Relationship between neck circumference and hypertension of primary and middle school students: a Meta-analysis
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摘要:
目的 系统评估中小学生颈围与高血压患病风险之间的关系，为学校开展高血压预防与健康宣教提供依据。 方法 计算机检索Web of science、PubMed、Scopus、CNKI和Wan Fang数据库，检索时限为建库至2019年12月。2位研究员独立筛选文献，提取资料与质量评价后，应用Stata 14.0软件进行Meta分析。 结果 共纳入8篇文献，包含20 475例研究对象。Meta分析结果显示，高颈围值人群与正常人群相比，高血压患病风险增加35%(OR=1.35，95%CI=1.20~1.51，P < 0.01)。亚组分析结果显示，肥胖中小学生颈围与高血压患病的相关性是正常体重者的1.41倍(OR=1.41，95%CI=1.23~1.61，P < 0.01)；欧美洲地区中小学生颈围与高血压患病风险的相关性较亚洲地区更为显著(OR=1.31，95%CI=1.11~1.53，P=0.01)；颈围平均值>28.5 cm时(OR=1.29，95%CI=1.02~1.64，P=0.03)，与高血压患病有关。 结论 中小学生颈围与高血压患病风险有关，特别是在肥胖人群。应加强对中小学生高颈围值群体血压监测和开展健康教育工作，预防高血压发生。 Abstract:Objective To systematically evaluate the relationship between neck circumference and hypertension of primary and secondary school students. Methods Web of science, PubMed, Scopus, CNKI and WanFang databases were searched by computer, and the retrieval time was from inception to December 2019. Two researchers independently screened the literature, extracted the data and evaluated the quality, and then performed Meta-analysis using Stata 14.0 software. Results A total of 8 studies were included, including 20 475 subjects. Meta-analysis results showed that the risk of hypertension increased by 35% in people with a high neck circumference compared with the normal population(OR=1.35, 95%CI=1.20-1.51, P < 0.01). The results of subgroup analysis showed that the correlation between neck circumference and hypertension of obese primary and secondary school students was 1.41 times higher than that of normal weight students(OR=1.41, 95%CI=1.23-1.61, P < 0.01). The correlation between the neck circumference and the risk of hypertension of primary and secondary school students in Europe and America was more significant than that in Asia(OR=1.31, 95%CI=1.11-1.53, P=0.01). When the mean value of neck circumference was greater than 28.5 cm(OR=1.29, 95%CI=1.02-1.64, P=0.03), it was associated with the incidence of hypertension. Conclusion The neck circumference of primary and middle school students is related to the risk of hypertension, especially in obese people. Blood pressure monitoring and health education should be strengthened to prevent hypertension. -
Key words:
- Neck /
- Hypertension /
- Meta-analysis /
- Students
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图 2 中小学生颈围与高血压患病风险的Meta分析
注：a为超重，b为肥胖。
Figure 2. Meta-analysis of neck circumference and risk of hypertension
图 3 BMI分层下中小学生颈围与高血压患病风险的Meta分析
Figure 3. Meta-analysis of neck circumference and hypertension in BMI stratification
图 4 不同地区中小学生颈围与高血压患病风险的Meta分析
Figure 4. Meta-analysis of neck circumference and hypertension in different regions
图 5 不同颈围平均值中小学生颈围与高血压患病风险的Meta分析
Figure 5. Meta-analysis of neck circumference and hypertension in different mean values
表 1 纳入研究文献基本特征及NOS评分
Table 1. Basic characteristics and NOS scores of included literature
第一作者与年份 地区 例数(男/女) 年龄/岁 研究方法 颈围平均值/cm BMI分层 校正因素 NOS评分 Liao 2008[15] 亚洲 2 847(1 475/1 372) 7 横断面研究 男童：27.32，女童：25.69 正常 未校正 8 Choy 2011[16] 亚洲 2 253(1 174/1 079) 7 横断面研究 男童：26.98，女童：25.88 正常/超重/肥胖 性别 9 Guo 2012[17] 亚洲 6 802(3 631/3 171) 5~18 横断面研究 正常体重：30.25，超重：30.65，肥 正常/超重/肥胖 年龄、性别、BMI、腰围 10 胖：32.00 Nafiu 2014[18] 欧美洲 1 058(561/497) 6~18 前瞻性研究 正常体重：31.45，超重：32.70，肥 正常 年龄、性别、身高、BMI、腰围、锥削指数 9 胖：33.80 Kuciene 2015[19] 欧美洲 1 947(962/985) 12~15 病例对照研究 男童：33.20，女童：31.20 正常 年龄、性别 10 Ferretti 2015[20] 欧美洲 1 668(752/916) 10~17 横断面研究 男童：31.80，女童：35.60 正常 性别、体重、臂围、腿围、体脂百分比 10 Kelishadi 2017[21] 亚洲 3 843(2 013/1 830) 7~18 横断面研究 男童：30.18，女童：29.50 正常 年龄、性别、居住环境、活动时间、社会地位 10 李新2017[22] 亚洲 57(25/32) 13~17 横断面研究 男童：39.54，女童：36.45 肥胖 年龄、性别、心肺耐力 9 
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