Relationship between overweight, obesity and high blood pressure among middle school students in Kaifeng City
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摘要:
目的 探索开封市中学生超重、肥胖与血压偏高之间的关联，为相关部门制定有效的干预措施提供依据。 方法 2019年9—10月，采用多阶段分层整群随机抽样方法，选取开封市4 058名中学生进行血压、身高、体重的测量，分析超重肥胖与血压偏高的关系。 结果 中学生血压偏高率为11.78%。与正常体重相比，超重(OR=1.65)和肥胖(OR=3.32)均增加血压偏高的风险(P值均 < 0.01)。超重和肥胖男生血压偏高的风险分别是正常体重者的1.87和4.16倍，超重和肥胖女生血压偏高的风险分别是正常体重的1.55和2.69倍。高中正常体重、初中超重/肥胖、高中超重/肥胖学生的血压偏高风险分别是初中正常体重学生的1.90，2.85和3.39倍(P交互=0.02)。 结论 预防中学生血压偏高应该从预防超重/肥胖开始，尤其对男生加以重视; 超重/肥胖的中学生学段越高，血压偏高的风险越大。 Abstract:Objective To analyze the association between overweight, obesity and high blood pressure among middle school students in Kaifeng city. Methods A multi-stage stratified cluster sampling method was used to select 4 058 middle school students in Kaifeng City to measure blood pressure, height and weight, and to analyze the relationship between overweight and obesity and high blood pressure from September to October 2019. Results The prevalence of high blood pressure in middle school students in Kaifeng was 11.78%. Compared with normal weight group, overweight (OR=1.65) and obesity (OR=3.32) were significantly correlated with the risk of high blood pressure (P < 0.01). The risk of high blood pressure in overweight and obese boys was 1.87-and 4.16-times higher than that in normal weight boys, respectively. The risk of high blood pressure for overweight and obese girls was 1.55-and 2.69-times higher than that for normal weight girls, respectively. The risk of high blood pressure in high school and normal weight group, middle school and overweight/obesity group, and high school and overweight/obesity group were 1.90, 2.85-and 3.39-times higher than that in middle school and normal weight group, respectively (P=0.02). Conclusion The prevention of high blood pressure in middle school students should start from the prevention of overweight and obesity, especially among overweight and obese boys. Risk of high blood pressure increases with grade among overweight/obese middle school students. -
Key words:
- Overweight /
- Obesity /
- Blood pressure /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同组别中学生血压偏高检出率比较
Table 1. Comparison of the prevalence of high blood pressure among middle school students with different characteristics
组别 选项 人数 血压偏高人数 χ2值 P值 性别 男 2 000 229(11.45) 0.41 0.52 女 2 058 249(12.10) 学段 初中 1 987 192(9.66) 16.90 < 0.01 高中 2 071 286(13.81) 是否喝含糖饮料 否 558 69(12.37) 0.21 0.64 是 3 500 409(11.69) 是否吃甜食 否 317 35(11.04) 0.18 0.67 是 3 741 443(11.84) 是否吃油炸食物 否 399 48(12.03) 0.03 0.87 是 3 659 430(11.75) 是否吃新鲜水果 否 143 16(11.19) 0.05 0.82 是 3 915 462(11.80) 是否吃蔬菜* 否 111 13(11.71) 0.01 0.99 是 3 945 464(11.76) 是否吸烟* 否 3 473 413(11.89) 0.28 0.60 是 584 65(11.13) 是否饮酒* 否 2 775 329(11.86) 0.03 0.86 是 1 277 149(11.67) 每周每天进行至少60 min 0 1 334 163(12.22) 0.82 0.66 中高强度运动次数 1~3 1 541 184(11.94) 4~7 1 181 131(11.09) 体重类型 正常 2 925 274(9.37) 80.10 < 0.01 超重 681 98(14.39) 肥胖 452 106(23.45) 注： ()内数字为检出率/%; *部分数据有缺失。 
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表 2 各体重类型中学生血压水平比较[M(P25，P75)，mm Hg]
Table 2. Comparison of the level of blood pressure among middle school students with different weight types [M(P25, P75), mm Hg]
性别 体型 人数 统计值 SBP DBP 男 正常 1 370 116.0(106.0，124.0) 70.0(65.0，78.0) 超重 365 120.0(112.0，128.0) 73.0(69.0，80.0) 肥胖 265 123.0(118.0，130.0) 76.0(70.0，80.0) Z值 122.91 62.34 P值 < 0.01 < 0.01 女 正常 1 555 109.0(100.0，118.0) 70.0(62.0，75.0) 超重 316 111.0(102.0，120.0) 70.0(66.0，76.5) 肥胖 187 118.0(109.0，125.0) 72.0(68.0，78.0) Z值 80.24 43.00 P值 < 0.01 < 0.01 合计 正常 2 925 110.0(102.0，120.0) 70.0(64.0，76.0) 超重 681 118.0(108.0，124.0) 72.0(68.0，78.0) 肥胖 452 120.0(110.0，128.0) 74.0(70.0，80.0) Z值 227.01 118.53 P值 < 0.01 < 0.01
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表 3 中学生超重或肥胖与血压偏高关联的多因素Logistic回归分析(n=4 058)
Table 3. Logistic regression analysis of association between overweight or obesity on prevalence of high blood pressure in middle school students(n=4 058)
性别 体重类型 β值 Wald χ2值 P值 OR值(OR值95%CI) 男 正常 1.00 超重 0.63 11.83 < 0.01 1.87(1.31~2.68) 肥胖 1.43 61.32 < 0.01 4.16(2.91~5.94) 女 正常 1.00 超重 0.44 5.98 0.01 1.55(1.09~2.21) 肥胖 0.99 25.58 < 0.01 2.69(1.83~3.94) 合计 正常 1.00 超重 0.50 15.55 < 0.01 1.65(1.29~2.12) 肥胖 1.20 83.66 < 0.01 3.32(2.57~4.29)
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