影响因素,尤其是在男生中。在青春期身高突增前对儿童进行肥胖的预防和干预可能有益于降低儿童期高血压的发生。
  • 表  1  研究对象基线及随访时基本特征性别间比较(x ±s)

    Table  1.   Characteristics of the studied children at baseline and during the follow-up period (x ±s)

    变量 男生
    (n=642)
    女生
    (n=671)
    合计
    (n=1 313)
    t/Z P
    基线(2017年)
        年龄/岁 8.6±0.6 7.6±0.6 8.1±0.8 29.30 < 0.01
        身高/cm 136.5±6.3 128.5±5.6 132.4±7.2 24.34 < 0.01
        体重/kg 33.7±8.4 25.2±4.4 29.4±7.9 22.83 < 0.01
        BMI/(kg·m-2) 18.0±3.5 15.2±2.0 16.6±3.2 17.28 < 0.01
        SBP/mm Hg 109.0±9.9 101.8±9.1 105.3±10.1 13.70 < 0.01
        DBP/mm Hg 59.9±6.9 58.0±6.5 58.9±6.8 5.04 < 0.01
    随访(2019年)
        年龄/岁 10.7±0.7 9.7±0.6 10.2±0.8 27.68 < 0.01
        身高/cm 148.5±7.4 141.8±6.7 145.1±7.8 17.12 < 0.01
        体重/kg 42.5±10.6 32.3±6.4 37.3±10.1 21.18 < 0.01
        BMI/(kg·m-2) 19.1±3.5 15.9±2.3 17.5±3.4 19.11 < 0.01
        SBP/mm Hg 112.3±9.9 106.7±9.0 109.5±9.8 10.77 < 0.01
        DBP/mm Hg 62.2±6.5 61.7±6.4 62.0±6.5 1.60 0.11
        睡眠时间/h* 8.3(0.8) 8.5(1.0) 8.5(1.0) -5.20 < 0.01
        每天水果摄入/份* 1.0(1.3) 1.0(1.1) 1.0(1.3) -0.12 0.90
        每天蔬菜摄入/份* 1.7(1.0) 2.0(1.6) 1.7(1.5) 0.30 0.77
        每天含糖饮料摄入/份* 0.1(0.3) 0.0(0.1) 0.1(0.2) 4.25 < 0.01
        每天肉制品摄入/份* 1.1(1.0) 1.0(1.0) 1.0(1.1) 7.11 < 0.01
    注:1 mm Hg=0.133 kPa,*为M(Q)。
    下载: 导出CSV

    表  2  2017—2019年不同人群血压偏高新发率性别间比较

    Table  2.   The incidence of elevated blood pressure in different groups between boys and girls during 2017-2019

    组别 统计值 男生 女生 合计
    人数 血压偏高新发人数 人数 血压偏高新发人数 人数 血压偏高新发人数
    基线超重肥胖
    超重肥胖 132 39(29.5) 36 12(33.3) 168 51(30.4)
    非超重肥胖 309 64(20.7) 505 78(15.4) 814 142(17.4)
    χ2 4.03 7.75 14.70
    P 0.05 0.01 < 0.01
    身高增长幅度
    低水平 234 44(18.8) 278 44(15.8) 512 88(17.2)
    高水平 207 59(28.5) 263 46(17.5) 470 105(22.3)
    χ2 5.77 0.27 4.12
    P 0.02 0.60 0.04
    总计 441 103(23.4) 541 90(16.6) 982 193(19.7)
    注: ()内数字为新发病率/%。
    下载: 导出CSV

    表  3  基线时不同身高突增幅度肥胖状态对不同性别被试血压偏高新发风险的影响

    Table  3.   Effect of different height increment and overweight/obesity group at baseline on the incidence of elevated blood pressure Sin different sexes

    模型 组别 男生(n=642) 女生(n=671) 合计(n=1 313)
    RR值(RR值95%CI) P RR值(RR值95%CI) P RR值(RR值95%CI) P
    模型1 B 1.63(0.93~2.85) 0.09 1.16(0.72~1.88) 0.54 1.29(0.90~1.85) 0.17
    C 1.51(0.68~3.37) 0.32 3.54(1.21~10.3) 0.02 2.08(1.11~3.90) 0.02
    D 2.19(1.23~3.89) 0.01 2.53(0.91~6.98) 0.07 2.45(1.53~3.93) < 0.01
    模型2 B 1.66(0.95~2.90) 0.08 1.16(0.71~1.88) 0.56 1.33(0.92~1.91) 0.13
    C 1.56(0.69~3.50) 0.29 3.39(1.16~9.92) 0.03 1.91(1.00~3.63) 0.05
    D 2.21(1.24~3.94) 0.01 2.44(0.88~6.78) 0.09 2.21(1.35~3.61) 0.00
    模型3 B 1.93(1.07~3.49) 0.03 1.08(0.65~1.80) 0.76 1.32(0.90~1.94) 0.15
    C 1.33(0.54~3.25) 0.53 4.47(1.45~13.75) 0.01 1.86(0.94~3.68) 0.08
    D 2.69(1.45~5.02) 0.00 2.15(0.70~6.66) 0.18 2.41(1.44~4.04) < 0.01
    注: B组为身高增长高水平非超重肥胖组;C组为身高增长低水平超重肥胖组;D组为身高增长高水平超重肥胖组。模型1未做调整;模型2调整年龄、性别、高血压家族史,性别仅在总体中进行了调整;模型3在模型2的基础上调整睡眠时间,水果、蔬菜、含糖饮料及肉制品摄入情况;各模型中均以身高增长低水平非超重肥胖组为参照组。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-12-23
  • 修回日期:  2021-02-23
  • 网络出版日期:  2021-04-16
  • 刊出日期:  2021-04-25

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