Association between plasma Irisin concentrations and changes in blood pressure among children: a cohort study
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摘要:
目的 分析儿童血浆鸢尾素(Irisin)质量体积浓度与血压变化的关联，并探讨体力活动(PA)和静态行为(SB)在该关联中的调节作用，为儿童高血压防治提供科学依据。 方法 采用前瞻性队列研究设计，2017年在广州市随机抽取5所小学共3 651名儿童进行问卷调查和体格检查，并于2019年随访。基线和随访均使用国际体力活动问卷调查PA和SB，采用电子血压计测量血压，根据基线的PA和SB数据筛选出符合标准的儿童，最终共有521名儿童纳入研究，对纳入的儿童采用ELISA方法测定基线血浆Irisin浓度。采用有序多分类Logistic回归分析Irisin质量体积浓度与血压变化的关联，通过分层分析探究PA和SB对上述关联的调节作用。 结果 研究对象总体中，血浆Irisin质量体积浓度与血压变化无明显关联(OR=0.98，P>0.05)。根据SB水平进行分层，在低SB水平的儿童中Irisin质量体积浓度与舒张压(DBP)变化呈负相关(OR=0.87，95%CI=0.77~0.98，P=0.02)。SB水平对Irisin浓度与DBP水平变化之间的相关性具有调节作用(P=0.01)。 结论 在低SB水平儿童中，较高Irisin水平与DBP水平降低相关，SB水平是Irisin质量体积浓度与DBP水平变化间关系的调节因素。 Abstract:Objective To investigate the longitudinal association of plasma Irisin concentrations with changes in blood pressure (BP) levels among children, and to assess the moderating effect of physical activity (PA) or sedentary behavior (SB) on the relationship between Irisin levels and BP. Methods Based on a cohort study, a cluster sampling method was used to select 3 651 school-aged children from five schools in Guangzhou in 2017 at the baseline survey and follow-up in 2019. Both at baseline and during follow-up, PA and SB were assessed by validated questionnaires, and BP levels were measured by an electronic sphygmomanometer. A final sample of 521 children were enrolled based on the PA and SB at baseline. Plasma Irisin concentrations were measured by ELISA at baseline. Logistic regression analysis was recruited for exploring the associations of plasma Irisin concentrations with changes in BP. Moderating effects of PA and SB on the relationship between Irisin concentrations and BP were estimated using stratified analysis. Results Logistic regression analysis indicated that there was no significant association between Irisin concentrations and changes in BP levels among children (OR=0.98, P>0.05). After stratification for SB, Irisin levels in the low SB subgroup were inversely associated with changes in diastolic blood pressure (OR=0.87, 95%CI=0.77-0.98, P=0.02). In addition, SB level had a moderating effect on the relationship between Irisin levels and the DBP changes (P=0.01). Conclusion Increased Irisin concentration is associated with the decrease of DBP level among low SB children. Furthermore, SB level shows moderating role in the relationship between Irisin concentrations and changes in DBP levels. -
Key words:
- Irisin /
- Plasma /
- Blood pressure /
- Cohort studies /
- Regression analysis /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同Irisin水平分组间儿童血压水平变化比较
Table 1. Comparison of changes in blood pressure by Irisin levels
Irisin水平 人数 SBP水平变化 DBP水平变化 血压水平变化 下降 持平 升高 下降 持平 升高 下降 持平 升高 低 260 33(12.7) 170(65.4) 57(21.9) 35(13.5) 177(68.1) 48(18.5) 43(16.5) 144(55.4) 73(28.1) 高 261 23(8.8) 200(76.6) 38(14.6) 32(12.3) 182(69.7) 47(18.0) 42(16.1) 153(58.6) 66(25.3) 合计 521 56(10.8) 370(71.0) 95(18.2) 67(12.9) 359(68.9) 95(18.2) 85(16.3) 297(57.0) 139(26.7) χ2值 8.02 0.21 0.64 P值 0.02 0.90 0.73 注： ()内数字为构成比/%。 
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表 2 儿童血浆Irisin浓度与血压水平变化的有序多分类Logistic回归分析(n=521)
Table 2. Logistic regression analysis of ordinal multi- classification of the plasma Irisin concentrations with changes in blood pressure(n=521)
血压 模型1 模型2 OR值(OR值95%CI) P值 OR值(OR值95%CI) P值 SBP 1.00(0.92~1.08) 0.94 1.01(0.93~1.10) 0.78 DBP 0.99(0.91~1.07) 0.73 0.98(0.90~1.06) 0.56 BP 0.98(0.91~1.05) 0.51 0.98(0.90~1.05) 0.51 注：模型1调整基线性别、年龄、身高；模型2调整基线性别、年龄、身高、BMI、父母文化程度、家庭人均月收入、家族高血压史、食盐摄入情况；自变量为连续变量，因变量为有序多分类变量。
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表 3 不同PA、SB水平下儿童血浆Irisin质量体积浓度与血压水平变化有序多分类Logistic回归分析[OR值(OR值95%CI)，n=521]
Table 3. Logistic regression analysis of ordinal multi-classification of the relationship of plasma Irisin concentrations among children with changes in blood pressure by different PA or SB status[OR(OR 95%CI), n=521]
指标 水平 SBP DBP BP PA 低 0.92(0.81~1.05) 1.02(0.90~1.16) 0.97(0.87~1.10) 高 1.09(0.97~1.22) 0.90(0.80~1.01) 0.97(0.87~1.07) SB 低 0.94(0.84~1.05) 0.87(0.77~0.98)* 0.91(0.82~1.01) 高 1.12(0.99~1.27) 1.08(0.96~1.22) 1.06(0.95~1.19) PPA调节 0.06 0.12 0.96 PSB调节 0.06 0.01 0.05 注： *P < 0.05；自变量为连续变量，因变量为有序多分类变量。
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