Relationship between body fat percentage and high blood pressure among junior high school students in Shanghai
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摘要:
目的 探讨上海市青春期学生体脂率与血压偏高的关联，为心血管疾病的早期预防和干预提供依据。 方法 采用多阶段分层整群抽样的方法在上海市16个区的16所学校中选取5 148名11~18岁初中生进行问卷调查和体格测量，采用生物电阻抗法(BIA)测量全身体脂率。按照中国儿童青少年血压参考标准判定血压偏高与否，采用t检验、χ2检验和Logistic回归等方法分析体脂率与血压偏高的关联。 结果 2019年上海市5 148名初中学生血压偏高检出率为10.98%，其中男生为8.99%，女生为13.13%，女生高于男生(χ2=22.48，P < 0.01)；男生全身体脂率平均为(20.90±10.73)%，随年龄增加而下降(F=10.04，P < 0.01)；女生全身体脂率平均为(25.14±8.03)%，随年龄增加而增加(F=69.23，P < 0.01)。控制年龄、饮食、运动、是否月经/遗精等影响因素后，无论男生还是女生，随着体脂率百分位的上升，血压偏高检出率呈上升趋势，体脂率≥P90的男生血压偏高的风险是体脂率＜P25男生的12.43倍(95%CI=6.98~22.14)，体脂率≥P90的女生血压偏高的风险是体脂率 < P25女生的6.12倍(95%CI=3.89~9.63)。 结论 青春期学生体脂率与血压偏高呈正相关，血压偏高检出率随体脂率百分位的上升而上升，且在男生中关联更明显。 Abstract:Objective To investigate the relationship between body fat percentage (BF%) and high blood pressure among adolescents in Shanghai, and to provide basis for early prevention and intervention of cardcovascular diseases. Methods By using stratified cluster sampling method, a total of 5 148 adolescent students in 16 schools from 16 districts of Shanghai were selected. Questionnaire survey and physical examination were performed. The bioelectrical impedance analysis (BIA) was used to measure body fat percentage. National Blood Pressure Reference for Chinese Han Children was used to define high blood pressure. And T test, chi-square test and Logistici regression were used to assess the relation between BF% with high blood pressure. Results The prevalence of high blood pressure in 5 148 junior middle school students in Shanghai was 10.98%, with girls (13.13%) higher than boys (8.99%)(χ2=22.48, P < 0.01). The average total body fat percentage of male students was (20.90±10.73)%, which decreased with age (linear trend variance is 10.04, P < 0.01). The average total body fat percentage of girls was (25.14±8.03)%, which increased with age (linear trend variance is 69.23, P < 0.01). After adjusted for age, diet, exercise and other influencing factors, the prevalence of hypertension showed an increasing trend with the increase of body fat percentage for both boys and girls. The risk of high blood pressure in boys with BF%≥P90 was 12.43 times higher than that in boys with BF% < P25(95%CI=6.98-22.14), while the risk of high blood pressure in girls with BF% ≥P90 was 6.12 times higher than that in girls with BF% < P25(95%CI=3.89-9.63). Conclusion There was a positive correlation between body fat percentage and high blood pressure in adolescents. The prevalence of high blood pressure increased with the increase of body fat percentage, which was more obvious in boys. -
Key words:
- Adiposity /
- Blood pressure /
- Regression analysis /
- Students
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表 1 上海市2019年不同组别初中生血压偏高检出率比较
Table 1. Prevalence of high blood pressure in junior middle school students in Shanghai, 2019
组别 统计值 男生 女生 合计 人数 检出人数 人数 检出人数 人数 检出人数 地区 市区 1 220 88(7.21) 1 021 126(12.34) 2 241 214(9.55) 郊区 1 460 153(10.48) 1 447 198(13.68) 2 907 351(12.07) χ2值 8.66 0.95 8.26 P值 < 0.01 0.33 < 0.01 年龄/岁 11 694 34(4.9) 634 45(7.1) 1 328 79(5.95) 12 687 53(7.71) 566 54(9.54) 1 253 107(8.54) 13 619 57(9.21) 627 99(15.79) 1 246 156(12.52) 14 585 82(14.02) 571 113(19.79) 1 156 195(16.87) 15~18 95 15(15.79) 70 13(18.57) 165 28(16.97) χ趋势2值 37.45 51.66 89.69 P值 < 0.01 < 0.01 < 0.01 BMI 消瘦 220 7(3.18) 109 1(0.92) 329 8(2.43) 正常 1 364 76(5.57) 1 742 168(9.64) 3 106 244(7.86) 超重 556 48(8.63) 338 73(21.60) 894 121(13.53) 肥胖 540 110(20.37) 279 82(29.39) 819 192(23.44) χ趋势2值 99.75 111.60 191.81 P值 < 0.01 < 0.01 < 0.01 月经/遗精 否 2 346 201(8.57) 557 40(7.18) 2 903 241(8.30) 是 323 38(11.76) 1 897 281(14.81) 2 220 319(14.37) χ2值 3.56 22.06 - P值 0.06 < 0.01 - 合计 2 680 241(8.99) 2 468 324(13.13) 5 148 565(10.98) 注： ()内数字为检出率/%。表中数据存在缺失值。 
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表 2 上海市2019年不同组别初中生体脂率比较(x±s)
Table 2. Body fat percentage in junior middle school students in Shanghai, 2019(x±s)
组别 男生 女生 人数 体脂率/% t/F值 P值 人数 体脂率/% t/F值 P值 地区 市区 1 220 21.06±10.79 0.68 0.49 1 021 24.47±7.52 -3.53 < 0.01 郊区 1 460 20.77±10.68 1 447 25.61±8.34 年龄/岁 11 694 22.71±11.18 8.95 < 0.01 634 22.34±8.11 43.04 < 0.01 12 687 20.52±10.97 566 24.34±7.64 13 619 20.84±10.49 627 25.98±7.68 14 585 19.81±9.99 571 27.61±7.53 15~18 95 17.63±9.68 70 29.14±8.33 营养状况 消瘦 220 7.91±5.11 2 394.1 < 0.01 109 14.52±4.23 977.70 < 0.01 正常 1 364 14.86±5.22 1 742 22.46±5.40 超重 556 26.30±5.25 338 31.61±4.61 肥胖 540 35.91±6.89 279 38.18±6.76 月经/遗精 否 2 346 20.85±10.78 -0.35 0.72 557 20.35±7.29 -16.99 < 0.01 是 323 21.07±10.34 1 897 26.57±7.68 合计 2 680 20.90±10.73 2 468 25.14±8.03 注：数据存在缺失项。
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表 3 不同体脂率男女生血压偏高检出率比较
Table 3. Prevalence of high blood pressure among students with different sex and different body fat rates
体脂率范围 男生 女生 人数 血压偏高率/% cOR值
(cOR值95%CI)人数 血压偏高率/% cOR值
(cOR值95%CI)＜P25 667 2.85 1.00 604 5.46 1.00 P25~＜P50 662 7.70 2.85(1.66~4.88) 624 9.13 1.74(1.12~2.71) P50~＜P75 678 9.00 3.37(1.99~5.71) 613 13.70 2.75(1.81~4.18) P75~＜P90 405 13.09 5.14(2.99~8.81) 379 19.26 4.13(2.67~6.37) ≥P90 268 21.30 9.21(5.36~15.84) 248 31.05 7.79(5.01~12.12) 注：数据存在缺失项。
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表 4 不同体脂率初中生血压偏高检出率Logistic回归分析
Table 4. Logistic regression of high blood pressure with different body fat rates in students
自变量 选项 男生(n=2 632) 女生(n=2 437) β值 标准误 Wald χ2值 aOR值
(aOR值95%CI)P值 β值 标准误 Wald χ2值 aOR值
(aOR值95%CI)P值 地区 0.36 0.15 6.03 1.44(1.08~1.91) 0.01 年龄 0.41 0.06 46.44 1.50(1.34~1.69) < 0.01 0.27 0.05 24.55 1.31(1.18~1.45) < 0.01 体脂率范围 P25~＜P50 1.14 0.29 15.77 3.13(1.78~5.51) < 0.01 0.36 0.23 2.39 1.43(0.91~2.25) 0.12 P50~＜P75 1.40 0.28 24.37 4.04(2.32~7.03) < 0.01 0.81 0.22 13.65 2.24(1.46~3.44) < 0.01 P75~＜P90 1.84 0.29 39.84 6.32(3.56~11.19) < 0.01 1.19 0.23 27.45 3.28(2.10~5.11) < 0.01 ≥P90 2.52 0.29 73.25 12.43(6.98~22.14) < 0.01 1.81 0.23 61.21 6.12(3.89~9.63) < 0.01 注：体脂率参照组为＜P25，地区参照组为市区。数据存在缺失项。
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